Effective Detection of the 2009 H1N1 Influenza Pandemic in U.S. Veterans Affairs Medical Centers Using a National Electronic Biosurveillance System 英文参考文献.docVIP

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Effective Detection of the 2009 H1N1 Influenza Pandemic in U.S. Veterans Affairs Medical Centers Using a National Electronic Biosurveillance System 英文参考文献.doc

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Effective Detection of the 2009 H1N1 Influenza Pandemic in U.S. Veterans Affairs Medical Centers Using a National Electronic Biosurveillance System 英文参考文献

EffectiveDetectionofthe2009H1N1Influenza PandemicinU.S.VeteransAffairsMedicalCentersUsing aNationalElectronicBiosurveillanceSystem PatriciaSchirmer1,2*,CynthiaLucero1,GinaOda1,JessicaLopez1,MarkHolodniy1,2 1OfficeofPublicHealthSurveillanceandResearch,DepartmentofVeterans Affairs,Palo Alto,California,United StatesofAmerica, 2DivisionofInfectious Diseases GeographicMedicine,StanfordUniversitySchoolofMedicine,Stanford,California,UnitedStatesofAmerica Abstract Background: The 2008–09 influenza season was the time in which the Department of Veterans Affairs (VA) utilized an electronic biosurveillance system for tracking and monitoring of influenza trends. The system, known as ESSENCE or ElectronicSurveillanceSystemfortheEarlyNotificationofCommunity-basedEpidemics,wasmonitoredfortheinfluenza seasonaswellasforariseininfluenzacasesatthestartoftheH1N12009influenzapandemic.Wealsodescribetrends notedininfluenza-likeillness(ILI)outpatientencounterdatainVAmedicalcentersduringthe2008–09influenzaseason, beforeandaftertherecognitionofpandemicH1N12009influenzavirus. Methodology/PrincipalFindings:WedeterminedprevalenceofILIcodedvisitsusingVA’sESSENCEfor2008–09seasonal influenza(Sept.28,2008–April25,2009correspondingtoCDC2008–2009fluseasonweeks40–16)andtheearlyperiodof pandemicH1N12009(April26,2009–July31,2009correspondingtoCDC2008–2009fluseasonweeks17–30).Differences in diagnostic ICD-9-CM code frequencies were analyzed using Chi-square and odds ratios. There were 649,574 ILI encounters captured representing 633,893 patients. The prevalence of VA ILI visits mirrored the CDC’s Outpatient ILI SurveillanceNetwork(ILINet)datawithpeaksinlateDecember,earlyFebruary,andlateApril/earlyMay,mirroringtheILINet data;however,thepeaksseenintheVAweresmaller.Of31ILIcodes,6decreasedand11increasedsignificantlyduringthe early period of pandemic H1N1 2009. The ILI codes that significantly increased were more likely to be symptom codes. Although influenza with respiratory manifestation (487.1) w