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Overview of Public Health Surveillance Denise Koo, MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention
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Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Intervention Evaluation: What works? Implementation: How do you do it?
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Public Health Surveillance Ongoing, systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.
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Public Health Surveillance Systematic, ongoing Collection Analysis Interpretation Dissemination Link to public health practice
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Purposes of Public Health Surveillance Assess public health status Define public health priorities Evaluate programs Stimulate research
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Core Public Health Functions Assessment Policy development Assurance
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Surveillance Information for Action
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Shigellosis United States, 1968-1998 0 0 5 5 10 15 Year 1968 1973 1978 1983 1988 1993 1998 Reported Cases per 100,000 Population Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Rate of Hepatitis A United States, 1998 < 5.0 5.0–9.9 10.0–19.9 >20.0 NA NYC DC PR VI GUAM AM SAMOA CNMI Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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TOXIC SHOCK SYNDROME (TSS) United States, 1983-1998 TOXIC SHOCK SYNDROME (TSS) United States, 1983-1998 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 National Center for Infectious Diseases (NCID) data* National Electronic Telecommunications System for Surveillance (NETSS) data 0 20 40 60 80 100 120 140 160 Year (Quarter) Reported Cases
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Botulism (Foodborne) United States, 1978-1998 Outbreak caused by potato salad, NM Outbreak caused by sautéed onions, IL Outbreak caused by fermented fish/sea products, AK Outbreak caused by baked potatoes, TX Laboratory- confirmed cases* NETSS data 0 0 10 20 30 40 50 60 70 80 90 100 110 Year 1978 1983 1988 1993 1998 Reported Cases Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Year Reported Cases (Thousands) Vaccine licensed 0 0 50 100 150 200 250 300 350 400 450 500 1963 1968 1973 1978 1983 1988 1993 1998 MEASLES — by year, United States, 1983–1998 0 0 5 5 10 15 20 25 30 Year 1983 1988 1993 1998 Reported Cases (Thousands) MEASLES (Rubeola) United States, 1963-1998 20 10
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Pertussis (Whooping Cough) United States, 1998 0 0 300 600 900 1,200 1,500 1,800 2,100 2,400 Age Group (Years) <1 1–4 5–9 10–14 15–19 20–29 30–39 40–49 50–59 >60 Reported Cases
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Poliomyelitis (Paralytic) Year 0 0 5 5 10 15 20 25 30 35 40 45 50 55 60 1968 1973 1978 1983 1988 1993 1998 Reported Cases Source: CDC. Summary of notifiable diseases. 1998. Rate/100,000 Population Year Inactivated Vaccine Oral Vaccine United States, 1968-1998
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Trends in Plasmid-Mediated Resistance to Penicillin and Tetracycline United States, 1988-1997 Source: Gonococcal Isolate Surveillance Project (GISP) Percent 0 2 4 6 8 10 12 1988198919901991199219931994199519961997 PPNG TRNG PPNG & TRNG Year
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Breast Cancer Screening
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Uses of Public Health Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Foreign- born Tuberculosis United States, 1986-1998 (U.S.- and foreign-born persons)
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Obesity United States, 1987-1998 Not available < 10 % …… ……. 10%-15% >15%
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Source: BRFSS 1998 Physical Activity Georgia 1998 Less than 15,000$ 15,000- 24,999$ Responses 25,000- 34,999$ 35,000- 49,999$ $50,000> NO YES PER CENT
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