Real-time syndrome surveillance in Ontario, Canada: the potential use of emergency departments and Telehealth
Real-time syndrome surveillance in Ontario, Canada: the potential use of emergency departments and Telehealth
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DOI：
10.1097/00063110-200402000-00002
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发表时间：
2004-02-01
影响因子：
4.4
通讯作者：
Moore, Kieran
中科院分区：
文献类型：
--
作者：
Moore, Kieran
目的：本文的目的是审查新的生物恐怖分子和新出现的传染病对加拿大安大略省公共卫生的威胁，并提出一种方法，将基于电话的健康信息服务和急诊科分诊与一线实时，每天24小时综合征监测系统。这种自动化的系统可能是有益的，在检测生物恐怖主义的威胁，以及在检测和监测疾病的爆发，如流感，诺瓦克，西尼罗河病毒，大肠杆菌0157或严重急性呼吸道syndrome.Method：Medline PubMed数据库进行了搜索，从1997年起有关生物恐怖主义和综合征监测的文章。检索了安大略卫生和长期护理部、安大略公共安全和安保部、疾病控制中心和加拿大卫生部加拿大人口和公共卫生分支的网站，以查找与生物恐怖主义和综合征监测有关的文章。访谈进行了关键线人从远程医疗工作人员，公共卫生服务的安大略和疾病控制和预防中心，亚特兰大，佐治亚州，美国。结果：实时综合征监测是一种新的手段，检测疾病爆发或可能的生物恐怖主义行为在第一次接触的医疗保健系统。它已成功地用于在早期阶段发现流感爆发。拟议的系统将是一个全省范围的生物恐怖事件和新出现的感染综合预警系统。它将使用与时间，人口统计学和空间数据相关联的症状群，以提高灵敏度和特异性。安大略的急诊科和远程医疗作为医疗保健系统的第一接触者，是进行综合征监测的绝佳机会。通过将接触和旅行数据纳入症状群，它们提供了适当识别新出现感染的风险患者的机会。这可以及早发现高危患者，并采取适当的公共卫生措施。在安大略使用远程保健的好处是，全省都可以使用远程保健，并在一个计算机化系统上收集大量数据。急诊部门还应该有一个统一的计算机化分诊数据收集系统，以方便监测。(C)2004年利平科特威廉姆斯&威尔金斯。
Objective: The purpose of this paper is to review new bioterrorist and emerging infectious threats to public health in Ontario, Canada, and to propose a means of integrating a telephone-based health information service and emergency department triage with a first-line real-time, 24-h a day syndrome surveillance system. This automated system could be beneficial in detecting a bioterrorist threat as well as in detecting and monitoring disease outbreaks such as influenza, Norwalk, West Nile virus, Escherichia coli 0157 or severe acute respiratory syndrome.Method: The Medline PubMed database was searched for articles relating to bioterrorism and syndromic surveillance from 1997 onwards. The websites of the Ontario Ministry of Health and Long-Term Care, Ontario Ministry of Public Safety and Security, Centers for Disease Control and Canadian Population and Public Health Branch of Health Canada were searched for articles relating to bioterrorism and syndromic surveillance. Interviews were conducted with key informants from Telehealth staff, the public health services of Ontario and the Centers for Disease Control and Prevention, Atlanta, GA, USA.Results: Real-time syndrome surveillance is a new means of detecting disease outbreaks or possibly acts of bioterrorism at the first contact with the healthcare system. It has been used successfully to detect influenza outbreaks at an early stage. The system that is proposed would be a province-wide integrated early warning system for both bioterrorist events and emerging infections. It would use clusters of symptoms tied to temporal, demographic and spatial data to increase sensitivity and specificity.Conclusion: Real-time syndrome surveillance is an evolving science. Emergency departments and Telehealth in Ontario lend themselves as first contacts to the healthcare system as excellent opportunities to perform syndrome surveillance. They offer the opportunity properly to identify at-risk patients for emerging infections by including contact and travel data into the symptom complex. This could identify at-risk patients early and lead to appropriate public health measures. The benefit of using Telehealth in Ontario is the provincial accessibility of Telehealth and the extensive data collected on one computerized system. Emergency departments should also have a uniform computerized triage data collection system to facilitate surveillance. (C) 2004 Lippincott Williams & Wilkins.