Biology Reference
In-Depth Information
The findings also suggest that the electronic flow of information among
users had not diminished personal communication but on the contrary had
increased its intensity and depth. As one user explained, investigating sig-
nals requires “a lot of human contact” and communication flows related to
NC DETECT enhance other interactions as well. As one user put it, “I think it
has greatly improved our relationship with hospital communication. I have
heard health directors say before, even if it is something that is not a flag that
we call them about … , they are more likely to call us now about other things
… even if they are not NC DETECT.”
More specifically, key informants described how the Annotation Report fea-
ture of NC DETECT—where users can post general comments—streamlines
communication about an investigation and reduces duplication of effort and
following up signals of no significance. Users also thought the Annotation
Reports enhanced the documentation of an investigation so the information
exchanged is captured in an accessible and retrievable manner for current
and future purposes.
The exchange of information among public health practitioners has
also improved as a consequence of NC DETECT according to informants.
Many local health departments do not have the resources to staff an epi-
demiologist, so regional epidemiologists use NC DETECT to keep local
health officers informed about a potential or confirmed outbreak in their
jurisdiction.
11.3.4 What Has been the Value added of biosurveillance
to Sentinel influenza Surveillance?
Influenza is not a reportable disease in North Carolina, unless it results in
death in a person under 18 years of age. As a result, surveillance for influ-
enza has traditionally relied on the Sentinel Providers Network (SPN). This
is a group of individual physicians who have agreed to tally cases of influ-
enza-like illness (ILI) and diagnosed cases of influenza and report them to
CDC weekly during the influenza season (see http://www.epi.state.nc.us/
epi/gcdc/flu.html). There are multiple drawbacks to this system. First, not
all physicians are sentinel providers, and representation may vary across the
state. Second, the SPN is not active year-round, so outbreaks of influenza in
the summer (for example) may not be detected at all. Third, testing to defini-
tively diagnose influenza becomes less frequent as the flu season progresses
and the strains circulating are well established.
ILI cases are reported to NC DETECT all year, and, like all other cases,
are updated every 12 hours. The data from NC DETECT are therefore more
timely than the SPN data and, additionally, will detect cases in the off-
season.
Therefore, the raw numbers of cases of ILI are much higher for NC
DETECT than the SPN. The NC DETECT data for ILI may present more
severe cases of ILI and a different age or socioeconomic population than
