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The Enhanced Passive Surveillance System: A Solution Supporting Data Collection, Integration and Analysis for Disease Surveillance
Lindsey Holmstrom, DVM Epidemiologist Institute for Infectious Animal Diseases A Department of Homeland Security Science and Technology Center of Excellence Texas A&M University, College Station, Texas, USA
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Disease Surveillance Systems
Leverage new tools &
technologies
Implement novel ways to
collect & evaluate data
Develop new surveillance streams & strategies
Encourages new partnerships
Rewards & incentivizes participation
Ensure information is available when
needed
Optimize Surveillance Competencies: Priorities
Future disease surveillance is focused on broader surveillance methods
Moving away from one disease/one surveillance plan
Application of innovative information science and technology systems
Integrated animal disease surveillance systems
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LIMS/submission form data
Test orders Test results
Animal Disease Surveillance
Active Surveillance
Analytical Risk-based, targeted Slaughter Programmatic, OIE list diseases
Enhanced Passive Surveillance
Participatory, community-based Opportunistic Disease Agnostic Vets/Producers
Diagnostic Laboratory
Internationally recognized assays
ELISA, PCR Sequencing
Integrated Disease Surveillance System
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• Automatic or near real-time data collection and analysis • Standardized, disease agnostic reporting
• Multiple data streams
• Data collection in the field using mobile applications
• Diagnostic laboratory data
• Use data, methods to allow for identification of subtle trends not visible to an individual
• Provide indicators to anomaly detection, investigation, quantification, localization, communication, and outbreak management
EPS System: Concept
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Enhances situational awareness and demonstrates the usefulness of multiple-data stream syndromic surveillance by:
Project Background
Applying the power of real-time reporting and data aggregation to animal and wildlife surveillance
Leveraging first responders (veterinarians) for animal and public health surveillance
Estimating baseline prevalence rates of observed animal health anomalies for each stream
Evaluating the significance of resulting signals as disease detection events
Providing early warning information obtained from validated signaling activity to stakeholders to assist in making decisions
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BFES Mobile Application
Enhanced Passive Surveillance System
BFES is a mobile application for real-time collection and
reporting of enhanced surveillance data
Veterinarians, producers, and production managers can
enter healthy and syndromic animal health data from
livestock/poultry premises and livestock markets
A web-based analyst workstation allows for the
integration of surveillance data with other data streams
(e.g., diagnostic laboratories, wildlife, and environmental
data sources) into a common display for analysis
Epidemiologists and other analysts can evaluate
and analyze the data in real-time through the use
of different visual, geospatial, and temporal
analysis tools
Embedded surveillance algorithms are included to
help determine baseline conditions in order to
detect any anomalies that may signal the onset of
an animal disease outbreak
EPS Analyst Workstation
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Integration of Data Streams
Laboratory Data Environmental Data
Common Integrated Picture
Season
Rainfall
Temperature
Vegetation
Soil
Test Order Counts
Test Results
Surveillance Data
Syndromic Reports
Production-level Indicator Data
Industry Wildlife Vet
Biologist
EPS Analyst
Workstation
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EPS Analyst Workstation
State Government Federal Government
Aggregation of all data streams into one common operating picture Web-based, user permissioned access for industry, States, and USDA Immediate access to data as surveillance reports are submitted from the field in
real-time Automated visual, geospatial, and temporal analysis tools Surveillance algorithms to calculate baselines and detect animal health
anomalies Data can be downloaded and imported into other statistical and analytical
programs User generated reports to end users
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Cattle/Small Ruminant: • Over 22,215 reports submitted since July 2012
• Represents the health status of over
1.1 million animals in 3 states
• Reporting activity 70-80% Equine:
• Over 4,229 reports submitted since August 2013
• Represents the health status of over 45,131 horses in Colorado
• Reporting activity is 80-100% Poultry:
• 40 syndromic reports submitted since August 2013
• Represents the health status of over 317,050 birds in Texas
• EPS Analyst Workstation: • Deployed in Federal Government (USDA) and 3 State Governments
• 11 government analysts trained on its use
Current Reporting by EPS Users
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Program Management Structure EPS Integrated Project Team (IPT)
IIAD Working Group Fed-only Working Group
Joint Working Groups
Data Access, Protection and Use (Federal Partners Only)
EPS Data Analysis and Baseline
Determination Methodologies
EPS Analyst Workstation Design
Lab Data Standardization/
Test Categorization
Data Standardization
and Ontology
Data Access, Protection and Use (Industry and State Partners Only)
Expansion, Sustainability, and
Transition
EPS System Assessment and
Detection Window Exercises
Industry*
*There will be separate
WGs for each industry
Data Access, Protection and Use
(Feds, States, and Industry)
Program Management
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Mixed Animal
• Beef cattle, dairy cattle, equine, poultry, small ruminants, swine, and wildlife
• 100+ Veterinary Practitioners in 6 states
• 58 BFES users currently
• 4 Veterinary Diagnostic Labs
• 6 State Government EPS AWS Deployed
Swine
• 10 Swine Companies/Practices
• Medium/large integrated operations, genetics operations , swine practices
• 30+ swine veterinarians in 13 states
• Coverage: ~5.2 million pigs monitored
• 3 Veterinary Diagnostic Labs
• 3+ State Government EPS AWS Deployed
Expansion of the EPS System (Year 1)
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Year 2 Focus
• Industry Expansion
• Feedlot: targeting 3 large feedlot regions/states and labs
• Wildlife: working with USDA APHIS Wildlife Services and USGS
• Big Data/Data Analytics partners
Year 3 Focus
• Industry Expansion
• Poultry: targeting 3 production systems (commercial egg layers, broilers/breeders, turkeys) and 2 labs
• Dairy: targeting 3 large dairy regions/states and labs
• Perform an exercise to evaluate the efficacy/utility of the system
• Transition a low-cost, low-maintenance system
Expansion to Other Industries
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Enhanced Passive Surveillance System
Outcome: A sophisticated system that serves as a central point for multiple groups to collaborate
and leverage their collective resources, facilitating access to critical, cutting-edge technologies to better assess animal health and inform decision-making
• Facilitates data sharing and communication among stakeholders
• Users engaged, customization of technology to meet requirements
• Creates new and strengthens current partnerships
• User permissioned access, data protection, security, and standardization
• Contributes evidence for:
• Claims of disease freedom and quantification of how much we are looking for disease
• Emerging disease detection or changes in endemic disease status
• Identifying areas for more intensive surveillance
• Identifying data trends, change in prevalence and geographic/temporal distribution of diseases (“anomalies”)
• Provides a template supporting national implementation
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• Incorporate community-based and participatory methods to enhance conventional surveillance
• Tracking of human and animal health activities
• Education/outreach of the health environment and risk factors
• Engage populations from being passive recipients of information to active participants in a collaborative community
The EPS System: International Applications
Integration of existing database systems
Adaptable system responsive to changing human/animal health
Automated, customizable tools Auto-population of data Data standardization Value back to participants
Country-specific reporting requirements
Reporting timeliness Data source authentication Data validation Data needs Continuous reporting and
sustainability
Challenges Solutions
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Questions?