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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?