Evaluation of the EpiCore outbreak verification system.

OBJECTIVE: To describe a crowdsourced disease surveillance project (EpiCore) and evaluate its usefulness in obtaining information regarding potential disease outbreaks. METHODS: Volunteer human, animal and environmental health professionals from around the world were recruited to EpiCore and trained to provide early verification of health threat alerts in their geographical region via a secure, easy-to-use, online platform. Experts in the area of emerging infectious diseases sent requests for information on unverified health threats to these volunteers, who used local knowledge and expertise to respond to requests. Experts reviewed and summarized the responses and rapidly disseminated important information to the global health community through the existing event-based disease surveillance network, ProMED. FINDINGS: From March 2016 to September 2017, 2068 EpiCore volunteers from 142 countries were trained in methods of informal disease surveillance and use of the EpiCore online platform. These volunteers provided 790 individual responses to 759 requests for information addressing unverified health threats in 112 countries; 361 (45%) responses were considered to be useful. Most responses were received within hours of the requests. The responses led to 194 ProMED posts, of which 99 (51%) supported verification of an outbreak, were published on ProMED and sent to over 87 000 subscribers. CONCLUSION: There is widespread willingness among health professionals around the world to voluntarily assist efforts to verify and provide supporting information on unconfirmed health threats in their region. By linking this member network of health experts through a secure online reporting platform, EpiCore enables faster global outbreak detection and reporting.

[Detection of a hepatitis A outbreak in Ceuta (Spain) through a microbiological surveillance system]. / Detección de un brote de hepatitis A en Ceuta a través del sistema de información microbiológica.

BACKGROUND: The Public Health Department of Ceuta informed the Spanish National Epidemiology Center of an increase in hepatitis A cases detected by the microbiological surveillance system. We conducted a study to confirm the outbreak and to initiate control measures. METHODS: A descriptive study and a case-control study were performed. A standardized telephone questionnaire was used to collect information on demographic characteristics, symptoms, and risk factors. RESULTS: Nineteen cases of hepatitis A were identified. Univariate analysis revealed an association between infection and eating raw vegetables (OR = 9.3; 95%CI: 1.5-57.6) or razor-shell (OR = 55; 95%CI: 4.3-703.4). In the logistic regression model, only razor-shell consumption remained a significant risk factor (OR = 36.1; 95%CI: 2.45-530.4). None of the 3 inspected restaurants had public health authorization or records of food purchase histories. CONCLUSIONS: We confirmed a hepatitis A outbreak associated with consumption of contaminated razor-shell in homes and restaurants. The microbiological surveillance system was the main means of detecting this outbreak.

Detección de un brote de hepatitis A en Ceuta a través del sistema de información microbiológica / Detection of a hepatitis A outbreak in Ceuta [Spain] through a microbiological surveillance system

Antecedentes: El Servicio de Vigilancia Epidemiológica deCeuta comunicó al Centro Nacional de Epidemiología un aumento de casos de hepatitis A, detectado por el sistema de información microbiológica (SIM). Se investigó la posible existencia de un brote y se instauraron las medidas de control oportunas.Métodos: Se realizó un estudio descriptivo y otro de casos y controles. La información sociodemográfica, clínica y sobre factores de riesgo se obtuvo mediante un cuestionario cumplimentado por vía telefónica.Resultados: Se identificaron 19 casos. En el estudio univariante se encontró una asociación entre enfermar y el consumo de verduras crudas (odds ratio [OR] = 9,3; intervalo de confianza [IC] del 95%: 1,5-57,6) y de navajas (OR = 55; IC del 95%: 4,3-703,4). En el análisis multivariante sólo se mantuvo la asociación con el consumo de navajas (OR = 36,1; IC del 95%: 2,4-530,4). Ninguno de los 3 restaurantes inspeccionadosdisponía de control de facturas ni albaranes.Conclusiones: Se confirmó un brote de hepatitis A asociado al consumo de navajas en domicilios y restaurantes. El SIM fue la herramienta fundamental para su detección

Background: The Public Health Department of Ceuta informed the Spanish National Epidemiology Center of an increase in hepatitis A cases detected by the microbiological surveillance system. We conducted a study to confirm the outbreak and to initiate control measures.Methods: A descriptive study and a case-control study were performed. A standardized telephone questionnaire was used to collect information on demographic characteristics, symptoms, and risk factors.Results: Nineteen cases of hepatitis A were identified. Univariate analysis revealed an association between infection and eating raw vegetables (OR = 9.3; 95%CI: 1.5-57.6) or razorshell (OR = 55; 95%CI: 4.3-703.4). In the logistic regression model, only razor-shell consumption remained a significant risk factor (OR = 36.1; 95%CI: 2.45-530.4). None of the 3 inspectedrestaurants had public health authorization or records of food purchase histories.Conclusions: We confirmed a hepatitis A outbreak associated with consumption of contaminated razor-shell in homes and restaurants. The microbiological surveillance system was the main means of detecting this outbreak