# Presentation: 760419

## BioSense: Improving Emergency Preparedness - Monitoring Injury Sub-syndromes

*Nelson Arboleda MD, MPH, Jerome Tokars MD, MPH, Roseanne English, Paul McMurray*
*Centers for Disease Control and Prevention (CDC)*

- To present preliminary findings on injuries reported to the BioSense System from non-federal hospital emergency departments.

**Objective**

- BioSense is a national surveillance system designed to improve the nation’s capabilities for disease detection, monitoring, and real-time health situational awareness.
- Analysis of BioSense data facilitates the identification, tracking, and management of emergent and routine health events, including potential bioterrorism events, injury related incidents and rapidly spreading naturally occurring events (1).
- BioSense enhances coordination between all levels of public health and healthcare by providing access to the same data at the same time, which can ultimately produce a faster and more coordinated response.
- BioSense is a network of networks, receiving data from a variety of sources.  Analysts at the BioIntelligence center (BIC) analyze and track BioSense data activity at a national level and support state and local public health system users (2).

**Background**

- Data are currently sent to BioSense from over 370 non-federal hospital emergency departments (ED), 893 Veterans Affairs (VA) and 369 Department of Defense (DoD) outpatient facilities.
- Data are analyzed and visualized through a secure web application which may be accessed by participating public health jurisdictions and facilities.
- Since 2003, 11 syndromes potentially indicative of infections due to agents of bioterrorism have been followed.  Since 2006, 78 sub-syndromes providing a more specific and granular view of data have also been followed.
- Eleven of the sub-syndromes are injury-related:  bites (animal), burns, carbon monoxide poisoning, falls, fractures and dislocations, heat -excessive, injury NOS, motor-vehicle traffic accidents , open wound, poisoning by medicines, and sprains and strains.
- This report includes data from non-federal hospital emergency departments.

**Methods**

- A total of 8,342,336 visits were recorded in the ED chief complaint category during January 2, 2006 to July 18, 2007.
- Of all such visits, the greatest proportion binned to the Respiratory (20.2%, 1,688,468), Injury (17.5%, 1,459,691), and Gastrointestinal (14.1%, 1,180,181) categories.
- Among the injury sub-syndromes, the most frequent were injury not otherwise specified (NOS) (6.7% of total visits), open wounds (3.4%), falls (3.1%), and motor vehicle crashes (MVC) (2.2%).

**Results**

- BioSense is an all-hazards system which provides information on infectious diseases, injuries, and chronic conditions.
- Injuries were the second most common chief complaint in these hospital emergency departments.
- Monitoring injury sub-syndromes using the BioSense System may assist in surveillance efforts during emergency responses including hurricanes and other major disasters.

**Conclusions**

- Further Information:
- Craig Hales MD, MPH, chales@cdc.gov_[http://](http://www.cdc.gov/biosense/)__[www.cdc.gov](http://www.cdc.gov/biosense/)__[/biosense/](http://www.cdc.gov/biosense/)_

- [1] Loonsk J, BioSense--a national initiative for early detection and quantification of public health emergencies. MMWR Morb Mortal Wkly Rep. 2004 Sep 24;53 Suppl:53-5.
- [2] _[Bradley CA](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Bradley%20CA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Rolka](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rolka%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)__[ H](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rolka%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Walker D](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Walker%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Loonsk](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Loonsk%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)__[ J](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Loonsk%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_., BioSense: implementation of a National Early Event Detection and Situational Awareness System. MMWR Morb Mortal Wkly Rep. 2005 Aug 26;54 Suppl:11-9.
- [3] _[Sokolow](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sokolow%20LZ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)__[ LZ](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sokolow%20LZ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Grady N](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Grady%20N%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Rolka](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rolka%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)__[ H](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rolka%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[Walker D](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Walker%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[McMurray P](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22McMurray%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, _[English-Bullard R](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22English-Bullard%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus)_, Loonsk J. Deciphering data anomalies in BioSense. MMWR Morb Mortal Wkly Rep. 2005 Aug 26;54 Suppl:133-9.