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H1N1 Surveillance in IHS

H1N1 Surveillance in IHS. John T. Redd, MD, MPH, FACP Chief, Infectious Diseases Branch Division of Epidemiology and Disease Prevention Albuquerque, NM . Overview. 2009 H1N1 Influenza Activity Overview of the IHS Influenza Awareness System (IIAS) Accessing IIAS Reports Vaccine review.

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H1N1 Surveillance in IHS

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  1. H1N1 Surveillance in IHS John T. Redd, MD, MPH, FACP Chief, Infectious Diseases Branch Division of Epidemiology and Disease Prevention Albuquerque, NM

  2. Overview • 2009 H1N1 Influenza Activity • Overview of the IHS Influenza Awareness System (IIAS) • Accessing IIAS Reports • Vaccine review

  3. Seasonal Flu Activity - October 2008

  4. 2009 H1N1 Influenza – October 2009

  5. Percentage of Visits for Influenza-like Illness (ILI) Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) for week ending Oct. 17th (Week 41) http://www.cdc.gov/h1n1flu/updates/us/#iligraph

  6. IHS Influenza Awareness System (IIAS)

  7. IHS H1N1 Surveillance System • Active surveillance in Sells started first weekend • Syndromic surveillance system conceived same weekend • Support/permission obtained from IHS CMO and Area CMOs • Programming began quickly; multiple modifications

  8. Data Flow • RPMS data uploaded automatically to Albuquerque nightly • Combined there • Analyzed in SAS

  9. IIAS RPMS patch that extracts data on a daily basis and exports to the IHS Division of Epidemiology and Disease Prevention (DEDP) Allows for timely monitoring of Influenza-Like Illness (ILI) trends ILI hospitalizations H1N1 and seasonal flu vaccine coverage Monitoring for potential H1N1 vaccine adverse events

  10. Data are exported daily from RPMS sites to a central server. Files from this server are then consolidated into a single dataset and reports are generated from this dataset. Facility 2 nonRPMS Facility 1 RPMS HHS Portal Site Server that receives export files Facility 3 RPMS Server where files are processed Facility 4 NextGen Facility Report National Report Area Report Reports are made available to individual facilities (Hospitals, Health Clinics, Health Stations, etc) using a community on the HHS portal site and web browser. Facility 5 nonWAN RPMS

  11. IIAS, cont. Sites and Areas have access to Facility, Area and National Reports Weekly summary of national data posted on the IHS H1N1 website www.ihs.gov/h1n1

  12. Influenza-like Illness Definition Primarily based on ICD-9 diagnosis codes but also incorporates body temperature. If patient is classified as ILI if they have either: 1) An ICD-9 diagnosis code of 488.1 or 487.x OR 2) A body temperature of 100º F or greater AND at least one of the following ICD-9 diagnosis codes: 079.99 464.00 478.9 382.00 464.10 480.9 382.9 464.20 485 460 465.0 486 461.8 465.8 490 461.9 465.9 780.6 462 466.0 780.60 463 466.19 786.2

  13. Fields Collected (Initial) • Gender, DOB, Community of Residence • Service unit, date of visit/hospitalization • Up to 3 ILI diagnoses • Temperature • Denominator

  14. Fields Collected (New) • Risk factor diagnoses • Asthma • Diabetes • Obesity • Pregnancy status • BMI • Severity codes

  15. Fields Collected (New) • Pneumococcal vaccine status • H1N1 vaccine status • Seasonal influenza vaccine status • Adverse events • Collaboration with FDA

  16. Clinics Covered

  17. Examples of ICD-9 Codes(total of 24 collected)

  18. Some of the reports available on the HHS ILI community portal site. These reports are available at the National, Area, and Facility levels.

  19. Percentage of Visits for Influenza-like Illness (ILI) IHS Influenza Awareness System for week ending October 31 (Week 43) Overall ILI % (ILI Visits/Total Visits) Week www.ihs.gov/h1n1

  20. Accessing IIAS Summary Reports

  21. IIAS summary reports National report available at: www.ihs.gov/h1n1 Available on the HHS portal: https://portal.hhs.gov/portal/server/pt

  22. HHS Portal - User Accounts IHS D1 users Use the same userID and password you use to log onto you computer Use “IHS” as the Authentication source Non-IHS D1 users Contact your Area CMO and request an account Include your first name, a middle initial, last name, the level of access requested (include ASUFAC number if requesting access to a facility) After your request is verified an email with your userID and temporary password will be sent to you Use “Other Users” as the Authentication source

  23. HHS Portal - Levels of access National Can view National, all Areas and all Facilities Area (full access) Can view National, only your Area and only Facilities in your Area Area (restricted access) Can view National, only your Area, no facilities Facility Can view National, only your Area and only your facility

  24. Accessing IIAS Questions A PDF with the instructions on accessing the report will be available on the IHS H1N1 Website: www.ihs.gov/h1n1 For additional questions, contact: Larry.Layne@ihs.gov Elverna.Bennett@ihs.gov

  25. Resources • IHS H1N1 Webex on RPMS tools https://ihs-hhs.webex.com/ihs-hhs/k2/e.php?AT=RINF&recordingID=35650872 • HHS Website: www.flu.gov • IHS H1N1 Website: www.ihs.gov/h1n1 • CDC H1N1 Website: www.cdc.gov/h1n1

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