Biomedical subjects

James D Nordin

Publications and source records attributed to James D Nordin.

5 recordsLinked to original sources

PubMed2006

The safety of trivalent influenza vaccine among healthy children 6 to 24 months of age.

OBJECTIVE: The objective of this study was to assess the safety of routine trivalent influenza vaccine (TIV) administration among healthy children 6 through 23 months of age, after the Advisory Committee on Immunization Practices recommendation. METHODS: The study was a retrospective case-control study of children receiving TIV in the first 2 seasons after the Advisory Committee on Immunization Practices recommendation. We assessed outcomes in the 42 days after vaccination in a population of 13,383 children. Each case subject was matched, according to age and gender, with 3 control subjects. Hazard ratios were calculated with conditional logistic regression analysis. RESULTS: We found no statistically significantly elevated hazard ratios for the first TIV dose. An elevated risk of pharyngitis was found for children receiving a second TIV dose. No elevated risk of seizure was found. CONCLUSION: These results, for a population of healthy children, showed no medically significant adverse events related to TIV among children 6 to 23 months of age.

Case-Control Studies↗

PubMed2005

Simulated anthrax attacks and syndromic surveillance.

We measured sensitivity and timeliness of a syndromic surveillance system to detect bioterrorism events. A hypothetical anthrax release was modeled by using zip code population data, mall customer surveys, and membership information from HealthPartners Medical Group, which covers 9% of a metropolitan area population in Minnesota. For each infection level, 1,000 releases were simulated. Timing of increases in use of medical care was based on data from the Sverdlovsk, Russia, anthrax release. Cases from the simulated outbreak were added to actual respiratory visits recorded for those dates in HealthPartners Medical Group data. Analysis was done by using the space-time scan statistic. We evaluated the proportion of attacks detected at different attack rates and timeliness to detection. Timeliness and completeness of detection of events varied by rate of infection. First detection of events ranged from days 3 to 6. Similar modeling may be possible with other surveillance systems and should be a part of their evaluation.

Anthrax↗

PubMed2004

Syndromic surveillance for measleslike illnesses in a managed care setting.

Surveillance for measles must be enhanced to support the objective of measles elimination in the United States. Many conditions produce febrile rash illnesses that are clinically similar to measles; investigations of measleslike illnesses (MLIs) should occur regardless of the incidence of measles. Few data exist regarding the incidence of MLI in the United States, and it is unknown how providers evaluate patients with such conditions. We searched databases at a large managed care organization to obtain complete ascertainment of MLI during 1994-1998. Among 6000000 patient encounters, 68 records were identified that met the study case definition. The incidence of MLI was 4.5 cases/100000 persons/year. Measles diagnoses were considered by physicians for 9 patients (13.2%); 2 were laboratory-tested and reported to the state health department and the other 7 were given alternative diagnoses. It was not possible to determine for the remaining MLI patients whether measles was ruled out on clinical grounds or whether the possibility was not considered. Provider education regarding evaluation and reporting of measles is warranted. Databases at health care plans can be used to address public health issues and to establish syndromic surveillance for communicable diseases.

Databases, Factual↗

PubMed2004

Syndromic surveillance for influenzalike illness in ambulatory care network.

Conventional disease surveillance mechanisms that rely on passive reporting may be too slow and insensitive to rapidly detect a large-scale infectious disease outbreak; the reporting time from a patient's initial symptoms to specific disease diagnosis takes days to weeks. To meet this need, new surveillance methods are being developed. Referred to as nontraditional or syndromic surveillance, these new systems typically rely on prediagnostic data to rapidly detect infectious disease outbreaks, such as those caused by bioterrorism. Using data from a large health maintenance organization, we discuss the development, implementation, and evaluation of a time-series syndromic surveillance detection algorithm for influenzalike illness in Minnesota.

Ambulatory Care↗

PubMed2003

Syndromic surveillance using minimum transfer of identifiable data: the example of the National Bioterrorism Syndromic Surveillance Demonstration Program.

Several health plans and other organizations are collaborating with the Centers for Disease Control and Prevention to develop a syndromic surveillance system with national coverage that includes more than 20 million people. A principal design feature of this system is reliance on daily reporting of counts of individuals with syndromes of interest in specified geographic regions rather than reporting of individual encounter-level information. On request from public health agencies, health plans and telephone triage services provide additional information regarding individuals who are part of apparent clusters of illness. This reporting framework has several advantages, including less sharing of protected health information, less risk that confidential information will be distributed inappropriately, the prospect of better public acceptance, greater acceptance by health plans, and less effort and cost for both health plans and public health agencies. If successful, this system will allow any organization with appropriate data to contribute vital information to public health syndromic surveillance systems while preserving individuals' privacy to the greatest extent possible.

Bioterrorism↗