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Volume 8, Number 8—August 2002

Research

Use of Automated Ambulatory-Care Encounter Records for Detection of Acute Illness Clusters, Including Potential Bioterrorism Events

Ross Lazarus*†Comments to Author , Ken Kleinman‡§, Inna Dashevsky‡, Courtney Adams‡, Patricia Kludt¶, Alfred DeMaria¶, and Richard Platt*‡§
Author affiliations: *Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; †University of Sydney School of Public Health, Sydney, Australia; ‡Harvard Pilgrim Health Care and Harvard Vanguard Medical Associates, Boston, Massachusetts, USA; §CDC Eastern Massachusetts Prevention Epicenter and HMO Research Network Center for Education and Research in Therapeutics, Boston, Massachusetts, USA; ¶Massachusetts Department of Public Health, Boston, Massachusetts, USA;

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Table 1

Daily public health surveillance report of office visits with diagnoses corresponding to infection syndromes: summary report for Monday, March 4, 2002, Massachusetts

Syndrome Rate/1,000 health plan members (no. of visits)a Probabilityb 1999 average rates for this weekday in the same month 2000 average rates for this weekday in the same month
All combined 2.015 (328) 1.918 2.123
Upper respiratory 1.087 (177) 0.999 1.151 1.251
Lower respiratory 0.405 (66) 0.999 0.369 0.474
Upper gastrointestinal 0.166 (27) 0.999 0.094 0.110
Lower gastrointestinal 0.227 (37) 0.999 0.221 0.173
CNS/neurologicc 0.000 (0) 0.003 0.007
Dermatologic 0.012 (2) 0.023 0.022
Sepsis/fever 0.000 (0) 0.057 0.086
Influenza-like illness 0.117 (19)
CDC bioterrorism category A Agentsd 0.000 (0) 0 0

aRepeated visits within 6 weeks excluded.
bProbability of at least this many episodes occurring at least once per year, when the data are adjusted for month, day of week, holidays, secular trend, and variability among census tracts
cCNS, central nervous system; CDC, Centers for Disease Control and Prevention.
dAnthrax, botulism, plague, smallpox, tularemia, and hemorrhagic fever.

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