BACKGROUND: Local epidemiologists use many different data sources to identify where and when people are potentially exposed to or potentially expose others to infectious agents. Information gathered from these investigative efforts for surveillance purposes is commonly manually tracked or entered into standalone databases (e.g., reportable diseases, foodborne illness complaints) that lack communication capabilities. As a result, human capacity, one of the most limited resources in public health, is necessary to complete time-consuming and often imperfect visual comparison of the surveillance data to identify potential outbreaks. To improve the capabilities of local outbreak surveillance, use of the data collection capabilities of Epi Info 7 and the spatial analysis features of ArcGIS were partnered.
METHODS: An Epi Info 7 SQL Server database was designed and created to capture potential exposure information (person, place, and time) from multiple sources (e.g., reportable diseases, general public complaints reporting public health issues). Using Python in ArcGIS, data from different sources, including the Epi Info 7 database and foodborne illness complaints, were imported, formed into data layers, and additional spatial features were created to facilitate spatial analysis. Report features in ArcGIS were used to identify disease or syndrome specific clusters to alert investigators of potential outbreaks.
RESULTS: Use of the Epi Info 7 SQL Server database has removed the need for local epidemiologists to manually track potential disease exposures and permits multiple personnel to input records into the database simultaneously. The time-consuming imperfect method of visually comparing line lists from different databases was improved through the spatial analysis and report features of ArcGIS to identify potential outbreaks.
CONCLUSIONS: Partnering Epi Info 7 and ArcGIS has permitted information from several previously separate databases to be combined in a single geographic information system program to rapidly identify potential outbreaks. Investigators continue to pursue expansion of the surveillance system to the regional level and improve the ease of use through online publishing applications of the collected analyzed data.