BACKGROUND: In response to locally acquired Zika virus, the Florida Department of Health (DOH) conducted active surveillance in select areas in Florida to identify locally acquired Zika virus infections and assess ongoing Zika transmission in the community. Data collected during these surveys were managed in the Outbreak Module (OM) within Merlin, Florida’s reportable disease surveillance application. Three types of OM events were used: index (cases and contacts), urosurvey (participants of residential, business or clinic urosurveying), and other (non-index cases). Residential urosurveying included people within a 150 mile radius of a locally acquired index case, business urosurveying focused on employees at a business or work-site and clinic urosurveying focused on people who lived or worked in the area of interest.
METHODS: Each person entered into Merlin receives a unique profile to which laboratory results, cases and OM events can be linked. During investigations of locally acquired Zika virus infections in Florida, an OM event was created for each locally acquired index case and all associated investigated contacts were linked to the event. Similarly, an OM event was created for each urosurvey and all survey participants were linked to that event. For each urosurvey OM event, an event-specific survey was generated in real-time and used to capture data collected on the paper questionnaires electronically.
RESULTS: As of December 15, 2016, 87 OM events (49 index, 32 urosurvey, 6 other) related to various investigations of locally acquired Zika virus infections in Florida are being managed in Merlin. These events include approximately 2,400 people, with around 2,200 (92%) having participated in any urosurvey event. Additional details on various types of events will be presented.
CONCLUSIONS: Merlin provided DOH the flexibility to effectively manage the large volume of cases and data associated with Florida’s Zika response in a systematic way. Merlin continued to support routine case reporting, while the OM facilitated flexible group-specific, event-level investigations. Event surveys were composed of core questions and site or setting-specific questions allowing for rapid data collection and entry. Use of core questions allowed for comparability within and between urosurvey event data, improving the ability to conduct ad-hoc analysis as investigations progressed. Managing data electronically within Merlin and the OM facilitated easy access to data for export, event-specific analysis, and linking for mapping. Analysis of these data are expected to provide valuable information to increase understanding of the Zika virus and its potential impacts on Floridians and the rest of the U.S. moving forward.