Leveraging Earth Observations and Health Data to Map Outbreak Risk and Inform Public Health Interventions for Zoonotic Disease Prevention
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Ellen Delgado Florian↗
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The Public Health Service guidelines. Governing research involving human subjects: An analysis of the policy-making process
The policy making process which led to development of the Public Health Service Guidelines governing research involving human subjects is outlined. Part 1 examines the evolution of PHS Guidelines, tracing (1) evolution of thought and legal interpretation regarding research using human subjects; (2) initial involvement of the Federal government; (3) development of the government's research program; (4) the social-political environment in which formal government policy was developed; and (5) various policy statements issued by the government. Part 2 analyzes the process by which PHS Guidelines were developed and examines the values and other underlying factors which contributed to their development. It was concluded that the evolution of the Guidelines is best understood within the context of a mixed-scanning strategy. In such a strategy, policy makers make fundamental decisions regarding the basic direction of policy and subsequent decisions are made incrementally and within the contexts set by the original fundamental decisions.
Frankel, M. S.↗
Public health applications of remote sensing of vector borne and parasitic diseases
Results of an investigation of the potential application of remote sensing to various fields of public health are presented. Specific topics discussed include: detection of snail habitats in connection with the epidemiology of schistosomiasis; the detection of certain Anopheles breeding sites, and location of transient human populations, both in connection with malaria eradication programs; and detection of overwintering population sites for the primary screwworm (Cochliomyia americana). Emphasis was placed on the determination of ground truth data on the biological, chemical, and physical characteristics of ground waters which would or would not support the growth of significant populations of mosquitoes.
Source record↗
Synthetic TEMPO Data Products at NASA SPoRT for Air Quality and Public Health Communities
Synthetic TEMPO (Tropospheric Emissions: Monitoring of Pollution) Data Products at NASA SPoRT (Short-term Prediction Research and Transition Center) for Air Quality and Public Health Communities. O2R/R2O (Operation-to-Research/Research-to-Operation).
Naeger, Aaron↗
On alert for Ebola: public health risk assessment of travellers from Uganda to the USA during the 2022 outbreak
Abstract Background On 20 September 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus. Methods From 6 October 2022 to 10 January 2023, Centers for Disease Control and Prevention (CDC) staff conducted public health assessments at five US ports of entry for travellers identified as having been in Uganda in the past 21 days. CDC also recommended that state, local and territorial health departments (‘health departments’) conduct post-arrival monitoring of these travellers. CDC provided traveller contact information, daily to 58 health departments, and collected health department data regarding monitoring outcomes. Results Among 11 583 travellers screened, 132 (1%) required additional assessment due to potential exposures or symptoms of concern. Fifty-three (91%) health departments reported receiving traveller data from CDC for 10 114 (87%) travellers, of whom 8499 (84%) were contacted for monitoring, 1547 (15%) could not be contacted and 68 (1%) had no reported outcomes. No travellers with high-risk exposures or Ebola disease were identified. Conclusion Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities that had low demonstrated yield during this and previous outbreaks. The efficiency of future responses could be improved by incorporating an assessment of risk of importation of disease, accounting for individual travellers’ potential for exposure, and expanded use of methods that reduce burden to federal agencies, health departments, and travellers.
General & Internal Medicine↗
Epidemic Intelligence Service Alumni in Public Health Leadership Roles
Since 1951, the Epidemic Intelligence Service (EIS) of the U.S. Centers for Disease Control and Prevention (CDC) has trained physicians, nurses, scientists, veterinarians, and other allied health professionals in applied epidemiology. To understand the program’s effect on graduates’ leadership outcomes, we examined the EIS alumni representation in five select leadership positions. These positions were staffed by 353 individuals, of which 185 (52%) were EIS alumni. Among 12 CDC directors, four (33%) were EIS alumni. EIS alumni accounted for 29 (58%) of the 50 CDC center directors, 61 (35%) of the 175 state epidemiologists, 27 (56%) of the 48 Field Epidemiology Training Program resident advisors, and 70 (90%) of the 78 Career Epidemiology Field Officers. Of the 185 EIS alumni in leadership positions, 136 (74%) were physicians, 22 (12%) were scientists, 21 (11%) were veterinarians, 6 (3%) were nurses, and 94 (51%) were assigned to a state or local health department. Among the 61 EIS alumni who served as state epidemiologists, 40 (66%) of them were assigned to a state or local health department during EIS. Our evaluation suggests that epidemiology training programs can serve as a vital resource for the public health workforce, particularly given the capacity strains brought to light by the COVID-19 pandemic.
60 APPLIED LIFE SCIENCES↗
Urban Sustainability and Public Health: Throwing the Bath Water Out and Not the Baby
This slide presentation reviews the affect of urbanization on community health. It exams urbanization trends in the Atlanta metro area and includes information on impervious surfaces, air quality, mitigation strategies, spatial growth modeling, land use, public health surveillance and different data collection methods.
Quattrochi, Dale A.↗
Money Matters: A Three-Step Process for Using Budget Data in Program Evaluation to Assess the Design and Management of a Novel Public Health Program
We applied a three-step process, abstracting and analyzing program budgets to examine how Colorectal Cancer Control Program (CRCCP) awardees are structuring their programs and to assess the fidelity of program design to the CRCCP public health model. We reviewed 23 state, one tribal organization, and six university awardee budgets. We assessed resource allocations, staffing structures, and contracted partners and their activities. Awardees allocated 83% of all funds to contracts and personnel. Program managers were the most budgeted personnel type across three measures: number of people, full-time equivalency, and personnel costs. Awardees not only contracted with health care systems and clinics (39% of all contracts) but also contracted other partner types. Contractors were mainly funded to implement evidence-based interventions (25%) and conduct evaluation (24%). Program design varied among awardees in the number of staff (0–22), number of full-time equivalencies (0–5.4), and the number of contracts (1–11) budgeted. State awardees budgeted more resources to contracts, compared with university awardees (57% vs. 31%), while universities budgeted more for total personnel costs (41% vs. 30%). We learned that awardees designed their programs with fidelity to the CRCCP model. Although implementation approaches varied, overall results suggest implementation requires a combination of internal capacities and contracted partners. Budgets provide opportunities to use already existing program data to evaluate program design, partnerships, and planned activities.
Uhd, Justin↗
Linking Asthma Exacerbation and Air Pollution Data: A Step Toward Public Health and Environmental Data Integration
Studies have shown that reducing exposure to triggers such as air pollutants can reduce symptoms and the need for medication in asthma patients. However, systems that track asthma are generally not integrated with those that track environmental hazards related to asthma. Tlvs lack of integration hinders public health awareness and responsiveness to these environmental triggers. The current study is a collaboration between health and environmental professionals to utilize NASA-derived environmental data to develop a decision support system (DSS) for asthma prediction, surveillance, and intervention. The investigators link asthma morbidity data from the University of Mississippi Medical Center (UMMC) and Mississippi Department of Health (MDH) with air quality data from the Mississippi Department of Environmental Quality (MDEQ) and remote sensing data from NASA. Daily ambient environmental hazard data for PM2.5 and ozone are obtained from the MDEQ air quality monitoring locations and are combined with remotely sensed data from NASA to develop a state-wide spatial and time series profile of environmental air quality. These data are then used to study the correlation of these measures of air quality variation with the asthma exacerbation incidence throughout the state over time. The goal is to utilize these readily available measures to allow real-time risk assessment for asthma exacerbations. GeoMedStat, a DSS previously developed for biosurveillance, will integrate these measures to monitor, analyze and report the real-time risk assessment for asthma exacerbation throughout the state.
Faruque, Fazlay↗
NASA's Systems Engineering Approaches for Addressing Public Health Surveillance Requirements
NASA's systems engineering has its heritage in space mission analysis and design, including the end-to-end approach to managing every facet of the extreme engineering required for successful space missions. NASA sensor technology, understanding of remote sensing, and knowledge of Earth system science, can be powerful new tools for improved disease surveillance and environmental public health tracking. NASA's systems engineering framework facilitates the match between facilitates the match between partner needs and decision support requirements in the areas of 1) Science/Data; 2) Technology; 3) Integration. Partnerships between NASA and other Federal agencies are diagrammed in this viewgraph presentation. NASA's role in these partnerships is to provide systemic and sustainable solutions that contribute to the measurable enhancement of a partner agency's disease surveillance efforts.
Vann, Timi↗
Evaluation of a laboratory-developed multiplex real-time PCR assay for diagnosis of syphilis, herpes and chancroid genital ulcers in four public health laboratories in the USA
Objective To evaluate the field performance of a multiplex PCR (M-PCR) assay for detection of herpes simplex virus (HSV)-1 and HSV-2, Treponema pallidum ( T. pallidum ) and Haemophilus ducreyi ( H. ducreyi ) in genital ulcer disease (GUD) specimens. Methods GUD M-PCR was performed on 186 remnant specimens, previously collected for HSV testing, by four public health laboratories (PHLs) and the Laboratory Reference and Research Branch (LRRB) at the Centers for Disease Control and Prevention. The results from the PHLs were compared with those of LRRB, which served as the reference testing method, and percentage agreement was calculated. Results HSV was detected in 31 of 52 (59.6%), 20 of 40 (50%), 43 of 44 (97.7%) and 19 of 50 (38.0%) specimens from PHL1, PHL2, PHL3 and PHL4, respectively. There were seven discrepant results for HSV, and the overall percent agreement between the PHLs and the LRRB was 94%–100%, with a kappa value of 0.922, which demonstrates high agreement. T. pallidum was identified in 7 of 51 (13.7%) specimens from PHL1 with 94.1% agreement and in 2 of 40 (5.0%) specimens from PHL2 with 100% agreement. The LRRB identified three additional T. pallidum -positive specimens from PHL1. The kappa value (0.849) for T. pallidum testing suggests good agreement. Consistent with the LRRB results, no T. pallidum was detected in specimens from PHL3 and PHL4, and H. ducreyi was not detected at any of the study sites. Conclusions The GUD M-PCR assay performed well in four independent PHLs and 12 suspected syphilis cases were identified in this study. The M-PCR assay could provide improved diagnostic options for GUD infections in state and local PHLs.
Infectious Diseases↗
Modeling Occupant Core Temperatures Across the Boston Building Stock to Advance Public Health
In recent history, extreme heat has been the cause of most deaths from a natural disaster. Exposure to extreme heat can aggravate preexisting conditions, increase hospitalization, and even cause death. Thus, modeling the thermal resilience of households across the United States will allow for a quantitative assessment of the health and safety risks posed by extreme heat. For the first time, we simulate occupant comfort in representative households across Boston by combining the granular results of the ResStock(TM) model with a two-node heat strain model. This model calculates occupants' core body temperature in each simulated household over a year. We compare the simulated core temperatures to two public health metrics: hyperthermia and heat stroke. Our results show for households in Boston that do not have or use aid conditioning, thousands potentially experience many dangerous heat events each summer and these events can last for more than a day at a time. These heat events peak during the late afternoon and evening, just as residents are coming home, cooking meals, and trying to go to sleep. We have found that multi-family buildings, renters, and low-income homes in more airtight and insulated homes are the most at risk for these events. These results demonstrate the scale and urgency of exposure to extreme heat.
32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
Applications of remote sensing in public health.
Current research concerning the determination of the habitat of mosquito vectors of disease is discussed. It is shown how advanced interpretative processes have enabled recognition of the breeding areas of salt marsh mosquitoes and the breeding sites of the mosquito responsible for the transmission of St. Louis strain of encephalitis and of human filariasis. In addition, remote sensing data have also been useful in the study of the habitat of endemic strains of Venezuelan encephalitis virus in Florida. The beginning of the application of remote sensing to such public health aspects as air, water, and urban degradation is noted.
Barnes, C. M.↗
Satellite and Reanalysis Air Quality Data and Services at NASA GES DISC for Public Health Study
Outbreaks of infectious diseases and health can be influenced by airborne and water-borne pollutants. Furthermore, air and water quality are associated with climate variability, industrialization, land use and land cover change, and water resource management. It is therefore crucial to understand environment-disease connections with existing long-term observed and modeled data, particularly for development of early warning systems for infectious disease outbreaks. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) (https://disc.gsfc.nasa.gov) archives large volumes of global environment data that are useful for research and applications regarding environmental factors and public health. Examples of air quality measurements are: Daily satellite remotely sensed data, including Aerosol Index (AI), O3, SO2, CO, and NO2 from Aura/OMI (October 2014 to present), and OMPS-NPP (January 2012 to present, currently research data products only) Hourly and monthly reanalysis modeled data, including PM2.5, O3, CO, SO2, BC, dust, AOD, and aerosol types from MERRA-2 (January 1980 to present) Examples of surface meteorology and land surface measurements are: hourly, daily, and monthly satellite precipitation from TRMM (December 1997 to March 2015) 30-minute and monthly satellite precipitation from GPM (March 2014 to present); Hourly and monthly modeled surface meteorology and land surface condition from MERRA-2 (January 1980 to present) and land surface assimilation models (January 1948 to present), including precipitation, surface temperature, relative humidity, wind, and soil moisture.This presentation will give an overview of relevant environmental data at the NASA GES DISC. Through a number of use cases, such as dust events and active fires, we will introduce data services that assist in finding the right data, enable visualization and analysis of the data online, and allow downloading of data in user-preferred format.
remote sensing data↗
The microbicidal potential of visible blue light in clinical medicine and public health
Visible blue light of wavelengths in the 400–470 nm range has been observed to have microbicidal properties. A widely accepted hypothesis for the mechanism of microbial inactivation by visible blue light is that the light causes photoexcitation of either endogenous (present within the microbe) or, exogenous (present in the biological medium surrounding the microbe) photosensitizers such as porphyrins and flavins, which leads to the release of reactive oxygen species that subsequently manifests microbicidal activity. Some of the factors that have been observed to be associated with enhanced microbicidal action include increased duration of exposure, and either pre- or co-treatment with quinine hydrochloride. In case of bacteria, repetitive exposure to the blue light shows no significant evidence of resistance development. Additionally, visible blue light has exhibited the ability to inactivate fungal and viral pathogens and, multidrug-resistant bacteria as well as bacterial biofilms. Visible blue light has demonstrated efficacy in eliminating foodborne pathogens found on food surfaces and exposed surfaces in the food processing environment as well as in the decontamination of surfaces in the clinical environment to minimize the spread of nosocomial infections. We conclude from reviewing existing literature on the application of the blue light in clinical medicine and public health settings that this microbicidal light is emerging as a safer alternative to conventional ultraviolet light-based technologies in multiple settings. However, further comprehensive studies and thorough understanding of the mechanism of microbicidal action of this light in different scenarios is warranted to determine its place in human health and disease.
60 APPLIED LIFE SCIENCES↗
Assessing Land Cover Change Dynamics in the Peruvian Amazon to Map Outbreak Risk and Inform Public Health Interventions for Zoonotic Disease Prevention
Dengue fever and leishmaniasis are two tropical diseases prevalent in Madre de Dios Region of Peru and have been associated with urbanization and road construction. Rapid land use changes such as mining, timber harvesting, and hydroelectric dam development lead to denser human presence in previously sparsely-populated areas which increases the proximity of human settlements to zoonotic disease vectors. In partnership with the Peruvian Ministries of Health (MINSA), the Environment (MINAM), and other in-country collaborators, a NASA DEVELOP team examined Land Use Land Cover (LULC) changes and reported dengue and leishmaniasis incidence in the Madre de Dios region. This sought to help MINSA and MINAM understand the spatial relationship between land use change and zoonotic disease incidence. We created a LULC classification script using Google Earth Engine (GEE) with Landsat 5 Thematic Mapper (TM) and Landsat 8 Operational Land Imager (OLI) imagery to classify land cover in 2010, 2015, and 2020 and evaluate changes over this time period. The team then compared the quantified results of the LULC assessment in conjunction with reported disease cases to evaluate disease incidence and key land cover changes across Madre de Dios’s 11 districts. Follow on work will use these products to develop more detailed outbreak risk maps. These products will allow MINSA, MINAM, and other partners to understand hotspots of land cover change in Peru and the relationship with outbreaks to inform public health decision makers and environmental policy.
Nataly Chacon-Buitrago↗
Methods for Characterizing Fine Particulate Matter Using Satellite Remote-Sensing Data and Ground Observations: Potential Use for Environmental Public Health Surveillance
This study describes and demonstrates different techniques for surfacing daily environmental / hazards data of particulate matter with aerodynamic diameter less than or equal to 2.5 micrometers (PM2.5) for the purpose of integrating respiratory health and environmental data for the Centers for Disease Control and Prevention (CDC s) pilot study of Health and Environment Linked for Information Exchange (HELIX)-Atlanta. It described a methodology for estimating ground-level continuous PM2.5 concentrations using B-Spline and inverse distance weighting (IDW) surfacing techniques and leveraging National Aeronautics and Space Administration (NASA) Moderate Resolution Imaging Spectrometer (MODIS) data to complement The Environmental Protection Agency (EPA) ground observation data. The study used measurements of ambient PM2.5 from the EPA database for the year 2003 as well as PM2.5 estimates derived from NASA s satellite data. Hazard data have been processed to derive the surrogate exposure PM2.5 estimates. The paper has shown that merging MODIS remote sensing data with surface observations of PM2.5 not only provides a more complete daily representation of PM2.5 than either data set alone would allow, but it also reduces the errors in the PM2.5 estimated surfaces. The results of this paper have shown that the daily IDW PM2.5 surfaces had smaller errors, with respect to observations, than those of the B-Spline surfaces in the year studied. However the IDW mean annual composite surface had more numerical artifacts, which could be due to the interpolating nature of the IDW that assumes that the maxima and minima can occur only at the observation points. Finally, the methods discussed in this paper improve temporal and spatial resolutions and establish a foundation for environmental public health linkage and association studies for which determining the concentrations of an environmental hazard such as PM2.5 with good accuracy levels is critical.
Al-Hamdan, Mohammad Z.↗
Integration of Airborne Aerosol Prediction Systems and Vegetation Phenology to Track Pollen for Asthma Alerts in Public Health Decision Support Systems
The residual signal indicates that the pollen event may influence the seasonal signal to an extent that would allow detection, given accurate QA filtering and BRDF corrections. MODIS daily reflectances increased during the pollen season. The DREAM model (PREAM) was successfully modified for use with pollen and may provide 24-36 hour running pollen forecasts. Publicly available pollen forecasts are linked to general weather patterns and roughly-known species phenologies. These are too coarse for timely health interventions. PREAM addresses this key data gap so that targeting intervention measures can be determined temporally and geospatially. The New Mexico Department of Health (NMDOH) as part of its Environmental Public Health Tracking Network (EPHTN) would use PREAM a tool for alerting the public in advance of pollen bursts to intervene and reduce the health impact on asthma populations at risk.
Luvall, Jeffrey C.↗