Environmental Factors Affecting Asthma and Allergies: Predicting and Simulating Downwind Exposure to Airborne Pollen

This slide presentation reviews the environmental factors that affect asthma and allergies and work to predict and simulate the downwind exposure to airborne pollen. Using a modification of Dust REgional Atmosphere Model (DREAM) that incorporates phenology (i.e. PREAM) the aim was to predict concentrations of pollen in time and space. The strategy for using the model to simulate downwind pollen dispersal, and evaluate the results. Using MODerate-resolution Imaging Spectroradiometer (MODIS), to get seasonal sampling of Juniper, the pollen chosen for the study, land cover on a near daily basis. The results of the model are reviewed

Multijurisdictional Approach to Biosurveillance, Kansas City

An electronic reporting system for a network of 22 laboratories was implemented in Kansas City, Missouri, with an independent organization acting as a data clearinghouse between the reporting laboratories and public health departments. The system ran in tandem with conventional reporting methods. Laboratory test orders and results were aggregated and mapped to a common nomenclature. Reports were delivered through a secure Internet connection to the Kansas City Health Department (KCHD); during the first 200 days of operation, 359 qualified results were delivered electronically to KCHD. Data were received more quickly than they were with conventional reporting methods: notification of chlamydia cases arrived 2 days earlier, invasive group A streptococcal disease cases arrived 2.3 days sooner, and salmonellosis cases arrived 2.7 days sooner. Data were more complete for all demographic fields, including address, age, sex, race, and date of birth. Two hundred fourteen cases reported electronically were not received by conventional means

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

Integration of Airborne Aerosol Prediction Systems and Vegetation Phenology to Track Pollen for Asthma Alerts in Public Health Decision Support Systems

This slide presentation reviews the study that used a model to forecast pollen to assist in warning for asthma populations. Using MODIS daily reflectances to input to a model, PREAM, adapted from the Dust REgional Atmospheric Modeling (DREAM) system, a product of predicted pollen is produced. Using the pollen from Juniper the PREAM model was shown to be an assist in alerting the public of pollen bursts, and reduce the health impact on asthma populations

Current NASA Earth Remote Sensing Observations

This slide presentation reviews current NASA Earth Remote Sensing observations in specific reference to improving public health information in view of pollen sensing. While pollen sampling has instrumentation, there are limitations, such as lack of stations, and reporting lag time. Therefore it is desirable use remote sensing to act as early warning system for public health reasons. The use of Juniper Pollen was chosen to test the possibility of using MODIS data and a dust transport model, Dust REgional Atmospheric Model (DREAM) to act as an early warning system

Use of MODIS Satellite Images and an Atmospheric Dust Transport Model To Evaluate Juniperus spp. Pollen Phenology and Dispersal

Pollen can be transported great distances. Van de Water et. al., 2003 reported Juniperus spp. pollen was transported 200-600 km. Hence local observations of plant phenology may not be consistent with the timing and source of pollen collected by pollen sampling instruments. The DREAM (Dust REgional Atmospheric Model, Nickovic et al. 2001) is a verified model for atmospheric dust transport modeling using MODIS data products to identify source regions and quantities of dust. We are modifying the DREAM model to incorporate pollen transport. Pollen release will be estimated based on MODIS derived phenology of Juniperus spp. communities. Ground based observational records of pollen release timing and quantities will be used as verification. This information will be used to support the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program and the State of New Mexico environmental public health decision support for asthma and allergies alerts

Modeling emergency department visit patterns for infectious disease complaints: results and application to disease surveillance

BACKGROUND: Concern over bio-terrorism has led to recognition that traditional public health surveillance for specific conditions is unlikely to provide timely indication of some disease outbreaks, either naturally occurring or induced by a bioweapon. In non-traditional surveillance, the use of health care resources are monitored in "near real" time for the first signs of an outbreak, such as increases in emergency department (ED) visits for respiratory, gastrointestinal or neurological chief complaints (CC). METHODS: We collected ED CCs from 2/1/94 – 5/31/02 as a training set. A first-order model was developed for each of seven CC categories by accounting for long-term, day-of-week, and seasonal effects. We assessed predictive performance on subsequent data from 6/1/02 – 5/31/03, compared CC counts to predictions and confidence limits, and identified anomalies (simulated and real). RESULTS: Each CC category exhibited significant day-of-week differences. For most categories, counts peaked on Monday. There were seasonal cycles in both respiratory and undifferentiated infection complaints and the season-to-season variability in peak date was summarized using a hierarchical model. For example, the average peak date for respiratory complaints was January 22, with a season-to-season standard deviation of 12 days. This season-to-season variation makes it challenging to predict respiratory CCs so we focused our effort and discussion on prediction performance for this difficult category. Total ED visits increased over the study period by 4%, but respiratory complaints decreased by roughly 20%, illustrating that long-term averages in the data set need not reflect future behavior in data subsets. CONCLUSION: We found that ED CCs provided timely indicators for outbreaks. Our approach led to successful identification of a respiratory outbreak one-to-two weeks in advance of reports from the state-wide sentinel flu surveillance and of a reported increase in positive laboratory test results

Use of MODIS Satellite Images and an Atmospheric Dust Transport Model to Evaluate Juniperus spp. Pollen Phenology and Transport

Pollen can be transported great distances. Van de Water et al., 2003 reported Juniperus spp. pollen, a significant aeroallergen was transported 200-600 km. Hence local observations of plant phenology may not be consistent with the timing and source of pollen collected by pollen sampling instruments. Direct detection of pollen via satellite is not practical. A practical alternative combines modeling and phenological observations using ground based sampling and satellite data. The DREAM (Dust REgional Atmospheric Model) is a verified model for atmospheric dust transport modeling using MODIS data products to identify source regions and quantities of dust (Nickovic et al. 2001). The use of satellite data products for studying phenology is well documented (White and Nemani 2006). In the current project MODIS data will provide critical input to the PREAM model providing pollen source location, timing of pollen release, and vegetation type. We are modifying the DREAM model (PREAM - Pollen REgional Atmospheric Model) to incorporate pollen transport. The linkages already exist with DREAM through PHAiRS (Public Health Applications in Remote Sensing) to the public health community. This linkage has the potential to fill this data gap so that the potential association of health effects of pollen can better be tracked for possible linkage with health outcome data which may be associated with asthma, respiratory effects, myocardial infarction, and lost workdays. Juniperus spp. pollen phenology may respond to a wide range of environmental factors such as day length, growing degree-days, precipitation patterns and soil moisture. Species differences are also important. These environmental factors vary over both time and spatial scales. Ground based networks such as the USA National Phenology Network have been established to provide national wide observations of vegetation phenology. However, the density of observers is not adequate to sufficiently document the phenology variability over large regions. Hence the use of satellite data is critical to observe Juniperus spp. pollen phenology. MODIS data was used to observe Juniperus spp. pollen phenology. The MODIS surface reflectance product(MOD09) provided information on the Juniper spp. cone formation and cone density (Fig 1). Ground based observational records of pollen release timing and quantities were used as verification. Techniques developed using MOD09 surface reflectance products will be directly applicable to the next generation sensors such as VIIRS

Progression of Pathogenic Events in Cynomolgus Macaques Infected with Variola Virus

Smallpox, caused by variola virus (VARV), is a devastating human disease that affected millions worldwide until the virus was eradicated in the 1970 s. Subsequent cessation of vaccination has resulted in an immunologically naive human population that would be at risk should VARV be used as an agent of bioterrorism. The development of antivirals and improved vaccines to counter this threat would be facilitated by the development of animal models using authentic VARV. Towards this end, cynomolgus macaques were identified as adequate hosts for VARV, developing ordinary or hemorrhagic smallpox in a dose-dependent fashion. To further refine this model, we performed a serial sampling study on macaques exposed to doses of VARV strain Harper calibrated to induce ordinary or hemorrhagic disease. Several key differences were noted between these models. In the ordinary smallpox model, lymphoid and myeloid hyperplasias were consistently found whereas lymphocytolysis and hematopoietic necrosis developed in hemorrhagic smallpox. Viral antigen accumulation, as assessed immunohistochemically, was mild and transient in the ordinary smallpox model. In contrast, in the hemorrhagic model antigen distribution was widespread and included tissues and cells not involved in the ordinary model. Hemorrhagic smallpox developed only in the presence of secondary bacterial infections – an observation also commonly noted in historical reports of human smallpox. Together, our results support the macaque model as an excellent surrogate for human smallpox in terms of disease onset, acute disease course, and gross and histopathological lesions

Transmission patterns of smallpox: systematic review of natural outbreaks in Europe and North America since World War II

BACKGROUND: Because smallpox (variola major) may be used as a biological weapon, we reviewed outbreaks in post-World War II Europe and North America in order to understand smallpox transmission patterns. METHODS: A systematic review was used to identify papers from the National Library of Medicine, Embase, Biosis, Cochrane Library, Defense Technical Information Center, WorldCat, and reference lists of included publications. Two authors reviewed selected papers for smallpox outbreaks. RESULTS: 51 relevant outbreaks were identified from 1,389 publications. The median for the effective first generation reproduction rate (initial R) was 2 (range 0–38). The majority outbreaks were small (less than 5 cases) and contained within one generation. Outbreaks with few hospitalized patients had low initial R values (median of 1) and were prolonged if not initially recognized (median of 3 generations); outbreaks with mostly hospitalized patients had higher initial R values (median 12) and were shorter (median of 3 generations). Index cases with an atypical presentation of smallpox were less likely to have been diagnosed with smallpox; outbreaks in which the index case was not correctly diagnosed were larger (median of 27.5 cases) and longer (median of 3 generations) compared to outbreaks in which the index case was correctly diagnosed (median of 3 cases and 1 generation). CONCLUSION: Patterns of spread during Smallpox outbreaks varied with circumstances, but early detection and implementation of control measures is a most important influence on the magnitude of outbreaks. The majority of outbreaks studied in Europe and North America were controlled within a few generations if detected early