Surveillance for Unexplained Deaths of Possible Infectious Etiologies During the COVID-19 Pandemic-Minnesota, 2020-2021.

IF 3 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Reports Pub Date : 2024-05-01 Epub Date: 2024-01-11 DOI:10.1177/00333549231218283

Melanie J Firestone, Linnea Thorell, Leslie Kollmann, Lydia Fess, Greta Ciessau, Anna K Strain, Richard Danila, Ruth Lynfield, Stacy Holzbauer

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引用次数: 0

Abstract

Objectives: Surveillance systems for unexplained deaths that might have an infectious etiology are rare. We examined the Minnesota Department of Health Unexplained Deaths and Critical Illnesses of Possible Infectious Etiology and Medical Examiner Infectious Deaths (UNEX/MED-X) surveillance system,-a system that expanded postmortem surveillance for infectious diseases during the COVID-19 pandemic by leveraging standard (medical examiner [ME]) and expanded (mortuary) surveillance to identify COVID-19-related deaths.

Methods: MEs, coroners, or morticians collected postmortem swabs from decedents with an infectious prodrome or with SARS-CoV-2 exposure before death but with no known recent infectious disease testing. The Minnesota Department of Health Public Health Laboratory used nucleic acid amplification, viral culture, and standard algorithms to test specimens collected postmortem for SARS-CoV-2, influenza virus, and other infectious pathogens. We reviewed UNEX/MED-X data from March 2, 2020, through December 31, 2021, and characterized decedents by location of swab collection (ie, ME or mortuary).

Results: From March 2, 2020, through December 31, 2021, the UNEX/MED-X surveillance system received samples from 182 decedents from mortuaries and 955 decedents from MEs. Mortuary decedents were older than ME decedents (median age, 78 vs 46 y). Seventy-three mortuary decedents (40.1%) and 197 ME decedents (20.6%) had SARS-CoV-2 detections. The UNEX/MED-X system identified 212 COVID-19-related deaths, representing 2.0% of total COVID-19-related deaths in Minnesota. Eighty-nine decedents (42.0%) were from racial and ethnic minority populations, representing 6.1% more COVID-19-related deaths among people from racial and ethnic minority populations than would have been detected without this surveillance system.

Practice implications: Expanded and standard UNEX/MED-X surveillance builds capacity and flexibility for responding to emerging public health threats. Similar programs should be considered elsewhere as resources allow.

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2020-2021 年 COVID-19 大流行期间明尼苏达州不明原因的可能感染性死亡监测。

目的：针对可能有感染病因的不明原因死亡的监测系统并不多见。我们研究了明尼苏达州卫生部的不明原因死亡和可能有传染病病因的危重病以及法医传染病死亡（UNEX/MED-X）监测系统，该系统在 COVID-19 大流行期间通过利用标准（法医 [ME]）和扩大（停尸房）监测来识别与 COVID-19 相关的死亡，从而扩大了对传染病的尸检监测：方法：法医、验尸官或殡仪员从有传染性前驱症状或死前接触过 SARS-CoV-2 但近期未进行过已知传染病检测的死者身上采集尸拭子。明尼苏达州卫生部公共卫生实验室使用核酸扩增、病毒培养和标准算法对尸体标本进行 SARS-CoV-2、流感病毒和其他传染病病原体检测。我们审查了 2020 年 3 月 2 日至 2021 年 12 月 31 日期间的 UNEX/MED-X 数据，并根据拭子采集地点（即法医或太平间）对死者进行了特征描述：从 2020 年 3 月 2 日至 2021 年 12 月 31 日，UNEX/MED-X 监测系统从停尸房收到了 182 位死者的样本，从医疗中心收到了 955 位死者的样本。停尸房的死者年龄大于医疗中心的死者（中位年龄为 78 岁对 46 岁）。73名停尸房死者（40.1%）和197名急诊室死者（20.6%）检测到 SARS-CoV-2。UNEX/MED-X 系统确定了 212 例 COVID-19 相关死亡病例，占明尼苏达州 COVID-19 相关死亡病例总数的 2.0%。89名死者（42.0%）来自少数种族和少数族裔人群，这意味着少数种族和少数族裔人群中与COVID-19相关的死亡人数比没有该监测系统时多了6.1%：扩展和标准的 UNEX/MED-X 监测增强了应对新出现的公共卫生威胁的能力和灵活性。在资源允许的情况下，其他地方也应考虑类似的计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health Reports 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.00

自引率

6.10%

发文量

164

审稿时长

6-12 weeks

期刊介绍： Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.

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