Fig 1.
Data flow of mpox case notifications from STLPHDs to CDC through the Call Center and REDCap, May 17, 2022 to July 15, 2022*.
*From May 17 to July 15, 2022, STLPHDs sent mpox case notifications to CDC’s Call Center; initially, CDC Call Center staff entered mpox case data into an Excel spreadsheet, later into a SharePoint database, and then directly into the Data Collation and Integration for Public Health Event Response (DCIPHER) platform. STLPHDs could send additional case data using the original case report form (CRF) via REDCap (a secure web-based application used to support data collection activities). CDC and STLPHDs revised approaches for assigning unique IDs for case notifications several times during the first weeks of the outbreak. Verifying unique IDs for each case was required before de-duplication, record reconciliation, and generating a Master mpox database.
Table 1.
Mpox case notification approaches and corresponding start and end dates, May 17, 2022 to January 31, 2023*.
Fig 2.
Data flow of mpox case notifications from STLPHDs to CDC through DCIPHER using the short CRF, July 1, 2022 to July 23, 2022*.
*After roll-out of the short case report from (CFR) on July 1, 2022, STLPHDs sent mpox case notifications directly to the Data Collation and Integration for Public Health Event Response (DCIPHER) platform. Data elements from the Call Center and REDCap were mapped to the short CRF. A Master mpox database was generated by compiling, verifying, de-duplicating, and reconciling records previously received from the Call Center, REDCap, and DCIPHER, using the data elements included in the short CRF. API refers to Application Programming Interface, an option for STLPHDs to send case data to DCIPHER.
Fig 3.
Data flow of mpox case notifications from STLPHDs to CDC through NNDSS and DCIPHER, from July 23, 2022 onwards*.
*CDC onboarded STLPHDs to the National Notifiable Diseases Surveillance System (NNDSS) on July 23, 2022. STLPHDs sent core mpox data to NNDSS using HL7 message mapping (MMG) Gen v2, NETSS, and NBS Master Message. STLPHDs sent mpox specific data using the short case report form (CRF) via the Data Collation and Integration for Public Health Event Response (DCIPHER) platform. NNDSS core data were augmented with short CRF data in DCIPHER. A Master mpox case database was generated by compiling, verifying, de-duplicating, and reconciling records previously received by the Call Center, REDCap, and DCIPHER. API refers to Application Programming Interface, an option for STLPHDs to send case data to DCIPHER.
Fig 4.
Epidemiologic curve of mpox case notifications, May 10, 2022, to January 31, 2023.
Interim case notification approaches are noted by implementation date*. *Daily case counts obtained from the Centers for Disease and Control and Prevention’s official aggregate mpox case count dataset. Available at: https://www.cdc.gov/poxvirus/mpox/response/2022/mpx-trends.html.
Table 2.
Summary of challenges and proposed solutions from the deployment of interim case notification approaches during the mpox outbreak in the United States, May 17, 2022–January 31, 2023.