The Unified Victim Identification System (UVIS) is an Internet-enabled database system developed for the Office of Chief Medical Examiner of the City of New York (OCME) in the aftermath of the September 11 attacks on New York City and the crash of American Airlines Flight 587. It is intended to handle critical fatality management functions made necessary by a major disaster. UVIS is a strong flexible role-based application and permissions can be controlled dynamically.
In the event of a mass casualty event, it will initially be used by New York City's 311 call center operators, the New York Police Department, and OCME to gather key information to facilitate compiling an accurate list of missing persons. UVIS will also be used by the OCME to track decedents and collect postmortem findings to facilitate the identification process after a disaster. UVIS also contains a Pandemic Flu module to prepare against such an eventuality. UVIS is a strong flexible role-based application and permissions can be controlled dynamically.
UVIS was built for the OCME by Nihilent, a consulting & solution integration company, and is a leading design thinking company, (formerly known as ICRA Sapphire).
Developed with public funds, UVIS is available to municipalities, counties, states, and other governmental agencies without charge, under license from New York City. Currently UVIS is in use at the Office of Chief Medical Examiner of the City of New York (OCME) and the State of New Jersey (OCSME).
The Ante-Mortem Section relates to activities carried out before an individual is absolutely known to be deceased. These include recording key information about the missing individual and managing interactions with the missing person's family members.
Mass casualty events generate numerous calls to government agencies: for example, the 2005 London subway bombing generated some 42,000 calls to the UK. Casualty Bureau call centers within the Bureau's first hour of operation.The Call Center module can handle tens of thousands of calls from individuals reporting or enquiring about missing persons, and record basic information about both the missing person and the caller.
The Missing Persons module enables NYPD Missing Persons detectives to conduct detailed interviews of family members, friends, and acquaintances of missing persons, and can store extremely detailed data ranging from clothing to physical characteristics such as eye and hair color to tattoo or scar information.
The UVIS Family Assistance Center module manages Family Assistance Centers (FACs), which are established to provide services to, and capture information from, the family and friends of injured, missing, or deceased disaster victims. Services generally provided at a FAC include: grief counseling; childcare; religious support; facilitation of family needs such as hotel, food, and transportation; ante-mortem data collection by the investigative authorities and the medical examiner or coroner; and notification of death to the next of kin. The UVIS Family Assistance Center module tracks all interactions and appointments with the family of missing persons, and can manage the personal items of victims received from family members for identification purposes.
The Records modules handles requests for records from family members, lawyers, and public administrators, providing “Chain of Custody” for all records.
The Post-Mortem Section deals with human remains recovered from mass casualty sites.
The Field Operations module can help users to manage incidents, field investigation, and the collection of remains and evidence, as well as maintaining records and documentation about remains and evidence. Because internet connectivity will often be unavailable at disaster sites, the Field Operations module has a Microsoft Windows-based client version that can capture data off-line and synchronize with the main database when connectivity is available.
The Disaster Mortuary Management module provides mortuary management functionality. It supports the accessioning of remains, both check-in and check-out; the examination of remains by Medical Examiner and Anthropology; the tracking and documentation of autopsies and individual remains; and the final disposition of remains to funeral homes.
This module has bidirectional (from ante- to post-mortem and back) one-to-many search capabilities based on multiple criteria. It possesses considerable identification tracking capabilities including DNA, fingerprint, radiology, and dental (see UDIM below). The module enables identification review and verification, including DNA re-sampling. It also enables the consolidation of fragmented remains as they are uncovered.
The Disaster Victim Identification module can conduct notification tracking, including communication both with family members and media about a given decedent. It is capable of issuing death certification either when remains are found or not. It also maintains a log of all family communications, and can schedule and track family visits.
A Forensic Odontology add-on, UDIM possesses detailed charting, complex and advanced search, and the ability to look for anomalies.
Pandemic influenza remains a serious threat. The U.S. Health and Human Services Department forecasts that if a lethal flu pandemic strikes, deaths could range from 209,000 to 1.9 million.
If an influenza pandemic occurs, the magnitude of the event would demand a response from the NYC OCME to assist any governmental health care facilities as well as to support facilities in the private sector. Health care facilities which would be affected by a flu pandemic include public and private hospitals, nursing homes, retirement facilities, prison health clinics, public health clinics, and mental health hospitals. During a flu pandemic causing mass fatalities, the limited morgues and decedent storage space at most health care facilities will be quickly overwhelmed. The proposed solution consists of temporary morgues, known as Body Collection Points (BCPs), at health care facilities. These would be either refrigerated 18-wheel trailers or refrigerated CONEX containers.
The UVIS Pandemic Flu module enables health care facility morgue managers to administer BCPs, allowing them to:
The Pandemic Flu module also enables medical examiner personnel to handle health care facilities’ requests for BCPs, managing the location and distribution of storage units at health care facilities, police precincts, or any other designated location. If necessary, they can place a request on behalf of a facility.
As well, Pandemic Flu module enables medical examiner personnel to create reports for decedents and to search for decedents using the specimen number, last name, first name, and/or date of death. They can also track and record the progress of a decedent’s case. Currently, the system tracks remains that are awaiting investigation, awaiting disposition, and transportation. UVIS tracks time elapsed in each state and color-codes each record, giving an immediate visual indication of the status of each case.
NYC OCME personnel can also search the New York State Electronic Death Record System (EDRS) for decedents.
As part of UVIS, the Pandemic Influenza module’s data is available for search within the system.
The Administrative Section allows users to create incidents, to which missing persons are attached; conduct records management; and carry out other system administration tasks.
UVIS is a multi-tiered, browser- and Windows-based application, written in Microsoft-based technology, and running on a minimum configuration of Microsoft Windows Server 2003 and Microsoft SQL 2000 / 2005 as the database engine.
Influenza A virus subtype H5N1 (A/H5N1) is a subtype of the influenza A virus which can cause illness in humans and many other animal species. A bird-adapted strain of H5N1, called HPAI A(H5N1) for highly pathogenic avian influenza virus of type A of subtype H5N1, is the highly pathogenic causative agent of H5N1 flu, commonly known as avian influenza. It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia. It is epizootic and panzootic, killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread. Many references to "bird flu" and H5N1 in the popular media refer to this strain.
Influenza vaccines, also known as flu shots or flu jabs, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While their effectiveness varies from year to year, most provide modest to high protection against influenza. The United States Centers for Disease Control and Prevention (CDC) estimates that vaccination against influenza reduces sickness, medical visits, hospitalizations, and deaths. Immunized workers who do catch the flu return to work half a day sooner on average. Vaccine effectiveness in those over 65 years old remains uncertain due to a lack of high quality research. Vaccinating children may protect those around them.
The Hong Kong flu, also known as the 1968 flu pandemic, was a flu pandemic whose outbreak in 1968 and 1969 killed an estimated one to four million people globally. It was caused by an H3N2 strain of the influenza A virus, which is descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes are reassorted to form a new virus.
Swine influenza is an infection caused by any one of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) is any strain of the influenza family of viruses that is endemic in pigs. As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.
Public health surveillance is, according to the World Health Organization (WHO), "the continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice." Public health surveillance may be used to track emerging health-related issues at an early stage and find active solutions in a timely manner. Surveillance systems are generally called upon to provide information regarding when and where health problems are occurring and who is affected.
An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been five in the last 140 years, with the 1918 Spanish flu pandemic being the most severe; this pandemic is estimated to have been responsible for the deaths of 50–100 million people. The most recent, the 2009 swine flu pandemic, resulted in under a million deaths and is considered relatively mild. These pandemics occur irregularly.
Trust for America's Health (TFAH) is a Washington, D.C.-based health policy organization. The organization's website calls the group "a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority."
The social impact of H5N1 is the effect or influence of H5N1 in human society; especially the financial, political, social, and personal responses to both actual and predicted deaths in birds, humans, and other animals. Billions of dollars are being raised and spent to research H5N1 and prepare for a potential avian influenza pandemic. Over ten billion dollars have been lost and over two hundred million birds have been killed to try to contain H5N1. People have reacted by buying less chicken causing poultry sales and prices to fall. Many individuals have stockpiled supplies for a possible flu pandemic.
Disease surveillance is an epidemiological practice by which the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe, and minimize the harm caused by outbreak, epidemic, and pandemic situations, as well as increase knowledge about which factors contribute to such circumstances. A key part of modern disease surveillance is the practice of disease case reporting.
The Office of Chief Medical Examiner of the City of New York (OCME) is a department within the city government that investigates cases of persons who die within New York City from criminal violence; by casualty or by suicide; suddenly, when in apparent good health; when unattended by a physician; in a correctional facility; or in any suspicious or unusual manner. The OCME also investigates when an application is made pursuant to law for a permit to cremate the body of a deceased person.
A mass fatality incident is an emergency management term used to identify an incident involving more dead bodies and/or body parts than can be located, identified, and processed for final disposition by available response resources.
Influenza, commonly known as "the flu", is an infectious disease caused by an influenza virus. Symptoms can be mild to severe. The most common symptoms include: high fever, runny nose, sore throat, muscle and joint pain, headache, coughing, and feeling tired. These symptoms typically begin two days after exposure to the virus and most last less than a week. The cough, however, may last for more than two weeks. In children, there may be diarrhea and vomiting, but these are not common in adults. Diarrhea and vomiting occur more commonly in gastroenteritis, which is an unrelated disease and sometimes inaccurately referred to as "stomach flu" or the "24-hour flu". Complications of influenza may include viral pneumonia, secondary bacterial pneumonia, sinus infections, and worsening of previous health problems such as asthma or heart failure.
Influenza-like illness (ILI), also known as flu-like syndrome/symptoms, is a medical diagnosis of possible influenza or other illness causing a set of common symptoms.
The 2009 swine flu pandemic was an influenza pandemic that lasted for about 19 months, from January 2009 to August 2010, and was the second of two pandemics involving H1N1 influenza virus. First described in April 2009, the virus appeared to be a new strain of H1N1 which resulted from a previous triple reassortment of bird, swine, and human flu viruses that further combined with a Eurasian pig flu virus, leading to the term "swine flu".
The pandemic H1N1/09 virus is a swine origin influenza A virus subtype H1N1 strain that was responsible for the 2009 swine flu pandemic. This strain is often called swine flu by the public media. For other names, see the Nomenclature section below.
The 2009 flu pandemic vaccines were influenza vaccines developed to protect against the pandemic H1N1/09 virus. These vaccines either contained inactivated (killed) influenza virus, or weakened live virus that could not cause influenza. The killed vaccine was injected, while the live vaccine was given as a nasal spray. Both these types of vaccine were produced by growing the virus in chicken eggs. Around three billion doses were produced, with delivery in November 2009.
In 2009, New Zealand had 3,175 cases and 19 deaths due to swine influenza.
Influenza prevention involves taking steps that one can use to decrease their chances of contracting flu viruses, such as the Pandemic H1N1/09 virus, responsible for the 2009 flu pandemic.
The 2009 flu pandemic was a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On 11 June 2009, WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experience mild symptoms", but some persons are in higher risk groups, such as those with asthma, diabetes, obesity, heart disease, or who are pregnant or have a weakened immune system. In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point respiratory failure.
The National Missing and Unidentified Persons System (NamUs) is a national clearinghouse and resource center for missing, unidentified, and unclaimed person cases throughout the United States. Funded and administered by the National Institute of Justice through a cooperative agreement with the University of North Texas Health Science Center's Center for Human Identification, all NamUs resources are provided to law enforcement, medical examiners, coroners, allied forensic professionals, and family members of missing persons.
Nihilent (Formerly known as ICRA Sapphire) www.nihilent.com has been playing a key role in UVIS implementation at various agencies.