Adams Sherry

Maryland utilizes ESSENCE for identification of emerging public health threats, including non-fatal overdoses. Synthetic cannabinoids are heterogeneous psychoactive compounds identified as substances of abuse [1]. In March 2018, the Illinois Department of Public Health received reports of unexplained bleeding in patients who reported using these products [2]. As a result, CDC initiated coordination of national surveillance activities for possible cases of coagulopathy associated with synthetic cannabinoids use. By May 2018, state health departments reported 202 cases, including five deaths [3]. On April 3, 2018, Maryland reported its index case - a female in her 20'™s who presented to an ED with nausea, blood in her stool, vaginal bleeding, bruising, an elevated internal normalized ratio (> 12.2), and bleeding oral ulcers after quitting use of a synthetic cannabinoid. She was successfully treated with Vitamin K. The first reported mortality in a Maryland resident was a male in his 30'™s who called EMS for fever and blood in his urine but subsequently went into cardiac arrest and was unable to be resuscitated. The patient was known to use synthetic cannabinoids. Brodifacoum exposure was confirmed by laboratory testing. As of September 2018, the Maryland Poison Control Center had received reports of 43 cases, and 3 deaths linked to the outbreak.

Objective: Develop a free text query to track synthetic cannabinoid-related ED visits. Assess trends in synthetic cannabinoid use from 2013-2018 using spatial and time-series analysis.

The electronic surveillance system for the early notification of community-based epidemics (ESSENCE) is the web-based syndromic surveillance system utilized by the Maryland Department of Health and Mental Hygiene (DHMH). ESSENCE utilizes a secure, automated process for the transfer of data to the ESSENCE system that is consistent with federal standards for electronic disease surveillance. Data sources in the Maryland ESSENCE system include ED chief complaints, poison control center calls, over-the-counter (OTC) medication sales, and pharmaceutical transaction data (specifically for anti-bacterial and anti-viral medications). All data sources have statewide coverage and are captured daily in near real-time fashion.

Objective

To examine the trends in prescription antiviral medication transactions and emergency department (ED) visits for influenza-like illness (ILI) and the relationship between these trends.

The electronic surveillance system for the early notification of community-based epidemics (ESSENCE) is the web-based syndromic surveillance system utilized by DHMH. ESSENCE utilizes a secure, automated process for the transfer of data to the ESSENCE system. Data sources in the Maryland ESSENCE system include emergency department (ED) chief complaints, poison control center calls, over-the-counter (OTC) medication sales, and pharmaceutical transaction data (for certain classes of anti-bacterial and anti-viral medication). All data sources have statewide coverage and are captured daily in near real-time fashion. OIT developed a web based application in conjunction with OP&R to allow the epidemiologists involved in the ESSENCE program to monitor and audit the transfer of this data. The application allows the user to indicate whether or not each data file has been consumed into ESSENCE for any date of the year. The user can edit these daily entries at any time to update the status of the data that has been received. The user may also query the database by data source, date, and date range to generate a report. The database also contains contact information for technical and infection control staff at the hospitals that participate in the ESSENCE program. Finally, the application can also generate reports that detail which users have logged into ESSENCE, when the log-in occurred, and which pages within ESSENCE were visited.

Objective

To describe the application and process developed by the Maryland Department of Health and Mental Hygiene (DHMH) Office of Preparedness and Response (OP&R) and Office of Information Technology (OIT) for monitoring and auditing the transfer of syndromic surveillance data.