On September 10, 2017, Hurricane Irma made landfall in Florida. Over 90% of Florida counties reported power outages as of September 11. During power outages, CO poisonings often occur due to indoor use of fuel combustion sources (e.g., cooking, heating) or generators for electricity. CO poisoning is a reportable condition in Florida; health care providers and laboratories are required to report suspected cases to the Florida Department of Health (FDOH). In Florida, approximately 202 cases of CO poisoning are reported each year (three-year average from 2014 to 2016). In addition to passive surveillance, FDOH uses the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) to find cases of CO poisoning. ESSENCE-FL provides access to ED data from 98% (255 out of 260) of EDs in Florida and all statewide FPICN call data (includes three poison control centers). ESSENCE-FL provides near real-time access to these data sets, as ED data are uploaded every 2 hours or once a day (depending on the hospital system) and FPICN data are uploaded every 10 minutes. The statewide FPICN database includes information about substance, signs and symptoms, exposure scenario, and patient identification information provided by the individual caller or clinician from a health care facility.
Objective: This study describes how Florida Poison Information Center Network (FPICN) and emergency department (ED) data accessed through Florida's syndromic surveillance system were used to conduct near real-time carbon monoxide (CO) poisoning surveillance and active case finding in response to Hurricane Irma in Florida..