Martin Colleen

A liver disease of unknown etiology, called unknown liver disease (ULD) by the community, was first identified in 2002 in Tigray; a rugged, semi-arid, mountainous region that is considered one of the most drought-prone and food insecure regions of Ethiopia. ULD is a chronic condition characterized by epigastric pain, abdominal distention, ascites, emaciation, and hepato/splenomegaly. In 2005, the Ethiopian Health and Nutritional Research Institute was assigned by the Ethiopia Ministry of Health to assist the Tigray Regional Health Bureau and oversee the disease investigation. In 2008, Centers for Disease Control and Prevention (CDC) assisted the Ethiopian team and jointly developed the surveillance tools. The surveillance system was implemented in 2009 with the objectives to determine the magnitude and distribution of the disease; identify disease trends; detect cases to provide them with clinical care; and inform health officials and funding bodies for resource allocation.  After several investigations, a local plant containing a particular type of pyrrolizidine alkaloid (PA) toxin that contaminated local foodstuffs was identified as the etiologic agent, and ULD was renamed PAILD in 2011.

Objective:

To describe the results of the evaluation of the PAILD active surveillance system and lessons learned for similar surveillance efforts in a resource-limited setting.

Synthetic cannabinoids include various psychoactive chemicals that are sprayed onto plant material, which is then smoked or ingested to achieve a “high.” These products are sold under a variety of names (e.g., synthetic marijuana, spice, K2, black mamba, and crazy clown) and are sold in retail outlets as herbal products and are often labeled not for human consumption. Law enforcement agencies regulate many of these substances; however, manufacturers may frequently change the formulation and mask their intended purpose to avoid detection and regulation.

On April 6, 2015, automated surveillance algorithms via surveillance through the National Poison Data System (NPDS), a web-based surveillance system of all calls to United States (US) poison centers (PCs), identified an increase in calls to PCs related to synthetic cannabinoid use. To identify risk factors and adverse health effects, CDC analyzed all calls to PCs about synthetic cannabinoid use from January to May, 2015.

Objective

The Centers for Disease Control and Prevention analyzed all calls to poison centers about synthetic cannabinoid use from January to May 2015 to identify risk factors and adverse health effects related to this emerging public health threat.