Mulay Prakash

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..

Since 2008, poisoning is the leading cause of injury-related death in the United States; since 1980, the poisoning-related fatality rate in the United States (U.S.) has almost tripled. Many poison-related injuries and deaths are reported to regional PCs which receive about 2.4 million reports of human chemical and poison exposures annually. Federal, state, and local PH agencies often collaborate with PCs and use PC data for PH surveillance to identify poisoning-related health issues. Many state and local PH agencies have partnerships with regional PCs for direct access to local PC data which help them perform this function. At the national level, the National Center for Environmental Health (NCEH) of the Centers for Disease Control and Prevention (CDC) conducts PH surveillance for exposures and illnesses of PH significance using the National Poison Data System (NPDS), the national PC reporting database and real-time surveillance system. Though most PC and PH officials agree that PC data play an important role in PH practice and surveillance, collaboration between PH agencies and PCs can be hindered by numerous challenges. To address these challenges and bolster collaboration, the PC and PH Collaborations Community of Practice (CoP) has collaborated with members to provide educational webinars; newsletters highlighting the intersection of PH and PC work; and in-person meetings at relevant national and international conferences. The CoP includes over 200 members from state and local PH departments, regional PCs, CDC, the American Association of Poison Control Centers (AAPCC), and the U.S. Environmental Protection Agency (EPA).

Objective:

To discuss the use of poison center (PC) data for public health (PH) surveillance at the local, state, and federal levels. To generate meaningful discussion on how to facilitate greater PC and PH collaboration.

Pesticide-related illness and injury is a reportable condition in Florida. In August and September 2016, aerial spraying for mosquito control was conducted in an effort to reduce the population of Aedes aegypti mosquitoes in Miami-Dade County.1 Two areas Wynwood (in August) and Miami Beach (in September) were sprayed with naled. Naled is an organophosphate insecticide registered with the U.S. Environmental Protection Agency (EPA) which is applied via aerial ultra-low volume (ULV) spraying. In addition to routine surveillance using FPICN and reportable disease surveillance data to identify acute naled-related illness, the Florida Department of Health (DOH) also monitored ED chief complaints data to identify any associated increase in ED visits.

Objective:

To describe the use of Florida Poison Information Center Network (FPICN) and Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) emergency department (ED) chief complaints data to identify acute naled-related illness following aerial spraying in Miami-Dade county, Florida in response to the Zika outbreak.