Heat-related Illness

LAC experienced several days of record-breaking temperatures during the summer of 2018. Downtown Los Angeles temperatures soared to 108°F in July with an average daily maximum of 92°F. Extreme heat events such as these can pose major risks to human health. Syndromic surveillance can be a useful tool in providing near real-time surveillance of HRI. In 2014, a working group was formed within the CSTE Climate Change Subcommittee to define and analyze HRI. The workgroup's goal was to provide guidance to public health professionals in adapting and implementing an HRI syndrome surveillance query. The Acute Communicable Disease Control Program's (ACDC) Syndromic Surveillance Unit utilized CSTE's HRI query to provide surveillance during the extreme heat season in 2018 in LAC. Additional modifications to the CSTE query were evaluated for potential improvements towards characterizing HRI trends.

Objective: To analyze Los Angeles County'™s (LAC) extreme heat season in 2018 and evaluate the Council of State and Territorial Epidemiologists' (CSTE) syndrome query for heat-related-illness (HRI) in Los Angeles County (LAC)

The Acute Care Enhanced Surveillance (ACES) system provides syndromic surveillance for Ontario's acute care hospitals. ACES receives over 99% of acute care records for emergency department (ED) visits; mean daily volume is 17,500 visits. ACES uses a maximum entropy classifier and generates more than 80 standard syndromes, fifteen of which are actively monitored for aberrational activity and are considered of higher public health relevance, including RESP (respiratory infection, non-croup), ILI (influenza-like illness), TOX (toxicological, chemical/drug exposure), AST (asthma), OPI (opioid exposure), CELL (cellulitis), GASTRO (gastroenteritis), ENVIRO (environmental, heat/cold exposure), MH (mental health), EOH (alcohol intoxication), DERM (rash), and SEP (bacteremia, sepsis). Syndromic surveillance provides a salient source of public health surveillance during extreme heat events; monitoring real-time ED visits can inform local public health authorities of health impacts, provide situation awareness to initiate and/or inform public health response, and help decision-makers allocate resources according to geographic (or demographic) vulnerability. While the use of syndromic surveillance has been well-characterized to monitor infectious disease outbreaks, its use to monitor the heat- health impacts is relatively novel for ACES users, specifically local public health authorities. This report describes the data collected during an extended extreme heat event in Ontario, Canada, to highlight the value of syndromic surveillance during extreme heat events and make recommendations regarding incorporating ACES data into routine workflows.

Objective: To describe the lessons learned for public health decision-makers from an analysis of Acute Care Enhanced Surveillance (ACES) data for the heatwaves experienced in Ontario, Canada in the summer of 2018.

Extreme heat and related illnesses are a critical concern in Arizona from May to September each year. From 2008 to 2016, Arizona medical facilities had an average of 1,790 emergency visits and 442 hospital admissions for heat-related illnesses (HRI) during the summer months. In 2016 alone, Arizona Emergency Departments (EDs) received a total of 2,484 visits for HRI and 527 of these cases were admitted as inpatients1. Pinal County, which has an estimated population of 430,237 individuals, contributes to the number of HRI visits to Arizona Emergency Departments that occur each year. In order to determine the burden of HRIs within the county, Pinal County Public Health Services District (PCPHSD) began to conduct heat-related illness surveillance in 2017 and found that 149 HRI cases had been reported that year3. PCPHSD continued to conduct HRI surveillance through summer 2018 to build on surveillance activities from 2017 and meet the following goals: 1) improve HRI case identification and assessment through enhanced HRI surveillance and interview processes, 2) determine risk factors and risk populations for HRIs in Pinal County, and 3) recommend and implement practical interventions to prevent HRIs among Pinal residents.

Objective: Determine risk factors and risk populations for heat-related illnesses in Pinal County, AZ by improving HRI case identification and assessment.

As part of a greater statewide excessive heat response plan, New Hampshire (NH) has been performing HRI surveillance since 2010 to guide response efforts and ultimately reduce HRI morbidity and mortality during situations of excessive heat. Historically, NH hospital Emergency Department Heat illness discharges average around 150 per year, typically in the summer months. NHÕs Excessive Heat Emergency Response Plan documents appropriate state-wide readiness, alerting, emergency, and recovery level of response for heat emergencies with its partners. Together with near real-time surveillance data, flexible query tools, and communication templates, NH is better able to respond to excessive heat emergencies at a moment's notice and take action with its partners to reduce HRI emergencies. Objective: During this presentation NH Division of Public Health Services (NH DPHS) will share how it was able to develop an effective HRI surveillance response through the development of partners, which allowed State of NH decision makers to affect action beyond detection.

Heat waves have serious health impacts such as heat exhaustion, heat stroke, dehydration, and death. Heat illness morbidity and mortality can be reduced with the identification of vulnerable populations and targeted public health interventions. In June and July of 2011, a heat wave occurred in Nebraska in which 28 days reached 90 degrees F or higher. Syndromic surveillance data were used to describe heat-related illness emergency department (ED) visits during this time.

Objective

The purpose of this study was to develop methodology to accurately identify and track heat illness in a timely manner using syndromic surveillance data.

Although heat illness is preventable, it is a leading cause of death among U.S. high school and college athletes (1). Despite this, the total burden of heat illness during sports and recreation is unknown. With over 250 million U.S. residents reporting occasional participation in sports or recreational activities (2), there is a large population at risk.

Objective

To examine the incidence and characteristics of heat illness during sports and recreation.