Morbidity

In 2016, there were approximately 63,000 deaths nationally due to drug overdose. This trend continues to increase with the provisional number of US deaths for 2017 being approximately 72,000 (1). This increase in overdose deaths is fueled largely by the opioid class of drugs. The opioid epidemic began in the 1990s with a steady rise in prescription opioid overdoses. However, after 2010 a rise in heroin overdose deaths also began to occur. In addition to the heroin deaths increasing, there was a sharp rise in overdose deaths due to synthetic opioids including illicitly manufactured fentanyl beginning in 2013 (2). In Missouri, ER visits follow similar trends with heroin overdose visits greatly increasing after 2011. While PDMPs help function as data sources that provide information on the licit drug supply, they cannot give much knowledge on the illicit supply. Because of this, drug seizure data from law enforcement can provide a much-needed tool in understanding the supply of illicit substances and their impact on a county™'s morbidity.

Objective: To evaluate the relationship between heroin and non-heroin opioid seizures reported by law enforcement and the number of ER visits due to heroin and non-heroin opioid poisoning in selected counties in Missouri.

Viral hepatitis is a global public health problem affecting millions of people every year, causing disability and death [1].The hepatitis B virus (HBV) is transmitted through the contact with the blood or other body fluids of an infected person. For formulating evidence-based policy of Public Health and data for action we should know about main ways of transmission HBV and population group with high risk of infection.

Objective

To develop model to study risk factors for hepatitis B (HB) and to identify the main causes affecting the incidence of HB.

On 12/14/06, a windstorm in western Washington caused 4 million residents to lose power; within 24 hours, a surge in patients presented to emergency departments (EDs) with carbon monoxide (CO) poisoning. As previously described, records of all patients presenting to King County EDs with CO poisoning between 12/15/06 to 12/24/06 (n=279) were abstracted, of which 249 met the case definition and eligibility requirements. We attempted to identify each of the 249 confirmed cases of CO poisoning in our syndromic ED data set by comparing the hospital name, date, time, age, sex, zip code, chief complaint, and diagnoses across the two data sets. We designated each record as an exact match, likely match, possible match, or unmatched on the basis of the available fields.

Objective

We evaluated ED and emergency medical services data for describing an outbreak of CO poisoning following a windstorm, and determined whether loss of power was followed by an increase in other health conditions.

On October 24, 2005, Hurricane Wilma made landfall on the southwest coast of Florida as a category 3 storm. The storm moved toward the northeast and passed through Palm Beach and Broward Counties before entering the Atlantic Ocean. Hurricane force winds and rain caused extensive damage to electrical infrastructure and traffic lights, and temporarily displaced thousands of residents. Power outages in Broward County affected over 90% of its 1.8 million residents, with some outages lasting >2 weeks. Boil water notices were declared for much of the county. Acute care hospitals remained open during this time, although services provided by health care providers in other settings were interrupted due to structural damage and power outages.

Objective

We used the syndromic surveillance system ESSENCE to describe the morbidity after Hurricane Wilma in Broward County, Florida.

Every year the United States generates close to 300 million scrap tires. Due to their high energygenerating capacity, tires can be used as a fuel source (tire-derived fuel, or TDF). In 2006 a paper mill located less than 3 miles from the Vermont border received a permit to conduct a 2-week test burn of TDF to evaluate its potential to replace oil as a source of fuel. Simulations and data from other mills suggested that tires may release metal emissions and fine particulates when they are burned. The Vermont Department of Health (VDH) conducted surveillance in the population living closest to the paper mill because metal emissions and fine particulates have been associated with adverse health effects.

Objective

The VDH established a short term surveillance system to track health effects related to a test burn of tire-derived fuel.

This paper describes the initiation, development and proof-of-concept phase of the ISDS DiSTRIBuTE influenza morbidity surveillance project [1].

Drug-related deaths have increased over the past decade throughout the United States. In New York City (NYC), every year there are approximately 900 psychoactive drug-related fatalities with the majority involving opioids. Unintentional drug overdose is the fourth leading cause of early adult death in NYC, and high rates of drug-related morbidity among drug users are evidenced by over 30,000 drug mentions in NYC emergency departments each year. Moreover, nonfatal overdose may be common among chronic drug users. Despite the relationship between fatal and non-fatal overdose clusters and continued increases in drug-related morbidity and mortality, no regular surveillance system currently exists. The implementation of a drug-related early warning system can inform and target a comprehensive public health response addressing the significant health problem of overdose morbidity and mortality.

Objective

This presentation describes how multiple syndromic data sources from emergency medical services ambulance dispatches and emergency department visits can be combined to routinely monitor citywide spatial patterns of adverse drug events and drug morbidity. This information can be used to target information, treatment and prevention services to drug “hotspots,” to provide early warning for drug-related morbidity, and to detect potential increased risk for overdose death.

Influenza infection is caused by the influenza virus, a single-stranded RNA virus belonging to the Orthomyxoviridae family. Influenza viruses are classified as types A, B and C. Influenza A and B viruses can cause epidemic disease in humans and type C viruses usually cause a mild, cold-like illness. The influenza virus spreads rapidly around the world in seasonal epidemics, resulting in significant morbidity and mortality. On the 10th of July 2017, a case of confirmed Influenza A/H1N1 was reported through the immediate disease notification system from a private hospital in the Hhohho region. A 49 year old female was diagnosed of Influenza A/H1N1 after presenting with flu-like symptoms. Contacts of the index case were followed and further positive cases were identified.

Objective:

To establish morbidity patterns of influenza A/H1N1 in Swaziland from 10th July to 15th August 2017.

Violence-related injuries are a major source of morbidity and mortality in NC. From 2005-2014, suicide and homicide ranked as NC's 11th and 16th causes of death, respectively. In 2014, there were 1,932 total violent deaths, of which 1,303 were due to suicide (67%), 536 due to homicide (28%), and 93 due to another mechanism of violent injury (5%). These deaths represent a fraction of the total number of violence-related injuries in NC.1 This study examined ED visit data captured by NC DETECT to identify and describe violent injuries treated in NC EDs and compare/contrast with fatalities reported by NC-VDRS.

Objective:

To describe violent injuries treated in North Carolina (NC) emergency departments (EDs) and compare to deaths reported by the NC Violent Death Reporting System (NC-VDRS).