The Florida Department of Health (FDOH) previously monitored Florida Poison Information Center (FPICN) data for timely detection of increases in carbon monoxide (CO) exposures before, during, and after hurricanes. Recent analyses have noted that CO poisonings have also increased with generator use and improper heating of homes during cold winter months in Florida. Similarly, increases in CO poisoning cases related to motor vehicles have been observed during summer months. CO is an odorless, colorless, poisonous gas causing sudden illness and death, if present in sufficient concentration in ambient air. The most common signs and symptoms include headache, nausea, lethargy/fatigue, weakness, abdominal discomfort/pain, confusion, and dizziness. This presentation summarizes Florida’s experience in identifying CO poisoning clusters using ESSENCE-based syndromic surveillance.
Poison Control
In recent years, the number of deaths from illicit and prescription opioids has increased significantly resulting in a national and local public health crisis. According to the Texas Center for Health Statistics, there were 1340 opioid related deaths in 2015.1 In 2005, by comparison, there were 913 opioid related deaths. Syndromic surveillance can be used to monitor overdose trends in near real-time and provide much needed information to public health officials. Texas Syndromic Surveillance (TxS2) is the statewide syndromic surveillance system hosted by the Texas Department of State Health Services (DSHS). To enhance the capabilities of TxS2 and to better understand the opioid epidemic, DSHS is integrating both Texas Poison Center (TPC) data and Emergency Medical Services (EMS) data into the system. Much of the data collected at public health organizations can be several years old by the time it is released for public use. As a result, there have been major efforts to integrate more real-time data sources for a variety of surveillance needs and during emergency response activities.
Objective: To improve Texas Syndromic Surveillance by integrating data from the Texas Poison Center and Emergency Medical Services for opioid overdose surveillance.
The Public Health Surveillance (PHS) component (one of five monitoring and surveillance components deployed in the Cincinnati drinking water contamination warning system) functions to detect public health incidents resulting from exposure to toxic chemicals that produce a rapid onset of symptoms. Within the PHS component, four data streams were monitored: 911 calls, Emergency Medical Services (EMS) logs, Local Poison Control Center call data, as well as Emergency Department data (via EpiCenter). The focus of this paper centers on the 911 and EMS surveillance tools. The 911 data is dependent on information provided by the caller and the information entered by the dispatcher. EMS data, on the other hand, is recorded by a medical professional, and although not provided as rapidly as 911 data, provides more detailed information. The data included in 911 and EMS alerts, when utilized together, can provide timely and beneficial information during investigation of a possible drinking water contamination incident.
Objective
This paper describes the design, application and use of 911 and EMS data in a drinking water contamination warning system.
Regional poison control centers (RPC) receive calls about a variety of poisoning exposures. Callers’ symptoms may not otherwise enter traditional public health (PH) surveillance systems. I report a 16-week pilot study of a new tool to enable the RPC to analyze and integrate call data with the PH, to augment ongoing disease surveillance efforts.
Objective
A new tool allowing analysis of poison control center data and integration of that data into public health surveillance efforts is described.
The National Poison Data System (NPDS) is maintained and operated by the American Association of Poison Control Centers (AAPCC) for the analysis, visualization, and reporting of call data from all 61 regional poison centers (PCs) in cooperation with CDC's National Center for Environmental Health (NCEH). NCEH collaborates with AAPCC toxicologists using NPDS to facilitate early recognition and monitoring of illness due to intentional or unintentional chemical or toxin exposures. NPDS algorithms identify statistically significant increases in callers' reported signs and symptoms - 131 clinical effects (CEs) such as rash and diarrhea - for detection of national poison exposure anomalies. Each day AAPCC toxicologists make decisions about NPDS anomalies' public health importance. Regional PCs are contacted as required for additional information about potentially important anomalies. NPDS also allows for individual case tracking through user-defined 'case-based definitions.' This additional method is especially useful during an outbreak when the agent and/or symptoms of affected persons are known.
To construct and validate a prediction algorithm that detects early increases in laboratory reports of enteric illnesses on the basis of calls to a poison control center reporting suspected foodborne illnesses.
To develop an automated system which examines Poison Control Center data and provides (1) early recognition of events, both man-made and naturally-occurring, which may pose a threat to public health, and (2) real-time notification to Poison Specialists, the on-site experts who evaluate those alerts.
For radiological incidents, collecting surveillance data can identify radiation-related public health significant incidents quickly and enable public health officials to describe the characteristics of the affected population and the magnitude of the health impact which in turn can inform public health decision-making. A survey administered by the Council of State and Territorial Epidemiologists (CSTE) to state health departments in 2010 assessed the extent of state-level planning for surveillance of radiation-related exposures and incidents: 70%–84% of states reported minimal or no planning completed. One data source for surveillance of radiological exposures and illnesses is regional poison centers (PCs), who receive information requests and reported exposures from healthcare providers and the public. Since 2010, the Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers (AAPCC) have conducted ongoing surveillance for exposures to radiation and radioactive materials reported from all 57 United States (US) PCs to NPDS, a web-based, national PC reporting database and surveillance system.
Objective
To describe radiation-related exposures of potential public health significance reported to the National Poison Data System (NPDS).
In 2010, there were 4,796 snake bite exposures reported to Poison Centers nationwide (1). Health care providers frequently request help from poison centers regarding snake envenomations due to the unpredictability and complexity of prognosis and treatment. The Missouri Poison Center (MoPC) maintains a surveillance database keeping track of every phone call received. ESSENCE, a syndromic surveillance system used in Missouri, enables surveillance by chief complaint of 84 different emergency departments (ED) in Missouri (accounting for approximately 90% of all ED visits statewide). Since calling a poison center is voluntary for health care providers, poison center data is most likely an underestimation of the true frequency of snake envenomations. Comparing MoPC and ESSENCE data for snake envenomations would enable the MoPC to have a more accurate depiction of snake bite frequency in Missouri and to see where future outreach of poison center awareness should be focused.
Objective
This study intends to use two different surveillance systems available in Missouri to explore snake bite frequency and geographic distribution.
UIs are among the leading causes of injury in children younger than 5 years in NYC. About 3000 calls are received each year by the NYC Poison Control Center (PCC) for this age group. Common UI exposures include medications, cosmetics, household cleaners, foreign bodies, and pesticides. We examined UIs in NYC from January 2010 to July 2014 for children <5 years to investigate the utility of syndromic surveillance in conjunction with the PCC in capturing real-time pediatric UIs over time.
Objective
To describe unintentional ingestions (UIs) in children <5 years using syndromic data from emergency departments in New York City (NYC) from 2010 to 2014.