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. 2006 Mar;96(3):547-53.
doi: 10.2105/AJPH.2004.061358. Epub 2005 Dec 27.

Diarrheal illness detected through syndromic surveillance after a massive power outage: New York City, August 2003

Melissa A Marx  1 , Carla V Rodriguez, Jane Greenko, Debjani Das, Richard Heffernan, Adam M Karpati, Farzad Mostashari, Sharon Balter, Marcelle Layton, Don Weiss
Affiliations

Diarrheal illness detected through syndromic surveillance after a massive power outage: New York City, August 2003

Melissa A Marx et al. Am J Public Health. 2006 Mar.

Abstract

Objectives: We investigated increases in diarrheal illness detected through syndromic surveillance after a power outage in New York City on August 14, 2003.

Methods: The New York City Department of Health and Mental Hygiene uses emergency department, pharmacy, and absentee data to conduct syndromic surveillance for diarrhea. We conducted a case-control investigation among patients presenting during August 16 to 18, 2003, to emergency departments that participated in syndromic surveillance. We compared risk factors for diarrheal illness ascertained through structured telephone interviews for case patients presenting with diarrheal symptoms and control patients selected from a stratified random sample of nondiarrheal patients.

Results: Increases in diarrhea were detected in all data streams. Of 758 patients selected for the investigation, 301 (40%) received the full interview. Among patients 13 years and older, consumption of meat (odds ratio [OR]=2.7, 95% confidence interval [CI]=1.2, 6.1) and seafood (OR=4.8; 95% CI=1.6, 14) between the power outage and symptom onset was associated with diarrheal illness.

Conclusions: Diarrhea may have resulted from consumption of meat or seafood that spoiled after the power outage. Syndromic surveillance enabled prompt detection and systematic investigation of citywide illness that would otherwise have gone undetected.

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Figures

FIGURE 1—
FIGURE 1—
Ratio of emergency department (ED) visits for diarrheal illness to other visits and total number of diarrhea visits: New York City, August 2003.
FIGURE 2—
FIGURE 2—
Number of over-the-counter pharmacy sales for antidiarrheal medications: New York City, August 2003. Note. Data are adjusted for day of week, holiday, and air temperature.
FIGURE 3—
FIGURE 3—
Participation in investigation on the basis of syndrome-based case definition: New York City, August 2003.
See this image and copyright information in PMC

References

    1. Associated Press. A timeline of the 2003 blackout. Available at: http://www.cnn.com/2003/US/08/17/blackout.chron.ap. Accessed October 29, 2003.
    1. Beatty ME, Phelps S, Rohner C, Weisfuse I. Blackout of 2003: Public Health Effects and Emergency Response. Pub Health Rep. 2006;121(1):36–44. - PMC - PubMed
    1. Audits International/FDA. 1999 US Food Temperature Evaluation. Available at: http://www.foodriskclearinghouse.umd.edu/Audits-FDA_temp_study.htm. Accessed October 25, 2005.
    1. Mitscherlich E, Marth EH. Microbial Survival in the Environment. Berlin: Springer-Verlag; 1984.
    1. Heffernan R, Mostashari F, Das D, Karpati A, Kulldorff M, Weiss D. Syndromic surveillance in public health practice: the New York City emergency department system. Emerg Infect Dis. 2004;10;858–584. - PubMed