EMS Syndromic Surveillance Strategies in Times of Disaster: On The Ground Focused Analysis

Background: Emergency medical systems (EMS) are rarely mentioned in syndromic surveillance for bio-terrorism or illness such as flu. EMS dispatch data may be the first marker in such an event. EMS are able to perform core syndromic surveillance as well as adjust monitoring in disasters. We describe how such an adjustment identified significant public health threats during a natural disaster.

Methods: retrospective observational case study of syndromic and adjusted monitoring specific to disaster characteristics using an EMS Biosurveillance system (FirstWatch, Inc) during the ice storm in Tulsa, OK, December 2007.

Results: Core surveillance complaints of respiratory, neurological and gastrointestinal complaints were elevated but not reaching threshold alert levels. Carbon monoxide poisoning was specifically added to the surveillance system and alerted on the second day into the disaster corresponding with increased generator use for electricity. Geospecific location indicators identified clusters of calls in predominantly Spanish speaking communities. Public health officials were able to release media alerts in Spanish addressing generator use and CO poisoning. There was a significant decrease in CO poisoning calls within the community after initiation of these alerts.

Conclusions: EMS data may be the first indicator of disease process within the community. EMS is able to quickly assess on-the-ground situations specific to a disaster. Adding CO monitoring into surveillance analysis and using geospecific indicators found elevated call volumes and identified clusters for CO poisoning calls to 911. PH officials directly targeted the at risk community resulting in decreased CO poisoning calls.