Building a State-Based Environmental Public Health Framework for Freshwater Harmful Algal Bloom Surveillance

Cyanobacteria (or blue-green algae) have been associated with a broad range of adverse health outcomes in both humans and animals. Exposure to cyanobacterial blooms and toxins has been associated with acute mortality and morbidity in dogs and livestock, and gastrointestinal illness, skin rashes and respiratory symptoms in humans. Efforts to conduct public health surveillance regarding exposures to cyanobacteria and their toxins have been hampered by the cost and logistics of obtaining confirmatory environmental samples, as well as the presence of concurrent exposures that may cause similar symptoms. As such, implementing public health interventions such as beach advisories and closures in a consistent and fully-informed manner has been difficult. The Wisconsin Department of Health Services has undertaken a new effort to enhance its surveillance efforts for hazards and health outcomes related to cyanobacteria and their toxins. Hazard surveillance endpoints for this initiative include cyanobacterial cell counts, toxin concentrations and a suite of surface water quality parameters. Targeted health outcomes include human and animal mortality, animal intoxications, and gastrointestinal, dermatological and respiratory effects in humans. In order to improve case ascertainment, new partnerships have been developed with statewide and local lakes associations, local environmental health officials, veterinarians, and poison control center staff. Expected outcomes from enhanced surveillance include the improved ability to predict the conditions in which bloom and toxin exposure are most likely to occur and enhanced data upon which to base decisions about beach access and recreational use of Wisconsin lakes.