Abstract

Harmful algal and cyanobacterial blooms (harmful algal blooms) are large colonies of algae or cyanobacteria that can harm humans, animals, and the environment (1-3). The number of algal blooms has been increasing in the United States, augmented by increasing water temperatures and nutrients in water from industry and agricultural run-off (4,5). The extent to which harmful algal bloom exposures cause human illness or long-term health effects is unknown. As the number of blooms increases annually, the likelihood of negative health outcomes (e.g., respiratory or gastrointestinal illness) from exposure also increases (4,5). To explore the utility of syndromic surveillance data for studying health effects from harmful algal bloom exposures, CDC queried emergency department (ED) visit data from the National Syndromic Surveillance Program (NSSP) for harmful algal bloom exposure-associated administrative discharge diagnosis codes and chief complaint text terms related to harmful algal bloom exposure (6). A total of 321 harmful algal bloom-associated ED visits were identified during January 1, 2017-December 31, 2019. An increase in harmful algal bloom-associated ED visits occurred during warmer months (June-October), consistent with seasonal fluctuations of blooms and recent publications (6,7). Although syndromic surveillance data are helpful for understanding harmful algal bloom-associated ED visits in the United States, exposures were documented infrequently with discharge diagnosis codes; 67% of harmful algal bloom-associated ED visits were identified through querying chief complaint text. Improving the documentation of harmful algal bloom exposures in medical records would further benefit future health studies.

Highlights

  • Syndromic surveillance data are useful for studying the extent of harmful algal bloom–associated illness

  • Electronic health record systems with longitudinal data could potentially provide data for monitoring long-term health effects from these exposures, the extent of which are largely unknown

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Summary

Morbidity and Mortality Weekly Report

Evaluation of Syndromic Surveillance Data for Studying Harmful Algal Bloom-Associated Illnesses — United States, 2017–2019. Syndromic surveillance data are helpful for understanding harmful algal bloom–associated ED visits in the United States, exposures were documented infrequently with discharge diagnosis codes; 67% of harmful algal bloom–associated ED visits were identified through querying chief complaint text. A query was created that comprises main terms from the chief complaint (e.g., red tide, algae) along with discharge diagnostic codes associated with exposure to harmful algal blooms (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-CM-10]) codes and their corresponding Systematized Nomenclature of Medicine [SNOMED]* Clinical Terms codes). A total of 321 harmful algal bloom–associated ED visits were identified during January 1, 2017–December 31, 2019 Among these visits, 106 (33%) were identified through ICD-CM-10 codes only; the addition of chief complaint text key terms to the query identified an additional 215 visits. The most frequent syndrome category was respiratory (41%), followed by gastrointestinal (14%), neurologic (10%), and dermatologic (8%) (Table 2)

Discussion
Sex Female Male
Syndrome type
What are the implications for public health practice?

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