Table.

Summary of 6 use cases of emergency department (ED) syndromic surveillance data and how they guided governmental response and decision making, New York City Department of Health and Mental Hygiene, 2012-2016

Case	Syndrome Definition	Purpose	Analysis Method	Results	Outcome
Synthetic cannabinoid drug use	Mentions of synthetic marijuana, K2, K-2, K-TWO, K TWO, or other street names of synthetic cannabinoid drugs	To monitor citywide ED visit trends related to synthetic cannabinoid drug use as seen in other parts of the country	Compare daily counts with a 1-year baseline to detect unusual increases for a single day; compare monthly aggregates to understand trends	A 220% increase in the number of monthly synthetic cannabinoid-related ED visits from December 2013 (n = 14) to June 2014 (n = 45)	Prompted the immediate release of a health advisory and initiation of a public health investigation. Neighborhoods with higher synthetic cannabinoid-related ED visits were prioritized for removal of synthetic cannabinoid products
Heat-related illness	Mentions of words such as heat, hot, heat stroke, and T67 and excluding words such as heater or hot food	To monitor and report on heat-related illness during heat waves and to provide timely information to the city’s heat emergency steering committee	Generalized linear regression models controlling for temporal and meteorological variables and comparing increases with previous years	Enhanced situational awareness during extreme heat events by supplementing weather observations and forecasts with a timely indicator of public health impact	Prompted additional public health messaging
Unreported suspected meningococcal disease or unnecessary prophylaxis	Mentions of meningitis; visits with mentions of exposure, prophylaxis, or contact	To identify potentially unreported cases of meningococcal disease and misuse of prophylaxis	Create and disseminate line list daily	Identified 451 ED visits with mention of meningitis from May 1, 2015, through April 30, 2016. No unreported cases of meningococcal disease were found during the period. Followed up on 17 instances where chief complaint indicated an exposure to or prophylaxis for meningitis but no suspected cases had been reported	Hospital staff members were educated about the appropriate use of antibiotic prophylaxis
Medical needs after severe weather	Mentions of medication, methadone, dialysis, or oxygen need	To provide situational awareness in the worst affected areas immediately after Superstorm Sandy	Recognize community needs and monitor their trends for several weeks after the storm	ED visits for medical needs increased acutely after Superstorm Sandy and remained slightly elevated for the next 30 days	Identified new medical needs in specific locations and provided timely information to public health officials
Asthma after building collapse	Mentions of asthma, wheezing, or chronic obstructive pulmonary disease	To investigate potential increases in asthma after a building collapse and fire in a Manhattan neighborhood	Compare trends in affected vs nonaffected areas	No increase was found	Quickly addressed potential health impacts and provided reassurance to officials
Ebola virus disease	Mentions of Ebola, Guinea, Liberia, Mali, or Sierra Leone	To monitor for potentially unreported cases of Ebola	Create and disseminate line list when cases identified	37 mentions of Ebola and 12 mentions of Ebola-affected countries	Prompted follow-up with ED for 3 questionable cases; none of the cases met the testing criteria