title: Development and Application of Syndromic Surveillance for Severe Weather Events Following Hurricane Sandy.
abstract: Following Hurricane Superstorm Sandy, the New Jersey Department of Health (NJDOH) developed indicators to enhance syndromic surveillance for extreme weather events in EpiCenter, an online system that collects and analyzes real-time chief complaint emergency department (ED) data and classifies each visit by indicator or syndrome.
  
  
  
  These severe weather indicators were finalized by using 2 steps: (1) key word inclusion by review of chief complaints from cases where diagnostic codes met selection criteria and (2) key word exclusion by evaluating cases with key words of interest that lacked selected diagnostic codes.
  
  
  
  Graphs compared 1-month, 3-month, and 1-year periods of 8 Hurricane Sandy-related severe weather event indicators against the same period in the following year. Spikes in overall ED visits were observed immediately after the hurricane for carbon monoxide (CO) poisoning, the 3 disrupted outpatient medical care indicators, asthma, and methadone-related substance use. Zip code level scan statistics indicated clusters of CO poisoning and increased medicine refill needs during the 2 weeks after Hurricane Sandy. CO poisoning clusters were identified in areas with power outages of 4 days or longer.
  
  
  
  This endeavor gave the NJDOH a clearer picture of the effects of Hurricane Sandy and yielded valuable state preparation information to monitor the effects of future severe weather events. (Disaster Med Public Health Preparedness. 2016;10:463-471).
authors.affiliation: 1Communicable Disease Service,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Stella
authors.initials: S
authors.lastname: Tsai
authors.affiliation: 1Communicable Disease Service,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Teresa
authors.initials: T
authors.lastname: Hamby
authors.affiliation: 1Communicable Disease Service,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Alvin
authors.initials: A
authors.lastname: Chu
authors.affiliation: 2Environmental and Occupational Health Surveillance Program,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Jessie A
authors.initials: JA
authors.lastname: Gleason
authors.affiliation: 3Brown University,Public Health Program,Providence,Rhode Island.
authors.forename: Gabrielle M
authors.initials: GM
authors.lastname: Goodrow
authors.affiliation: 1Communicable Disease Service,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Hui
authors.initials: H
authors.lastname: Gu
authors.affiliation: 1Communicable Disease Service,New Jersey Department of Health,Trenton,New Jersey.
authors.forename: Edward
authors.initials: E
authors.lastname: Lifshitz
authors.affiliation: 4Drexel University,Environmental and Occupational Health Program,Dornsife School of Public Health,Philadelphia,Pennsylvania.
authors.forename: Jerald A
authors.initials: JA
authors.lastname: Fagliano
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology; D002249:Carbon Monoxide Poisoning / Q000453:epidemiology; D055867:Cyclonic Storms; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D009515:New Jersey / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D013577:Syndrome
keywords: carbon monoxide poisoning; disrupted outpatient medical care; hurricane; severe weather; syndromic surveillance