Citation

Jones SA, Soto K, Grogan E, Senetcky A, Logan S, Cartter M. MMWR Morb. Mortal. Wkly. Rep. 2020; 69(8): 220-221.

Copyright

(Copyright © 2020, (in public domain), Publisher U.S. Centers for Disease Control and Prevention)

DOI

10.15585/mmwr.mm6908a4

PMID

32107368

Abstract

On the morning of August 15, 2018, the Connecticut Department of Public Health (CTDPH) learned from media reports about multiple persons found unresponsive in a city park in New Haven County after using synthetic cannabinoids (SCs), manmade psychoactive substances that can cause unpredictable and sometimes severe health effects. Prevalence of acute SC poisonings has increased in the United States in recent years (1). Syndromic surveillance data collected in near real-time have been used to track outbreaks of illness and to improve public health authorities’ situational awareness about trends in suspected drug overdoses (2). CTDPH monitored syndromic surveillance data from emergency department (ED) visit records to identify the magnitude of the SC overdose outbreak and provide situational awareness during the outbreak to state and local health departments.

Since January 2018, CTDPH syndromic surveillance system has collected data on ED visits from all 38 EDs in Connecticut by using the EpiCenter system (Health Monitoring Systems, Inc.). Using Health Level Seven messaging,* EDs transfer visit data (e.g., patient sex, age, ZIP Code of residence, chief complaint, and triage notes) to EpiCenter upon patient registration and discharge in near real-time (i.e., <5 minutes).

Within 20 minutes of receiving the first media report, CTDPH developed an ad hoc syndrome definition to identify ED visits for suspected SC overdoses by querying EpiCenter. The syndrome definition was derived from keywords in the chief complaint, selected in an iterative process from terms in media reports and ED visit record reviews. Initial keywords included terms for SCs (e.g., “K2,” “spice,” or “weed”) and later refined to include terms for location (e.g., “green,” “bench,” or “park”). By midday on August 15, a total of 25 suspected outbreak-related ED visits had been identified; by 5:00 p.m. on August 16, the number had increased to 55, all in New Haven County. CTDPH leadership and the local health department were updated with these data via periodic e-mails. The outbreak response ended on August 17. The U.S. Department of Justice Drug Enforcement Administration determined that SCs implicated in this outbreak contained AMB-FUBINACA, an ultrapotent SC with strong depressant effects (3,4).

On August 20, CTDPH further refined the syndromic case definition to include keywords in either chief complaint or triage notes to retrospectively identify outbreak-related ED visits during August 15–16 that were missed by ...

Language: en