Disease surveillance and nonprescription medication sales can predict increases in poison exposure

Real-time Outbreak and Disease Surveillance (RODS) is a national real-time syndromic surveillance system that classifies hospital registration chief complaints into one of seven syndromic categories. The National Retail Data Monitor (NRDM) is a public health surveillance tool that is designed to collect and analyze the daily sales of 18 categories of nonprescription medications. The goal of RODS and NRDM is to provide early warning of disease outbreaks, such as biological terrorism. The purpose of this study was to determine whether peak syndromic activity and the consequential purchase of nonprescription medications could predict an increase in poisoning exposures involving NRDM-monitored medications. Data from the RODS and NRDM databases were plotted graphically to portray activity that occurred during 2003. Data from a regional poison information center electronic medical record system that involved all human exposure calls related to NRDM-monitored medications in 2003 were extracted and graphed. Analysis included comparisons between the data sets. Poison center exposure volume correlated predictably and simultaneously with the peak activity in both the RODS and NRDM databases. There was no delay between the onset of an influenza outbreak in December 2003, the sale of nonprescription palliative mediations, and the increase in poison center exposure call volume. Increased availability of and access to nonprescription medications resulted in more poisoning exposure calls. Real-time surveillance using other databases can help to forecast poison center activity. This knowledge allows the poison center to provide anticipatory guidance to the residents of its region.