provide case data to TESS every 4 to 10 minutes. To assist in improving public health surveillance, CDC’s National Center for Environmental Public Health, the Agency for Toxic Substances and Disease Registry (ATSDR), and AAPCC are working to utilize this new feature to convert TESS into a real-time public health surveillance system. This conversion has the potential to generate more immediate and appropriate responses to public health threats that may be related to toxins or chemicals in the environment. On a pilot basis at present, these federal agencies are using TESS for continuous national toxicosurveillance of poison control center data to detect new hazards. Figure 7-3 shows an example, using cases of calls about contaminated water, of how center data may be analyzed and displayed to detect exposure excesses (Watson et al., 2003). It illustrates the detection prospects for the real-time data system even without the application of signal detection algorithms.

In addition to the national toxicosurveillance effort performed in conjunction with AAPCC, some poison control centers participate in local syndromic surveillance and report notifiable conditions affecting multiple individuals to local and/or state health officials. For example, the Minnesota Poison Control System, in cooperation with the Minnesota Department of Health, provides active surveillance to detect infectious

FIGURE 7-3 TESS—water and contaminated water—total and cases with any clinical effects.

SOURCE: American Association of Poison Control Centers TESS program and participating poison control centers.

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