and Veterans Affairs (VA) treatment facilities as part of the Centers for Disease Control and Prevention’s (CDC’s) BioSense Program1 and from hospital emergency rooms and urgent care centers participating in other surveillance programs (e.g., Florida’s ESSENCE program [defined later in this chapter]). Reporting surveillance involves collecting data from poison control centers, physician clinics, and other sources, and investigating unusual clusters of symptoms that could be exposure related.

At the time of the workshop, only Alabama had detected an increase in illness through syndromic surveillance (29 exposure-related emergency room visits, mostly inhalation related). Additionally, Alabama had detected 66 exposure-related illnesses through reporting surveillance, with most being inhalation related. Louisiana had detected a total of 143 exposure-related illnesses through reporting surveillance. Most illnesses were inhalation-related illnesses among rig workers or clean-up workers, with the most commonly reported symptoms being headache, nausea, and throat irritation.


Donald E. Williamson, State Health Officer

The entire Alabama coastline has been impacted by the Deepwater Horizon disaster, with all oyster reefs and coastal water closed for fishing at the time of the workshop, reported Donald Williamson. Although large amounts of oil were still rolling onshore, the swimming advisory that was at one point issued for all coastal waters has been lifted for some, but not all, beaches. As with the other states, Alabama has been conducting both syndromic and reporting surveillance.

Alabama’s hospital syndromic surveillance includes tracking visits to 8 hospital emergency rooms and 20 high-volume urgent care centers and Federally Qualified Health Centers in two spill-affected counties. Exposure-related data are collected daily and collated weekly. Of a total of 19,429 complaints between the middle of May and the time of the workshop, 29 were related to oil exposure (18 via inhalation, 8 via dermal contact, and 3 via ingestion). Syndromic surveillance of DoD and VA treatment facilities through the BioSense program had not detected any anomalies at the time of the workshop.


BioSense receives and displays clinical care data in real-time from more than 1,730 DoD, VA, and other hospitals nationwide. The data are used to detect and monitor disease trends at the national, state, and local levels.

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