Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness

Abstract

Context: The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. Objective: We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. Materials and Methods: The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000–2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). Results: About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R²=0.489 (min R²=0.248, max R²=0.717), with mean ± SD of R²=0.494 ± 0.121. Median number of parameters used (degrees of freedom – 1) was 7. Conclusions: NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

Keywords:

• Centers for Disease Control and Prevention
• epidemiology
• Geographic Information Systems
• influenza
• National Poison Data System
• poisoning
• public health
• statistical models

Acknowledgements

The authors would like to acknowledge Scott Epperson of the Centers for Disease Control and Prevention for his assistance with obtaining CDC ILI data. The authors would like to acknowledge Abigail Spyker for her design and production of Figure S2, online supplementary video. The American Association of Poison Control Centers (AAPCC, www.aapcc.org) maintains the national database of information logged by the 57 US poison control centers. Case records in this database are from self-reported calls; they reflect only information provided when the public or healthcare professionals report an actual or potential exposure to a substance (e.g., an ingestion, inhalation, or topical exposure), or request information. Exposures do not necessarily represent a poisoning or overdose. The AAPCC is not able to completely verify the accuracy of every report made to member centers. Additional exposures may go unreported to poison control centers and data referenced from the AAPCC should not be construed to represent the complete incidence of national exposures to any substance(s).

Disclosure statement

The authors report no declarations of interest.