Timely public health interventions reduce heat-related illnesses (HRIs). HRI emergency department (ED) visit data provide near real-time morbidity information to local and state public health practitioners and may be useful in directing HRI prevention efforts. This study examined statewide HRI ED visits in North Carolina (NC) from 2008-2010 by age group, month, ED disposition, chief complaint, and triage notes. The mean number of HRI ED visits per day was compared to the maximum daily temperature. The percentage of HRI ED visits to all ED visits was highest in June (0.25%). 15-18 year-olds had the highest percentage of HRI visits and were often seen for sports-related heat exposures. Work-related HRI ED visits were more common than other causes in 19-45 year-olds. Individuals ≥65 years were more likely admitted to the hospital than younger individuals. The mean daily number of HRI ED visits increased by 1.4 for each 1°F (degree Fahrenheit) increase from 90°F to 98°F and by 15.8 for each 1°F increase from 98°F to 100°F. Results indicate that HRI prevention efforts in NC should be emphasized in early summer and targeted to adolescents involved in organized sports, young adults with outdoor occupations, and seniors. At a maximum daily temperature of 98°F, there was a substantial increase in the average daily number of HRI ED visits. ED visit data provide timely, sentinel HRI information. Analysis of this near real-time morbidity data may assist local and state public health practitioners in identification of HRI prevention strategies that are especially relevant to their jurisdictions.
PrEP prescribing and referral among LHDs in NC remains extremely limited. Increased PrEP-related training and support for LHD-based providers could enhance PrEP access, especially in rural and underserved areas.
OBJECTIVE--To determine incidence of animal bite injuries among humans in North Carolina by use of statewide emergency department visit data; to evaluate incidence rates on the basis of age, sex, urbanicity, biting species, and month for selected species; and to characterize bite-related emergency department visits. DESIGN--Retrospective cohort and cross-sectional study. SAMPLE--Records of 38,971 incident animal bite-related emergency department visits in North Carolina from 2008 to 2010. PROCEDURES--Emergency department visits were selected for inclusion by means of external-cause-of-injury codes assigned with an international coding system and keyword searches of chief complaint and triage notes. Rates were calculated with denominators obtained from census data. Cross-sectional analysis of incident emergency department visits was performed. RESULTS--By the age of 10, a child in North Carolina had a 1 in 50 risk of dog bite injury requiring an emergency department visit. Incidence rates for dog bites were highest for children ≤ 14 years of age, whereas the incidence rate for cat bites and scratches was highest among individuals > 79 years of age. Lifetime risk of cat bite or scratch injury requiring an emergency department visit was 1 in 60 for the population studied. Rabies postexposure prophylaxis was administered during 1,664 of 38,971 (4.3%) incident visits. CONCLUSIONS AND CLINICAL RELEVANCE--Emergency department visit surveillance data were used to monitor species-specific bite incidence statewide and in various subpopulations. Emergency department surveillance data may be particularly useful to public health veterinarians. Results may inform and renew interest in targeted animal bite prevention efforts.
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