Public Health Surveillance of Illness Related to Harmful Algal Blooms: Florida's Experience
Harmful Algal Blooms (HABs) occur throughout the world with Florida having the distinction of
being home to all major toxin-producing marine, estuarine and freshwater microalgae. The
subtropical warm climate, 1200 miles of coastline, varied aquatic habitats, and the human
interface through seafood consumption and from water activities compose an environment where
the presence of aquatic toxins can have a significant impact on public health.
During the past 2 decades there has been a dramatic increase in the population along Florida’s
coastline; 80% of the population lives near the coast and greater numbers either vacation or
participate in recreational activities at the shore. Coincident with this increase in population, has
been an apparent increase in frequency and distribution of toxic blooms.
The increased reliance of the state on tourism for its economic health together, with an increasing
population at risk for exposure to HABs makes the assessment of health related illness from
aquatic toxins an important and emerging public health issue.
Florida is fortunate that there are surveillance and reporting systems that offer the opportunity for
the identification and description of HAB related illness. The Florida Poison Information System,
the Florida Department of Health Reportable Disease Network (Merlin) and the syndromic
surveillance system (ESSENCE) provide a mechanism for documenting health impacts from
human exposures to HABs including Karenia brevis red tides, ciguatera fish poisonings, saxitoxin
related poisonings, and cyanobacteria (blue green algae) associated illness. These reports are now
tracked and collated using the newly implemented CDC Harmful Algal Bloom Illness
Surveillance System (HABISS). HABISS is the innovative system that uniquely provides a
federal perspective for HAB related illness in the US with a centralized system.
This presentation will address the implementation of a statewide HAB surveillance effort
including historically important illness (such as neurotoxic shellfish poisoning) and newly
emerging illness (brevetoxin associated respiratory illness, cyanobacteria related illness). The
linkage to the CDC HABISS system will be highlighted including use by public health managers
for response decision making and collaborations across state boundaries.
The importance of including HAB related illness as part of comprehensive public health illness
surveillance and reporting system will be emphasized including development of partnerships
between local, state, and federal entities.