Experience Publishing MMWR Report about Suspected Palytoxin Inhalation Exposures – Alaska, 2012-2014

BACKGROUND:  In August 2014, the Alaska Section of Epidemiology (SOE) received a report of a patient complaining of bitter metallic taste, fever, weakness, cough, and muscle pain 7 hours after introduction of live zoanthid coral into his home aquarium. Palytoxin, a potent toxin known to produce the reported effects, is contained in some zoanthid marine corals. SOE launched an epidemiologic investigation, during which investigators interviewed exposed persons, obtained five environmental specimens for testing, and provided advice about avoiding continued exposure. SOE collaborated with the Food and Drug Administration, Center for Food Safety and Applied Nutrition to analyze coral specimens. CDC's MMWR was selected for presenting our exposure and follow-up investigation because MMWR reaches a broad audience, specifically targeting state and federal public health officials, is open access (is freely available to all), and is easily retrieved in internet searches.

METHODS:  Our manuscript submission process was fairly simple and the editors were responsive and helpful in a timely manner. From our publication process we have two issues for future authors to keep in mind: 1) authors might check with the MMWR editors if the review and clearance process takes longer than the authors expect, and 2) the last few days before publication require short edit turnarounds that occur in a few hours or overnight. Thus, authors should have at least one person always available during this time period to address edits and questions. To ease this burden, authors can work with MMWReditors to select a publication date that will be favorable for both authors and editors.

RESULTS:  Publishing in MMWR provided considerable visibility for our topic, particularly in the public health field. We heard from citizens, scientists, the media, and public health professionals about our report. This report was carried in the national and international media, including Scientific American, Smithsonian Magazine, and AOL.com. Since, there has been an open discussion with the media and public health scientists to troubleshoot exposures and spread the message about this important, albeit lesser known, potential public health and occupational exposure.

CONCLUSIONS: Publishing in MMWR with its wide reach and open access has helped serve global public health by spreading the message. We saw evidence of this from the technical assistance requests from the public and public health agencies, in addition to national and international media inquiries and postings on multiple hobbyist and professional blogs.