A/TCHHSD uses two syndromic surveillance systems: (1) Realtime Outbreak and Disease Surveillance (RODS) system* utilizes chief complaint data from emergency department visits in 14 Austin Metro area hospitals; and (2) National Retail Data Monitor (NRDM)* utilizes OTC medications sales data. ATCEMS has an automated system to track the types of calls to EMS and transport to area hospitals. All three systems also provide data on patient age, sex, home zip code and receiving hospital. Information on the use of syndromic surveillance and EMS systems for each natural disaster (ice, extreme heat and fire) will be presented. Each case study will provide information on: (1) salient features of the natural disaster; (2) rationale for the type(s) of surveillance resources employed; (3) data analysis; (4) results; (5) data dissemination; (6) advantages and limitations; (7) lessons learned; and (8) process improvements.