Slowly but surely, public-health departments and hospitals in the United States are beginning to implement real-time disease surveillance systems to detect possible acts of bioterrorism. Such a system was rolled out in Utah just in time for the Winter Olympics, and it may soon be implemented at hospitals in other regions of the country.
In Salt Lake City hospitals and at other regional urgent-care facilities, the Real-Time Outbreak and Disease Surveillance System, developed by the University of Pittsburgh is being used in conjunction with a disease surveillance system developed before Sept. 11 by the state of Utah. "We were concerned about outbreaks of any diseases during the winter games," says Dr. Robert Rolfs, Utah state epidemiologist. But Utah's homegrown system lacks the ability to analyze in real-time patient complaints and symptom data that may indicate that a biological or chemical attack, or a naturally occurring disease outbreak, has taken place. "We became particularly concerned about real-time data analysis after the anthrax outbreak on the East Coast," Rolfs says.
The surveillance system also has been deployed in some facilities in western Pennsylvania. The Biomedical Security Institute, a joint venture between the University of Pittsburgh and Carnegie Mellon launched earlier this month to advance the nation's ability to detect and respond to disease outbreaks, is in discussions with a few other regions about transporting the surveillance system to their health-care systems, says Dr. Andrew Moore, co-director of the institute. (Go to the sidebar article, "Is A Nationwide Health-Data Network Possible?")
Although specific implementations can vary, in general the surveillance system works this way: All participating health-care facilities enter patient information, such as age, residence, and symptoms (but not names, to comply with privacy regulations) into the system, which is then transmitted to a central database over the Internet or direct lines. The system then mines patient data from all facilities in a region for unusual health-problem patterns or increases in complaints that could indicate a biological attack, such as anthrax, or a naturally occurring outbreak, like the flu. The system is one of several separate disease-surveillance projects under way at various universities, laboratories, and health-care providers that aim to help public-health officials--and the U.S. Center for Disease Control and Prevention--detect and respond to terrorist attacks quickly.