An automated tracking system that receives data from all military medical facilities in the Washington, D.C., area could serve as a model for designing a national system for detecting outbreaks of diseases and biological terrorism.
As described in the October issue of the American Journal of Preventive Medicine, the system, known as Electronic Surveillance System for Early Notification of Community-Based Epidemics, or ESSENCE, was created in 1999 in recognition that the D.C. area would be a "high-value target for any terrorist attack and that no such system existed in the national capital area," says Maj. Michael D. Lewis, M.D., M.P.H., of Walter Reed Army Institute of Research.
Subsequent to the events of September 11, 2001, coverage by the system was expanded to over 300 military treatment facilities around the world.
Tests of the preparedness of U.S. public health systems have shown they are often inadequately prepared for deliberate attacks with outbreak-causing diseases, say the army's developers of ESSENCE.
"We believe that ESSENCE is the largest and one of the first U.S. systems to rely on near-real time, patient-level diagnostic data," they note. Data from individual centers generally take less than three days to make it into the system.
The system makes use of readily available data from patients visits to military clinics to classify cases of illness across the region into groups of syndrome categories, such as gastrointestinal, respiratory infection or fever, that allow the system to compare the actual disease incidence against predictions based on historic patterns.
Routinely collected electronic patient information is sent to Military Health System computers that extract and collate information needed to monitor disease levels and identify unusual fluctuations. These data reflect visits by active-duty personnel,
Contact: Will O'Bryan
Center for the Advancement of Health