CDC building system to warn of bioterror

Computers to collect data on doctor, ER visits, drugs


ATLANTA - The Centers for Disease Control and Prevention is building a computerized network designed to provide an early warning of any bioterror attack by monitoring visits to doctors offices and emergency rooms and drugstore sales in major U.S. cities.

Although the CDC has not disclosed the cost and location, the initial effort is expected to be concentrated in eight or 10 U.S. cities that also will have the Environmental Protection Agency's new Bio-Watch air quality monitors. The EPA monitors are designed to provide 24-hour notice of any release of anthrax, smallpox or other deadly germs.

The CDC network substantially expands the agency's disease-monitoring capabilities by gathering a host of largely untapped electronic information, from pharmaceutical sales to calls to poison control centers. Officials hope to detect any bioterror incident before it is even recognized by doctors.

"The foundation of our current surveillance system is that a condition has to be recognized by the medical system before anyone can respond to it," said David Fleming, the CDC's deputy director for public health science. "We are going to be actively investigating ways of tapping the information that is already electronically available."

Although the CDC already has more than 100 health-surveillance programs nationwide, most of them track specific diseases, such as tuberculosis and measles, or trends in clusters of diseases, such as food-borne illness and hospital infections.

These traditional surveillance systems require that a disease be diagnosed before it is reported. That can cost lives.

Early detection of bioterrorism is complicated because many potential agents initially produce the same generalized symptoms - fevers, headaches, diarrhea, vomiting or rashes - associated with many diseases.

The new approach, called syndromic surveillance, collects information on the signs and symptoms reported by patients to physicians. In some cases, it also could incorporate information on absenteeism at work, veterinary visits, requests for medical lab tests and even sales of over-the-counter medications in supermarkets.

There is no waiting for a diagnosis. Instead, the system feeds daily reports on fevers, headaches, diarrhea, vomiting, stuffy noses, coughs or rashes into central computers, where they are compared with "normal" seasonal, daily and regional fluctuations in known illnesses.

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