When Jerry Huffman went on vacation recently to Myrtle Beach, S.C., he took his laptop with him. Each day he rose at 4 a.m. as usual to download data on Baltimore ambulance runs, animal deaths and cough syrup sales, and answer the question that rules his life:
Have bioterrorists attacked?
"Paranoia," Huffman says, without hesitation, when asked what trait has proved useful in his work. "I'm paranoid. I'm semi-obsessed with this job."
From a windowless office at the Baltimore Health Department decorated with an American flag cut from a T-shirt and a harrowing list of pathogens, Huffman runs the city's bioterrorism surveillance system, distinguished by its bare-bones cost and comprehensive data.
A biological assault on the United States - say, in retaliation for an American invasion of Iraq - would not be announced by a telltale explosion, probably not even by warning notes like those found in the anthrax letters 18 months ago. It might begin with a release of invisible aerosol in a shopping mall, or the arrival at an airport of foreign travelers notable for their unrestrained coughing.
Then people would start getting sick - a fever here, a rash there; a stop at a drugstore, a trip to the emergency room. By the time the number of cases and exotic diagnoses were noticed, an epidemic of plague, or hemorrhagic fever or smallpox could be raging.
To catch this nightmare early, Baltimore has Huffman. A data manager for a defense contractor for 20 years, he came to the Health Department in 1999 to track child immunizations and restaurant inspections. Then came Sept. 11, 2001.
Within a week, Huffman was refocused on terrorism, trolling for trouble in a sea of data.
Huffman, 46, is a paunchy guy with graying hair, narrow wire-rimmed glasses and a smoking habit that sends him periodically to hide in the garage next door for a nicotine fix. He estimates that he spends 60 percent of his time on biosurveillance; that share of his $56,000 annual salary and computer time are the system's only costs.
Huffman seems to have found his niche, says Health Commissioner Dr. Peter L. Beilenson. "Jerry likes to think like a terrorist," he says. In this field, that's the highest of compliments.
Huffman gives new meaning to the concept of "a morning person." He wakes without an alarm clock between 3:30 a.m. and 4 a.m. and taps into the Fire Department's files on the previous day's ambulance runs while catching the earliest TV news.
By 7:30, he's at his desk, turning ambulance data into color-coded charts and dot-covered city maps. Local emergency rooms send patient data for the past 24 hours. Animal control reports dead dogs and cats; some lethal, heavier-than-air gases might affect pets first.
By late morning, Huffman has e-mailed his charts to his bosses, to City Hall and to the state health department.
If there's an odd cluster of breathing problems in Northeast Baltimore, a spike in downtown ambulance calls at 11 a.m., or a sudden tripling of sales of over-the-counter flu medication, they are instantly visible.
With a few clicks of the mouse, he can zero in on an apparent trouble spot: Are the cases in a single block? Did the patient have a longstanding medical condition? Were the ambulance calls from a multicar wreck?
On weekends, Huffman works from home, e-mailing his daily report to Beilenson's handheld Blackberry computer.
Huffman's hair-trigger system inevitably raises false alarms.
One recent day, animal control reported 13 dead cats and dogs, twice the average. A quick check revealed the gruesome explanation: Snow banks were melting, releasing the carcasses of animals plowed into the drifts. "That was more than I really wanted to know," Huffman says.
On another occasion in October, "I'm doing my thing and I see that all of a sudden sales of flu medication are through the roof," Huffman says. That sent what he calls the "Jerry Paranoid Meter" off the scale. He flashed out his warnings, made some phone calls and found the cause: Giant Food had 8-ounce bottles of Robitussin on sale.
Many communities are following Baltimore's lead. New York not only tracks illness but samples the air for air pathogens. The Maryland Department of Health helps run a surveillance system for the Washington area, collecting data from Montgomery and Prince George's counties.
Some experts think Baltimore's approach, using raw data collected by non-physicians, is too blunt an instrument. Dr. Alan P. Zelicoff, senior scientist at Sandia National Laboratories in New Mexico, has a Web-based system that uses physicians to spot suspicious cases.
Some cities believe elaborate surveillance may not be worth the cost. It's likely that no system would have given early warning of the anthrax letters; cases were too few and too scattered.
But Huffman's careful tracking has produced spinoffs, Beilenson says. Drug overdose data are guiding a new program to allow addicts to give an antidote to overdose victims. Tracking medication sales gives early warning of flu season, helping to time vaccination programs. The system helped officials respond quickly to an outbreak of the bacterial disease shigella in day care centers last year.
But Huffman's focus remains on man-made terror. "It's rewarding," he says. "You feel you're really making this city safer."
His preoccupation brings certain liabilities to family life. Recently, he and his wife drove to a Lancaster, Pa., restaurant for dinner. Huffman mused that the Amish country would be a soft target for bioterrorists: lots of tourists passing through to spread the infection, but no surveillance system to catch it quickly.
"My wife says, `Good God, is that all you think about?'" Huffman recalls.