Disembodying emerging infectious disease.

摘要

Electronic event-based surveillance for emerging infectious disease is a new tool for the early detection of potential infectious disease outbreaks. Today, a web of electronic information encircles the earth; it propagates from countless little points around the globe, making possible a completely new paradigm in emerging infectious disease surveillance.;In a very abstract sense, these new electronic event-based surveillance systems look for perturbations in the vast web of data, much as a spider would sense any changes in the tension of its web. A perturbation in the flow of data around the globe is like a tug on a line of silk. It alerts us to the entry of some change in infection dynamics.;Most new diseases, like HIV and SARS, are zoonotic, passing from animals into humans. An understanding of how ecosystems and human systems interact is key to understanding the early part of this process.;Unstructured information, such as that trolled by computers at GPHIN or Argus, is useful not only because it searches for an early signal, but also because the raw information has not yet been bureaucratically packaged in narrow administrative ways. Administrative rigor can introduce certain types of information blindness, which can cause us to miss an early infectious disease signal.;The health of the "sea if microbes" is a commons, similar to the health of the atmosphere. It is in everyone's interest to maintain a strong public health infrastructure and to avoid the generation of strong infectious disease gradients that can carry infectious disease into broad human populations. Risk is generated collectively and is held statistically in ecosystems and human systems. Degradation of the commons causes loss of systemic resiliency, and changes can ripple through various layers of an ecosystem.;Infectious disease in one area can quickly spread via global air travel to large urban populations throughout the world. Aviation has more tightly coupled all parts of the microbial commons, including both human-natural systems, and developed-developing human systems.;In biopolitical terms, the view that infectious disease enters broad human populations through the "at-risk" body of the Other is flawed.