Syndromic Surveillance

摘要

Heightened awareness of the risks of bioterrorism since 9/11 coupled with a growing concern about naturally emerging and reemerging diseases such as West Nile, severe acute respiratory syndrome (SARS), and pandemic influenza have led public health policymakers to realize the need for early warning systems. The sooner health officials know about an attack or a natural disease outbreak, the sooner they can treat those who have already been exposed to the pathogen to minimize the health consequences, vaccinate some or all of the population to prevent further infection, and identify and isolate cases to prevent further transmission. Early warning systems are especially important for bioterrorism because, unlike other forms of terrorism, it may not be clear that an attack has taken place until people start becoming ill. Moreover, if terrorism is the cause, early detection might also help to identify the perpetrators. "Syndromic surveillance" is a new public health tool intended to fill this need. The inspiration comes from a gastrointestinal disease outbreak in Milwaukee in 1993 involving over 400,000 people that was eventually traced to the intestinal parasite Cryptosporidium in the water supply. After the fact, it was discovered that sales of over-the-counter (OTC) antidiarrhea medications had increased more than threefold weeks before health officials knew about the outbreak. If OTC sales had been monitored, the logic goes, thousands of infections might have been prevented.