Following the attacks of September 11, 2001 and the anthrax letters, the ability to detect biological threats as quickly as possible became a top priority. In 2003 the Department of Homeland Security (DHS) introduced the BioWatch program--a federal monitoring system intended to speed detection of specific biological agents that could be released in aerosolized form during a biological attack.

The present volume evaluates the costs and merits of both the current BioWatch program and the plans for a new generation of BioWatch devices. BioWatch and Public Health Surveillance also examines infectious disease surveillance through hospitals and public health agencies in the United States, and considers whether BioWatch and traditional infectious disease surveillance are redundant or complementary.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON EFFECTIVENESS OF NATIONAL BIOSURVEILLANCE SYSTEMS: BIOWATCH AND THE PUBLIC HEALTH SYSTEM
• Reviewers
• Preface
• Acronyms and Abbreviations
• Summary
• 1. Introduction and Background
  • STUDY CHARGE AND COMMITTEE MEMBERSHIP
  • SCOPE OF THE STUDY
  • CURRENT FEDERAL FUNDING FOR CIVILIAN ACTIVITIES FOR DEFENSE AGAINST BIOLOGICAL THREATS
  • BIOLOGICAL THREATS TO HUMAN HEALTH
  • DETECTING BIOLOGICAL THREATS
  • TERMINOLOGY
  • CONSIDERATIONS GUIDING THE COMMITTEE’S WORK
  • RELATED ACTIVITIES
  • THE COMMITTEE’S REPORT
  • REFERENCES
• 2. The BioWatch System
  • BIOWATCH PROGRAM PLANNING AND MANAGEMENT
  • BIOWATCH OPERATIONS
  • RESPONSE TO A BIOWATCH ACTIONABLE RESULT
  • COSTS OF THE BIOWATCH SYSTEM
  • REFERENCES
• 3. Evaluation of the BioWatch System
  • EVALUATION OF THE CURRENT BIOWATCH SYSTEM
  • PERFORMANCE OF BIOWATCH TECHNOLOGY
  • PUBLIC HEALTH RESPONSE TO A BAR
  • PLANS FOR BIOWATCH GENERATION 3
  • CHALLENGES TO DEVELOPMENT OF GENERATION 3 TECHNOLOGY
  • BIOWATCH PROGRAM PLANNING AND MANAGEMENT
  • REFERENCES
• 4. Detecting Biological Threats Through the Public Health and Health Care Systems: Current Status
  • FRAMEWORK FOR INFECTIOUS DISEASE SURVEILLANCE
  • SURVEILLANCE OF INFECTIOUS DISEASES
  • DATA INTEGRATION AND SITUATIONAL AWARENESS
  • PUBLIC HEALTH RESOURCES FOR DISEASE SURVEILLANCE
  • CONCLUDING REMARKS
  • REFERENCES
• 5. Enhancing Surveillance to Detect and Characterize Infectious Disease Threats
  • LEGALLY MANDATED REPORTING
  • AUTOMATION OF HEALTH CARE INFORMATION SYSTEMS AND PUBLIC HEALTH LINKAGES
  • LABORATORY AND DIAGNOSTIC TESTING CAPACITY
  • INFORMATION INTEGRATION AND KNOWLEDGE SHARING
  • NATIONAL BIOSURVEILLANCE STRATEGY
  • COSTS OF INFECTIOUS DISEASE SURVEILLANCE AND ENHANCEMENTS
  • RECOMMENDATIONS
  • REFERENCES
• 6. BioWatch and Enhanced National Biosurveillance Resources
  • EXPLORING THE EFFECTIVENESS OF BIOSURVEILLANCE RESOURCES
  • EXAMINING THE POTENTIAL FOR EARLIER DETECTION TO IMPROVE OUTCOMES
  • AN ECONOMIC PERSPECTIVE ON COSTS AND BENEFITS OF BIOWATCH
  • COMPLEMENTARY SURVEILLANCE ROLES FOR BIOWATCH AND PUBLIC HEALTH AND HEALTH CARE
  • INCORPORATING BIOWATCH INTO AN ENHANCED NATIONAL SURVEILLANCE SYSTEM
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• Appendix A Study Activities
• Appendix B Glossary
• Appendix C Summary of Research into the Costs of Enhanced Public Health Surveillance Systems
• Appendix D Biographical Sketches of Committee Members

This study was supported by Contract No. HSHQDC-08-C-00043 between the National Academy of Sciences and the Department of Homeland Security. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine) and NRC (National Research Council). 2011. BioWatch and public health surveillance: Evaluating systems for the early detection of biological threats. Abbreviated version. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.