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Biosurveillance

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Definitions[]

Biosurveillance (BSV) is

“ the process of active data-gathering with appropriate analysis and interpretation of biosphere data that might relate to disease activity and threats to human or animal health — whether infectious, toxic, metabolic, or otherwise, and regardless or intentional or natural origin — in order to achieve early warning of health threats, early detection of health events, and overall situational awareness of disease activity.[1] ”
“ the process of gathering, analyzing, and interpreting data in order to achieve early detection and warning and overall situational awareness of biological events with the potential to have catastrophic human and economic consequences.[2] ”

History[]

Since at least the 1990s, there has been an ongoing and evolving effort by the federal government in conjunction with its partners to address the need for a strategic approach to improving disease surveillance and response. Recognizing the potentially devastating consequences that could flow from biological events — both natural and intentional — responsible federal officials and other experts have, in various formats, called for better integration of multiple disparate surveillance and related mission activities to help support a strong national biosurveillance capability. Recently, the use of social networks to monitor public information streams has emerged as a method to improve the sensitivity of biosurveillance systems.

Overview[]

Biosurveillance represents a new paradigm for public health information that seeks to integrate and efficiently manage health-related data and information across a range of information resources. The dual purposes of biosurveillance are (1) to detect as early as possible a potentially catastrophic biological event and (2) to enhance situational awareness — including awareness, comprehension of meaning, and projection into the near future about events — by improving the quality of information available to support response and policy actions in the face of such an event.

The primary goal is to create decision advantage over the life cycle of a health event by achieving timely and accurate situation awareness of population health. While traditional public health surveillance contributes to situation awareness, it alone is not sufficient to meet the information needs for situation awareness across the phases of an event (i.e., pre-event, detect, respond, recover).

Differences from public health surveillance[]

There are a number of differences between traditional public health surveillance and biosurveillance for human health. Biosurveillance, for example, includes information about human health that can be preliminary and indicative of health problems, such as groups of disease symptoms (syndromes) and laboratory test orders. Biosurveillance also includes collecting relevant information about animals (domestic and wild), plants, and the environment and may be recorded in quantitative or qualitative form, such as in health-care provider notes and news reports. Traditional public health surveillance focuses on the collection, analysis, and dissemination of data on individuals (i.e. cases) diagnosed with or suspected of having a disease, injury, or an exposure of public health importance. Known as case-based surveillance, this type of surveillance is used when regular, frequent, and timely information on individuals is needed to make inferences about factors that increase the likelihood of illness among individuals, or, in other words, put them at risk of getting the illness. This information is needed to prevent or control the disease, condition, or exposure. Cases may be reported at the individual level or as aggregate counts. When reported as aggregate counts the data are used, not for drawing inferences about risk factors, but rather to monitor whether the amount of illness in the population is increasing or decreasing.

Characteristics[]

Biosurveillance processes and systems are characterized by the following:

  • Dependent on quality data and information.
  • Flexible to balance and meet the need for speed, scale and specificity.
  • Adaptive to the information needs of an event and has capabilities that extend beyond public health surveillance to support the breadth of information requirements across phases of an event.
  • Scalable, allowing the needed granularity of information at the local level while addressing the need for situation awareness at other levels, based on their roles and responsibilities.
  • Supports the sharing of data across all levels of government for acute events, but does not necessitate the sharing of all data across all levels.
  • Sustainable, allowing activities that result in a successful biosurveillance initiative to be viewed as core activities of all the key stakeholders that comprise the system.
  • Possesses notification and reporting channels and information products that are well characterized, explicit, and designed to optimize situation awareness among all public health responders with a need to know.
  • Provides the ability to capture unanticipated incidents through reliance on human judgment.
  • Requires a skilled workforce.

Functions[]

A successful biosurveillance capability comprises the following functions:

  • Case detection: Discovery of the existence of single instances of a specific disease or exposure.
  • Cluster detection: Continuous analysis of aggregate health-related data to detect unusual patterns or conditions that may signal an adverse human health event.
  • Integration: The integration of multiple and disparate sources of data and information.
  • Signal validation: Confirmation of acute public health events that require investigation or a response.
  • Event characterization: Processes that specify the causative agent, source, route of transmission and other characteristics of an event in order to guide effective response actions.
  • Notification and communication: Processes that ensure that persons with the need and right to know have the information they need as soon as the information is available and that all users understand their responsibilities for use and management of the information.
  • Quality control/improvement: Measurement to confirm that objectives are being met. An integrated biosurveillance capability at all levels of government will enable more timely, comprehensive, all-source, analyzed, and accessible information for decision making.

Challenges[]

Challenges in achieving an integrated and nationwide biosurveillance system in the United States include:

  • the need for the federal government to collaborate with the primary owners of these data, that is, with State, tribal, territorial, and local government and with organizations and individuals outside of government.
  • the wide range of sources of health-related data, including public health, environmental, plant, animal or vector monitoring systems, laboratories, medical records, administrative records, police records, vital records (e.g., birth and death certificates), and non-traditional sources such as open press and classified reporting.

A key requirement will be to develop methodologies, tools, and models to systematically harvest and contextualize all sources of biosurveillance data. Integrating other sources, such as social biosurveillance models, will also be important for early identification of outbreaks.

Laws and Presidential Directives[]

The following is a list, in chronological order, of the laws and Presidential Directives issued to date that relate to biosurveillance:

References[]

  1. ↑ Homeland Security Presidential Directive 21.
  2. ↑ Numerically Controlled Industrial Equipment: Progress and Problems, at 5.

Source[]

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