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A Survey of Usage Protocols of Syndromic Surveillance Systems by State Public Health Departments in the United States

Uscher-Pines, Lori; Farrell, Corey L.; Cattani, Jacqueline; Hsieh, Yu-Hsiang; Moskal, Michael D.; Babin, Steven M.; Gaydos, Charlotte A.; Rothman, Richard E.

Journal of Public Health Management and Practice: September-October 2009 - Volume 15 - Issue 5 - p 432–438
doi: 10.1097/PHH.0b013e3181a5d36b
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Objective To broadly describe current syndromic surveillance systems in use throughout the United States and to provide basic descriptive information on responses to syndromic system signals.

Methods Cross-sectional survey (telephone and e-mail) of state epidemiologists in all 50 states and the District of Columbia.

Results Forty-one states participated in the survey for a response rate of 80 percent. Thirty-three states (80%) had at least one syndromic surveillance system in addition to BioSense operating within the state. Every state with an urban area at highest risk of a terrorist attack reported monitoring syndromic surveillance data, and a state's overall preparedness level was not related to the presence (or lack) of operational syndromic surveillance systems. The most common syndromic surveillance systems included BioSense (n = 20, 61%) and RODS (n = 13, 39%). Seventy-six percent of states with syndromic surveillance initiated investigations at the state level, 64 percent at the county level, and 45 percent at both the state and county levels.

Conclusions The majority of states reported using syndromic surveillance systems, with greatest penetration in those at highest risk for a terrorist attack. Most states used multiple systems and had varied methods (central and local) of responding to alerts, indicating the need for detailed response protocols.

This study broadly describes current syndromic surveillance systems in use throughout the United States and provides basic descriptive information on responses to syndromic system signals.

Lori Uscher-Pines, PhD, is Postdoctoral Fellow, Department of Environmental Health Sciences, The Johns Hopkins School of Public Health. She has also served as a preparedness planner at the Philadelphia and New Jersey Departments of Public Health.

Corey L. Farrell, MPH, is Research Associate, Center for Biological Defense, University of South Florida. She is currently a BSN candidate at The Johns Hopkins University School of Nursing.

Jacqueline Cattani, PhD, is Professor of Global Health and is Director, Center for Biological Defense, University of South Florida.

Yu-Hsiang Hsieh, PhD, is Assistant Professor, Department of Emergency Medicine, The Johns Hopkins University School of Medicine.

Michael D. Moskal, MBA, is Vice President, CUBRC's Information Exploitation Sector.

Steven M. Babin, PhD, is a specialist in environmental and atmospheric sciences and environmental public health, with an interdisciplinary background in pathology, laboratory medicine, electrical engineering, and engineering physics. He is a Science Advisor to the Earth & Sky and A Moment of Science radio shows and a reviewer for more than eight scientific journals.

Charlotte A. Gaydos, DrPH, is Professor, Infectious Diseases, The Johns Hopkins University and is Director, International STD Research Laboratory.

Richard E. Rothman, MD, is Associate Professor, Department of Emergency Medicine and Division of Infectious Diseases, The Johns Hopkins University School of Medicine.

Corresponding Author: Lori Uscher-Pines, PhD, Department of Environmental Health Sciences, The Johns Hopkins School of Public Health, 1358 Indian Creek Dr, Wynnewood, PA 19096.

This study was supported in part by the US Department of Homeland Security through a grant (N00014-06-1-0991) awarded to the National Center for Study of Preparedness and Critical Event Response (PACER) at Johns Hopkins University. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not represent the policy or position of the Department of Homeland Security.

© 2009 Lippincott Williams & Wilkins, Inc.