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Integrated Biosurveillance&Bioterrorism PreparednessAdvanced Briefing for IndustryDec, 2004: 

Integrated Biosurveillance & Bioterrorism Preparedness Advanced Briefing for Industry Dec, 2004 Telemedicine & Advanced Technology Research Center US Army Medical Research & Materiel Command

Slide2: 

Anthrax Cases in DC Flu Flu Flu Biosurveillance Challenges Outbreak Detection  Preparation, Response, Recovery Outbreak Attribution: Natural vs Accidental vs Intentional Data courtesy of Medstar & Georgetown University

Slide3: 

POTENTIAL DATA SOURCES FOR EPIDEMIC OUTBREAK DETECTION Enviroclimatic Travel Patterns Media Information Internet Traffic Government Reports Telecommunication Commerce TIME SPECIFICITY Syndromic Medical Surveillance RISK INDICATIONS & WARNINGS DIAGNOSED DISEASE School/Work Absenteeism Over-the-Counter Pharmacy Sales Unexplained Animal/ Human Deaths Nurse Triage Calls Stock Market Indices Clinical Signs Clinical Symptoms Test/Lab Orders Emergency Department Visits UNKNOWN MEDICAL DISTURBANCE CLINICAL PRE-DIAGNOSTIC Test/Lab Results Pathology Findings Autopsy Results

Biosurveillance Projects : 

Biosurveillance Projects ALADDIN – Automated Link Analysis for Data-Mining of Distributed Information Phase II SBIR - Charles River Analytics Bayesian Belief Network, clinical & non-clinical data Health Information Data Mining for Early Identification of Bioterrorism Phase II SBIR – Dynamics Technology AADP - Automated Anomaly Detection Processor, clinical & non-clinical data ESSENCE - Electronic Surveillance System for the Early Notification of Community-based Epidemics Worldwide daily syndromic surveillance of military outpatient clinic visits Evaluating incorporation of microbiology lab orders

Biosurveillance Projects: 

Venezuelan Equine Encephalitis Outbreak, 1995 Epidemic Start Point Epidemic End Point Biosurveillance Projects Enviroclimatic marker: Normalized Difference Vegetation Index Analysis of other data sources ongoing at ISIS Center - Georgetown Univ

Biosurveillance Projects – West Nile Virus: 

Month Apr Oct Precipitation 2002 2003 Biosurveillance Projects – West Nile Virus Month Apr Oct Environment 2002 Utah State Univ, ISIS Center - Georgetown Univ Assessment of Environmental Competence for Disease Transmission

Slide7: 

Progression of WNV Across the USA Utah State Univ, ISIS Center - Georgetown Univ

Biosurveillance Projects - SARS: 

Biosurveillance Projects - SARS Retrospective evaluation of data sources 10/02: enviro-clim – lowest temperature in 62 yrs 11/02: media – school, factory closings reported 2/03: socio-economic – stores, parks deserted 2/03: transportation – subways, buses deserted 2/03: telecom – increased cell phone text messaging 2/03: internet – PROMED “unusual pneumonia” WHO global alert issued 15 March 03 8 countries already involved, including US Ultimately >8400 people infected in 30 countries Case fatality rate up to 15% ISIS Center - Georgetown Univ

Biosurveillance Projects - Argus: 

Biosurveillance Projects - Argus Objectives Policy & legal review Prospective prototype Response issues Disease models SARS/Avian influenza Rift Valley Fever Geographic areas Asia/Pacific East Africa Data sources News Media Transportation Telecommunication Enviroclimatic MOH Websites ISIS Center - Georgetown Univ, Utah State Univ, NASA, Univ MD, AT&T, Purdue Univ

Slide10: 

Established at Drexel University in Philadelphia, 2000 Rural partner in western PA - St Francis Univ Web-based training a major focus www.cimerc.org Chem-bio self assessment survey Incident scenario guidebook Educational and informational resources Argentina effort – Spanish translations, evaluations Other potential collaboration

CIMERC Self Assessment Survey: 

- Completed within minutes - Expert opinions & references provided - Snapshot of local or regional readiness - Targeted resource allocation CIMERC Self Assessment Survey Sample questions…

CIMERC Problem Simulation Exercises20 Scenarios…: 

CIMERC Problem Simulation Exercises 20 Scenarios… Conventional Disasters Terrorism - Conventional Explosives Chemical Agent Release Infectious Disease Outbreak Contagious Disease Outbreak Nuclear/Radiological Incident

Future Directions: 

Future Directions Biosurveillance Incorporation of other data sources – animal, plant, biosensor Integration with response community National efforts & guidelines – BioSense, CDC, NBIS/NBIC, Military Bioterrorism Preparedness Targeted, modular advanced distributed learning Novel, simulation-based response training