BioSurveillance

Information is imperative to detecting and intervening in a disease outbreak, but the enormous amount of information that public health leaders must sift through can become overwhelming and obstructive. In the disease outbreak environment, it is imperative to understand which sources of information add value and should be used for decision making in this limited timeframe. Recent research has found that social media sources and news media sources may provide indicators of disease outbreaks prior to traditional reporting sources (i.e. surveillance systems) (1). WHO uses informal information sources for about 65% of their outbreak investigations and relies on informal sources for daily surveillance activities (2).

Objective

Share the results of a survey on knowledge and attitudes regarding digital disease detection amongst ISDS members and share the resulting framework.

The National Biosurveillance Integration Center (NBIC) has the responsibility to integrate, analyze, and share the nationÍs biosurveillance information provided from capabilities distributed across the public and private sectors. The integration of information enables early warning and shared situational awareness of biological events so that critical decisions directing response and recovery efforts are well-informed and, ultimately, save lives. Emerging infectious diseases may disseminate internationally to the DHS workforce and/or domestic U.S. population. The growth of air travel facilitates rapid movement of people over international boundaries, enabling infected persons to travel great distances while potentially infectious to others. A large number of DHS personnel work in ports of entry in airports seaports and U.S. border states, encountering thousands of travelers a day and often encountering potentially infectious people in the course of their duties. The NBIC obtained intra- and interagency information to examine patterns of direct air travel to the U.S. from areas of activity for H7N9 flu and MERS-CoV in order to identify airports where U.S. personnel may more likely encounter potentially infectious travelers.

Objective

NBIC drew upon multiple sources of information to study ports of entry at higher risk for travelers who may have been exposed to emerging pandemic viruses, specifically Middle Eastern coronavirus (MERS-CoV) and (H7N9) Influenza A.

In emergencies, public health agencies must be able to respond to health threats that can affect entire communities. Agency leaders need to achieve situational awareness through the development of flexible, timely, and accurate electronic biosurveillance systems. Drawing on various sources, the North Carolina Preparedness and Emergency Response Research Center (NCPERRC) and Public Health Informatics Institute (PHII) developed recommendations for state and local public health agencies to build or enhance their biosurveillance capabilities.

Objective

To review and summarize best practices of thought leaders and implementers of biosurveillance systems with an emphasis on event-related situational awareness.

Chartered by the 'Implementing Recommendations of the 9/11 Commission Act of 2007' ® (Public Law 110-53), the National Biosurveillance Integration Center (NBIC) is housed within the Department of Homeland Security. The mission of NBIC is to enable early warning and shared situational awareness of acute biological events and support better decisions by federal agency partners and the agencies of state, local, and tribal governments. It does this through the rapid identification, characterization, localization, and tracking of biological events worldwide (whether they occur in the human, animal, plant, or environmental realms) that may have an impact on the U.S. homeland. During the spring of 2013 there were human disease outbreaks caused by two emerging novel viruses: Avian Influenza A (H7N9) virus in China and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in multiple countries in the Middle East and Europe. During these two events NBIC leveraged its expertise in enhancing collaboration and shared situational awareness among federal agencies.

Objective

To demonstrate NBIC's innovative approach in facilitating information sharing among U.S. federal agencies during the recent outbreaks of H7N9 influenza and MERS-CoV.

Los Alamos National Laboratory (LANL) has been funded by the Defense Threat Reduction Agency to develop tools that enhance situational awareness in infectious disease surveillance. We have applied the concept of the surveillance window to the development of a cross platform app (SWAP). This app allows the user to place information on case counts or disease occurrence in a specific location within the context of a historical outbreak curve to help determine whether prevention or mitigation action should be taken. By placing a frame of reference for where a case count is during an outbreak (in the early, peak, or late stages) and indicating whether the unfolding events are still within a surveillance window that would allow for feasible control, the app provides enhanced situational awareness of a decision maker. This tool therefore increases the granularity of situational awareness available to any user in the global biosurveillance community.

Objective

The goal of this project is to develop a cross platform app that contextualizes incoming information during an infectious disease outbreak based on historical data. The app makes use of a surveillance window concept in order to support decision making. This effort is part of a larger project with the goal of developing reference tools and analytics to provide decision-makers with timely information to predict, prepare for, and mitigate the spread of disease.

Electronic epi-biosurveillance presents an opportunity to provide real-time disease surveillance alerts from remote areas to central disease management units, to rapidly decrease reporting times for reportable diseases, and to enable appropriate response scenarios to be put in place in a timely manner. Over the past year, with the support of GEIS and Johns Hopkins Applied Physics Lab, we have piloted an electronic disease reporting system in four sites in the Cameroon military and evaluated these surveillance efforts, to understand how such infrastructure may impact this resource-limited setting.

Objective

Pilot and evaluate an electronic disease surveillance system in the Cameroon military and assess the capabilities of this system to fulfill reporting and early warning requirements.

Much attention has been given recently to the purported ability of social media to provide early warning and/or situational awareness and event characterization during a biological event of national concern. The National Biosurveillance Integration Center's (NBIC) innovation project on Social Media Analysis seeks to demonstrate the viability of extracting relevant, health information from social media data, with the ultimate goal to establish an operational social media system for biological event surveillance. Early work in this project has focused on demonstrating the relevance of social media to the biosurveillance problem through data analysis and algorithm development. Preliminary assessments of a commercial social media product also yielded valuable insights for the system architecture required to support such an operational tool. In addition to continued analysis of data utility (algorithm development) and system architecture, future work will include development of a comprehensive concept of operations (CONOPS) for implementation and use of a social media capability within the NBIC.

Objective

Through ongoing and future projects we will examine the utility of social media data for biosurveillance, including machine learning approaches for algorithm development, as well as the system and organizational architectures required to implement an operational system.