The use of syndromic surveillance systems by state and local health departments for the detection of bioterrorist events and emerging infections has greatly increased since 2001. While these systems have proven useful for tracking influenza and identifying large outbreaks, the value of these systems in the early detection of bioterrorism events has been under constant evaluation [3,4].
The 2001 U.S. anthrax mailings, which followed a week after the tragic events of September 11th, highlighted the nation's vulnerability to bioterrorist attacks. This event, known by its FBI code name "Amerithrax," resulted in 22 known infections and five deaths in various east coast locations, including Connecticut . These cases enforced the need for an effective, federal, state, and locally-integrated biosurveillance system network that can provide early warnings to reduce casualties, as called for in U.S. Homeland Security Presidential Directive-21 (HSPD-21) and emphasized in recent CDC reports . This presentation reviews several post-2001 anthrax cases and the roles played by various biosurveillance systems in their identification. Recommendations for the use of modeling and the development of regional and national coordinated surveillance systems are also discussed.