Fifteen years have passed since the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 called for the establishment of nationwide surveillance and reporting mechanisms to detect bioterrorism-related events. In the 1990s, several health departments established surveillance systems to detect prediagnostic (ie, before diagnoses are confirmed) signs and symptoms for the early identification of disease occurrences. However, it was the 2002 act, following the September 11 and anthrax attacks, that provided the impetus and resources for the growth of syndromic surveillance across the country. Syndromic surveillance is now a core component of many US health departments’ surveillance activities. Public health practitioners use it daily to identify potential events of public health concern, track disease trends, and inform responses to confirmed and rumored events. Syndromic surveillance also provides real-time information for health events that are not supported by case reporting or laboratory reporting, such as injuries and suicidality.
This supplemental issue of Public Health Reports contains 18 articles that describe the use of syndromic surveillance for event identification, situational awareness, and enhanced response to diseases, conditions, and activities that affect population health. The data used in syndromic surveillance can come from various sources, but the articles in this supplement focus on the use of electronic health record (EHR) data from clinical settings. The articles describe the value of real-time data for public health decision making and the challenges of collecting and interpreting data that are generated primarily for health care practice and billing purposes.