Real-Time Public Health Biosurveillance

Systems and Policy Considerations
  • Henry Rolka
  • Jean O’Connor
Part of the Integrated Series in Information Systems book series (ISIS, volume 27)

Chapter Overview

Biosurveillance includes all efforts by public health officials to capture and interpret information about hazards and threats of public health significance, including naturally occurring outbreaks of diseases, reportable conditions and syndromes, occurrences of zoonotic diseases, environmental exposures, natural disasters, and conditions caused by acts of terrorism. Partnerships, such as those between governments and the private sector, non-governmental organizations, healthcare providers, public utilities, and the veterinary medicine community, are a critical component of a comprehensive approach to biosurveillance. Partnerships allow for the collection of data from diverse sources and allow for the inclusion of a range of stakeholders. However, establishing biosurveillance systems with the capacity to quickly collect, analyze and exchange diverse types of data across stakeholder groups is not without practical, technological, political, legal, and ethical challenges. This chapter first explores recent biosurveillance efforts, then examines the legal and policy structure and considerations associated with biosurveillance efforts, and finally provides a framework for considering the needs of stakeholders in the development of new biosurveillance systems.


Biosurveillance Public health Analytics Stakeholders Policy Law 


  1. 1.
    Centers for Disease Control and Prevention. National Strategy for Biosurveillance Coordination. In press.Google Scholar
  2. 2.
    U.S. Const. amend. X.Google Scholar
  3. 3.
    WHO. The world health report 2007 - A safer future: global public health security in the 21st century, 2007. [].
  4. 4.
    Thacker SB, Berkelman RL (1988). Public Health Surveillance in the United States.Epidemiol Rev, 10:164–90.PubMedGoogle Scholar
  5. 5.
    Jajosky RA, Groseclose SL (2004). Evaluation of Reporting Timeliness of Public Health Surveillance Systems for Infectious Diseases. BMC Public Health, 4:29.PubMedCrossRefGoogle Scholar
  6. 6.
    Prevent proliferation of weapons of mass destruction [website]. [].
  7. 7.
    Buckeridge DL, Burkom H, Campbell M, Hogan WR, Moore AW (2005). Algorithms for Rapid Outbreak Detection: A Research Synthesis. J Biomed Inform, 38:99–113.PubMedCrossRefGoogle Scholar
  8. 8.
    Lombardo J (2007). Disease Surveillance: A Public Health Informatics Approach. NewJersey: John Wiley and Sons.Google Scholar
  9. 9.
    Embrey EP, “Statement by Deputy Assistant Secretary of Defense for Force Health Protection and Readiness on The Role of Department of Defense Biosurveillance Efforts-Including ESSENCE - in Support of the National Biosurveillance Integration System(NBIS)”, Before the House Committee on Homeland Security, May 11, 2006.Google Scholar
  10. 10.
    Wagner MM, Espino JU, Tsui F-C, Gesteland P, Chapman WW, Ivanov O, Moore AW,Wong WK, Dowling J, Hutman J. Syndrome and Outbreak Detection from Chief Complaint Data: Experience of the Real-Time Outbreak and Disease Surveillance Project. Presented at the National Syndromic Surveillance Conference, New York Academy of Medicine, New York, October 20–24, 2003.Google Scholar
  11. 11.
    Public Health Security and BioTerrorism Preparedness and Response Act of 2002, Pub.L. No. 107–188, 116 Stat. 594.Google Scholar
  12. 12.
    Cecchine G, Moore M (2006). Infectious Disease and National Security: Strategic Information Needs, Prepared for the Office of the Secretary of Defense, RAND National Defense Research Institute. [].
  13. 13.
    Marburger J (2003). Keynote Address on National Preparedness by Director of the Office of Science and Technology Policy, Executive Office of the President. [].
  14. 14.
    National Center for Health Statistics. International Classification of Diseases Ninth Revision, Clinical Modification, Sixth Edition. [Accessible at:].
  15. 15.
    Bradley CA, Rolka H, Walker D, Loonsk J. (2005). BioSense: Implementation of a National Early Event Detection and Situational Awareness System. MMWR Morb Mortal Wkly Rep, 26(54 Suppl):11–9.Google Scholar
  16. 16.
    Sokolow LZ, Grady N, Rolka H, Walker D, McMurray P, English-Bullard R, Loonsk J(2005). Practice and Experience Deciphering Data Anomalies in BioSense. MMWR Morb Mortal Wkly Rep, 26(54 Suppl):133–9.Google Scholar
  17. 17.
    Kulldorff M (2001). Prospective Time Periodic Geographical Disease Surveillance Using a Scan Statistic. J R Stat Soc A, 164(1):61–72.CrossRefGoogle Scholar
  18. 18.
    Smith K (2006). Creating a Nation-wide, Integrated Bio-surveillance Network. Statement for the Record by Acting Deputy Chief Medical Officer, Department of Homeland Security to U.S. House of Representatives Committee on Homeland Security, Subcommittee on Prevention of Nuclear and Biological Attack. [].
  19. 19.
    Skinner RL (2007). Better management needed for the National Bio-Surveillance Integration System Program, U.S. Department of Homeland Security, Office of the Inspector General. [].
  20. 20.
    Jacobson v. Massachusetts, 197 U.S. 11 (1905).Google Scholar
  21. 21.
    U.S. Const. art I, § 8.Google Scholar
  22. 22.
    Neslund VS, Goodman RA, Hadler JL (2007). Frontline Public Health: Surveillance Field Epidemiology. In: Goodman R, Hoffman RE, Lopez W, Matthews GW, Rothstein MA, Foster KL, editors. Law in Public Health Practice, 2nd ed. New York: Oxford University Press. pp. 222–37.CrossRefGoogle Scholar
  23. 23.
    See, for example, South Dakota v. Dole, 483 U.S. 203 (1987).Google Scholar
  24. 24.
    Homeland Security Presidential Directive 10: Biodefense for the 21st Century (April 28,2004) [].
  25. 25.
    Pandemic and All Hazards Preparedness Act, Pub. L. No. 109–417, 120 Stat. 2831.Google Scholar
  26. 26.
    Homeland Security Presidential Directive 21: Public Health and Medical Preparedness(Oct 17, 2007) [].
  27. 27.
    National Commission on Terrorist Attacks against the United States (2004). 9/11Commission Report: Final Report of the National Commission on Terrorist Attacks against the United States, July 22, 2004. [].
  28. 28.
    International Health Regulations 2005. WHO: Geneva, 2006.Google Scholar
  29. 29.
    Wilson K, McDougall C, Upshur R (2006). The New International Health Regulations and the Federalism Dilemma. PLoS Med, 3(1):e1. [].
  30. 30.
    C.F.R. § 160.202.Google Scholar
  31. 31.
    U.S. Const. amend. V.Google Scholar
  32. 32.
    U.S. Const. amend. IV.Google Scholar
  33. 33.
    Davenport TH, Harris JG (2007). Competing on Analytics. Boston, MA: Harvard Business School Press, pp. 153–73.Google Scholar
  34. 34.
    Schum DA (1994). The Evidential Foundations of Probabilistic Reasoning. New York:John Wiley and Sons, Inc.Google Scholar

Suggested Reading

  1. 1.
    Homeland Security Presidential Directive 10: Biodefense for the 21st Century (April 28,2004) [Available at:].
  2. 2.
    International Health Regulations 2005, WHO: Geneva, 2006.Google Scholar
  3. 3.
    Lombardo JS. Disease Surveillance: A Public Health Informatics Approach.Google Scholar
  4. 4.
    National Commission on Terrorist Attacks against the United States (2004). 9/11 Commission Report: Final Report of the National Commission on Terrorist Attacks Against the United States, July 22, 2004. [Available at:].
  5. 5.
    Pandemic and All-Hazards Preparedness Act, Pub. L. No. 109-417, 120 Stat. 2831.Google Scholar
  6. 6.
    Homeland Security Presidential Directive 21: Public Health and Medical Preparedness(Oct 17, 2007) [Available at:].
  7. 7.
    Wagner J. Handbook of Biosurveillance.Google Scholar

Online Resources

  1. 1.
    BioSense Website (
  2. 2.
    Centers for Disease Control and Prevention Website (
  3. 3.
    Health Level-7 Messaging Website (
  4. 4.
    International Health Regulations Website (

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Office of Critical Information Integration and Exchange, National Center for Zoonotic, Enteric, and Vector-borne DiseasesCenters for Disease Prevention and ControlAtlantaUSA

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