We have taken into account the following information you have provided concerning the data that are to be transmitted to the GDR, recognizing that DTRA is currently considering many details regarding this issue:
In summary, the data that are transmitted to the GDR will consist of (a) periodic reports that aggregate and analyze individual data points, (b) laboratory data that are particularly relevant to outbreaks and trends, (c) medical findings with regard to patients of particular concern, keeping in mind the importance of protecting privacy information, and (d) animal sampling information that is relevant to human health concerns.
Data that are transmitted will include all positive findings for the 16 agents, classes of agents, and diseases of interest to DOD/DTRA, which are as follows: anthrax (human and animal); brucellosis (human and animal); plague; tularemia; smallpox virus; Crimean-Congo hemorrhagic fever; tick-borne encephalitis; fevers of unknown origin requiring hospitalization; flu-like symptoms requiring hospitalization; foot and mouth disease; rinderpest; sheep, goat, and camel pox; highly pathogenic Newcastle disease; highly pathogenic avian influenza; glanders; and classical swine fever. Positive findings should be accompanied by information concerning the sources of illnesses. In some cases, DTRA should be more specific as to whether animal and/or human data are of interest for the diseases. Also, the committee is particularly concerned about the omission of pneumonia, which could be associated with tularemia and plague.
Data on other pathogens or diseases will be transmitted if host countries decide to transmit such data. There is no DTRA requirement in this regard, although EIDSS is capable of handling data concerning other pathogens and diseases.
Flow of data to the GDR will be nearly real-time as data flow into EIDSS in host countries. However, one host country will not have direct access to data from another host country via EIDSS, and access via the GDR is yet to be determined. In the case of an outbreak, cross-country data sharing is presumably anticipated.
Epidemiological data sheets will be prepared and transmitted as appropriate; they should indicate the significance of information of particular interest, including the results of tests involving patients.
DTRA will limit dissemination of data by the GDR to U.S. government departments and agencies (although this current position is under review). It is anticipated that at a future date, DTRA will define the extent of this limitation.
Also, we note that specialists from the Centers for Disease Control and Prevention (CDC) have already provided you on an informal basis with preliminary comments on many of the details of EIDSS, and particularly the types of information that should be included and the formatting of information.
I am sure you recognize that greater definition of the information content throughout the TADR network is required; therefore, this letter report addresses only general aspects of EIDSS and the GDR within the broader context of the overall TADR network.