Appendix A
Study Activities

COMMISSIONED WORK

In two areas, the committee commissioned additional work by outside experts. David L. Buckeridge of McGill University conducted a modeling exercise to compare the timeliness of detection of biological threats via environmental air sampling, clinical case finding, and syndromic surveillance. Industrial Economics, Incorporated (IEc), a professional services firm, conducted an analysis of costs of the BioWatch program and of surveillance activities to detect biological threats through the public health and health care sectors.

COMMITTEE MEETINGS

The committee held three information-gathering meetings in Washington, DC, during the period July 2008 through November 2008. During these meetings the committee received briefings from federal, state, and local government officials; medical and laboratory professionals; and academic and private-sector researchers regarding biological threats, bioaerosol detection technologies, clinical diagnostic testing, and surveillance and detection of disease threats in clinical settings and through public health systems.

The first meeting, held on July 30–31, 2008, included speakers involved in creating the legislation relevant to the committee’s charge and speakers from selected federal agencies and professional organizations, as well as



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Appendix A Study Activities COMMISSIONED WORK In two areas, the committee commissioned additional work by outside experts. David L. Buckeridge of McGill University conducted a modeling exercise to compare the timeliness of detection of biological threats via en- vironmental air sampling, clinical case finding, and syndromic surveillance. Industrial Economics, Incorporated (IEc), a professional services firm, con- ducted an analysis of costs of the BioWatch program and of surveillance activities to detect biological threats through the public health and health care sectors. COMMITTEE MEETINGS The committee held three information-gathering meetings in Washing- ton, DC, during the period July 2008 through November 2008. During these meetings the committee received briefings from federal, state, and local government officials; medical and laboratory professionals; and aca- demic and private-sector researchers regarding biological threats, bioaero- sol detection technologies, clinical diagnostic testing, and surveillance and detection of disease threats in clinical settings and through public health systems. The first meeting, held on July 30–31, 2008, included speakers involved in creating the legislation relevant to the committee’s charge and speakers from selected federal agencies and professional organizations, as well as 8

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0 BIOWATCH ANd PuBlIC HEAlTH SuRVEIllANCE speakers presenting the scientific perspective on bioaerosol detection tech- nology and testing and a review of federal biosurveillance activities. At the second meeting, held September 22–24, 2008, the committee heard from speakers on the topics of bioterrorism risk and risk analy- sis, BioWatch as a risk-management response, the basis for the BioWatch approach, the current operational approach and future plans, environ- mental monitoring and public health surveillance and response, surveil- lance in public health and health care, and laboratory roles in BioWatch and in infectious disease surveillance in the public health and health care systems. Speakers were chosen for their expertise in their fields. At the third meeting, held November 3–5, 2008, the committee heard from speakers on the topics of critical information needs for decision mak- ers, index case recognition, point-of-care diagnostics, and other operational approaches to environmental monitoring for bioterrorism. The committee also heard briefings on aspects of the threat, on aerosol plume modeling, and on past and projected costs for BioWatch. The fourth and fifth meetings, held December 2–3, 2008, in Irvine, Cal- ifornia, and January 26–27, 2009, in Washington, DC, respectively, were deliberative and writing meetings during which the committee developed and refined its recommendations and the members of the committee worked together to draft the report. The committee also kept in close contact by telephone and electronic communication throughout the study. Invited Speakers The following individuals were invited speakers at meetings of the committee: Amy Altman, Ph.D. Diane Berry, Ph.D. Luminex Corporation Department of Homeland Security Atar Baer, Ph.D. Debora Boyle, D.V.M., Ph.D. Seattle-King County Department of University of Minnesota Health, WA Michael Brown, Ph.D. Vickie Baselski, Ph.D. Los Alamos National Laboratory University of Tennessee David Buckeridge, M.D., Ph.D. Paul Benda McGill University Pentagon Force Protection Agency Michael Bullard, M.D. Steven Bennett, Ph.D. University of Alberta, Edmonton Department of Homeland Security

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 APPENdIx A Svetlana Deyneka, M.D., M.P.H. Penny Hitchcock, D.V.M. North Carolina Division of Public Department of Homeland Security Health Harvey Holmes, Ph.D. Pamela Diaz, M.D. Centers for Disease Control and Centers for Disease Control and Prevention Prevention Robert Hooks Jeffrey Engel, M.D. Department of Homeland Security North Carolina Department of Richard Hopkins, M.D., M.S.P.H. Health and Human Services Florida Department of Health Hawazin Faruki, Dr.P.H. William Jenkins, Jr. Laboratory Corporation of America Government Accountability Office (GAO) Martin Fenstersheib, M.D., M.P.H. CAPT Malcolm Johns Santa Clara County Health Depart- ment, CA Department of Homeland Security P. Joseph Gibson, Ph.D., M.P.H. Robert Kadlec, M.D., M.T.M.H., M.A. Marion County Health Depart- ment, IN White House Mary Gilchrist, Ph.D. Lawrence Kerr, Ph.D. Massachusetts Department of Pub- National Counterproliferation lic Health Center Chevelle Glymph, M.P.H. Sara Klucking, Ph.D. Washington, DC, Department of Department of Homeland Security Health Gerald Kost, M.D., Ph.D. Ray Gordon University of California, Davis– Department of Homeland Security Lawrence Livermore National Laboratory James Hadler, M.D., M.P.H. Frances Ligler, D.Phil., D.Sc. Public Health Consultant Naval Research Laboratory Steven Hanna, Ph.D. COL Mark Malatesta Harvard School of Public Health Department of Defense Katherine Heilpern, M.D. Emory University

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 BIOWATCH ANd PuBlIC HEAlTH SuRVEIllANCE Patrick Mendonca Barry Rhodes, Ph.D. U.S. Postal Service Centers for Disease Control and Prevention Michael Osterholm, Ph.D., M.P.H. Edward Rhyne University of Minnesota Department of Homeland Security Tara O’Toole, M.D., M.P.H. Jeffrey Runge, M.D. Center for Biosecurity, University of Pittsburgh Medical Center Department of Homeland Security Herminia Palacio, M.D., M.P.H. Mary Shaffran, M.P.A. Harris County Public Health and Association of Public Health Environmental Services, Texas Laboratories Art Papier, M.D. Denise Sockwell, M.S.P.H. Logical Images, Inc. Virginia Department of Health Sudha Pottumarthy, Ph.D. Daniel Sosin, M.D., M.P.H. Houston Public Health Laboratory, Centers for Disease Control and Texas Prevention Rep. David Price, Ph.D. Jeffrey Stiefel, Ph.D. U.S. House of Representatives Department of Homeland Security Stephen Quake, D.Phil. Jerome Tokars, M.D., M.P.H. Stanford University Centers for Disease Control and Prevention INTERIM REPORT As called for by the Statement of Task, the committee prepared an interim report that outlined initial progress on addressing the major issues under consideration by the committee. The report was prepared at a point before conclusions or recommendations had been developed. It was released on February 10, 2009, and it is available at http://www.nap.edu/catalog. php?record_id=12599.