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Biowatch and Public Health Surveillance: Evaluating Systems for the Early Detection of Biological Threats - Abbreviated Version
if a large-scale aerosol attack occurs where BioWatch is deployed, if an airsampler lies in the path of the release, and if the pathogen used is one ofthose included in the BioWatch laboratory assays. To date, the BioWatchsystem has generated dozens of BioWatch Actionable Results, none ofwhich has been associated with bioterrorism or human illness. The annualized direct cost of continuing the current program (Generation 2) overthe next 10 years is estimated to be $80 million; if the planned transitionto the timelier and more widely deployed Generation 3 is successful, theestimated annualized direct cost for acquisition and operation over 10 yearsis $200 million.
Given the BioWatch system’s serious technical and operational challenges and its costs, DHS should assess its effectiveness and frame programgoals from a risk-management perspective; conduct systematic operationaltesting of current and proposed BioWatch technologies; establish an external advisory panel with technical and operational expertise; and strengthencollaboration and coordination with public health officials in BioWatchjurisdictions.
Infectious disease surveillance through the public health and health caresystems is broader and more flexible than BioWatch, having the potential todetect infectious diseases resulting from various exposures. Surveillance isan essential activity for health departments at local, state, and federal levelsand relies on information from health care providers and laboratories in thepublic and private sectors. But insufficient data are available to measure theoverall costs and effectiveness of infectious disease surveillance.
To enhance disease surveillance capabilities, the Department of Healthand Human Services (HHS) should lead efforts to develop, test, and evaluate new disease surveillance methods and technologies to improve clinicalrecognition and reporting of infectious diseases of concern. DHS and HHSshould aim to integrate BioWatch’s health protection role more effectivelyinto a stronger, nationally coordinated public health surveillance systemand should further the development of mechanisms for improving situational awareness of biological threats, including secure sharing of relevantintelligence information with state and local health officials. DHS and HHSshould also collaborate to build and sustain essential state and local workforce and operational capacities for detecting and responding to diseaseoutbreaks and biological attacks.
Concern about the possibility of bioterrorism and epidemics of emerging infectious diseases has spurred interest among the national security, public health, and health care communities in developing new and better ways to detect biological threats as quickly as possible so that preventive measures or treatment can be started in time to reduce illnesses and deaths.