Worldwide Biosurveillance Network Still a Distant Goal (UPDATED)

A measles outbreak and a deadly strain of flu that caused the deaths of some children this winter are just two examples of diseases that recently caught U.S. public health officials by surprise.

“The rate and scope and spread of the illnesses were not detected before severe consequences occurred,” said Jeff Runge, former chief medical officer for the Department of Homeland Security, and now director of the National Collaborative for Bio-Preparedness at the University of North Carolina-Chapel Hill. The West African Ebola outbreak was also unexpected, he added.

“These are cautionary tales underscoring the need for better biological intelligence,” he said at an Armed Forces Communications and Electronics Association homeland security conference.

Since the anthrax attacks of 2001, the U.S. government’s intention has been to create a global disease-monitoring system. This proposed network would be similar to weather services that report not only what is occurring now, but offers forecasts and predictions so governments, the public and private sectors can react. This regime would also include plant and animal diseases that pose threats to humans.

“It has been 10 years since we embarked on this, and progress has been quite slow,” Runge added.

President Barack Obama issued a national strategy on biosurveillance in 2012, which included a technology roadmap identifying research-and-development priorities.

The document said a biosurveillance network should provide essential information to decision-makers, said Navy Cmdr. Franca Jones, director of medical programs in the office of the assistant secretary of defense for nuclear, chemical and biological defense.

That information must be put in the hands of doctors, veterinarians, “all the way to a mayor that might be making a decision to stop a metro line from running,” said Jones, who helped co-write the national strategy while serving in the White House.

“We’ve got a lot of capability. We don’t have a lot of money to build new capability. [And] the capability we have is just not leveraged ideally,” she said.

Not only are federal agencies such as the Centers for Disease Control, and departments of Health and Human Services and Agriculture reluctant to share information, nations are as well, she noted.

“This entire enterprise is predicated on transparency, openness and sharing of data. Without the data, we can’t get information that is essential for decision-makers,” she added. “We need to figure out how to open the spigot.”

And that leads to privacy issues. Data must come from patients, and many hospitals and doctors will not share patient-level information even if identifiers are stripped away, she noted.

The network will also have to be global, Jones said. It’s not simply a homeland security problem. The Ebola outbreak that began in West Africa and spread to the United States is an example. Countries are going to have to share data with each other.

“We are only as strong as our weakest link,” she added. The ultimate goal is to be ahead of the curve when it comes to infectious diseases, Jones said. That would include forecasts on the spread of a disease and what the impacts would be if measures such as vaccination campaigns were taken.

Correction: The name of Cmdr. Franca Jones was misspelled.

Topics: Homeland Security, Disaster Response, Science and Technology