Biology Reference
In-Depth Information
Initially, most of the work in developing the system involved convincing
new EDs to launch the system. In 2003, approximately 1 year after initiat-
ing NC DETECT, only about 12% of all ED visits were covered by the sys-
tem. For the system to be truly useful to health officials, more EDs had to
participate. In 2004, in a major breakthrough, the North Carolina General
Assembly enacted a bill mandating that all state EDs report their data to the
NC DETECT system (North Carolina General Assembly 2004). As of 2009,
North Carolina remained the only U.S. state with such a reporting mandate
on the topics. Following passage of the bill, ED coverage increased from
25% of all ED visits in 2004 to nearly 97% of visits by 2007. NC DETECT sys-
tem grew in other ways over that time period as well, incorporating infor-
mation from the Carolinas Poison Center, the emergency medical system,
and the Piedmont Wildlife Center (a regional center located in the center of
the state).
Although the justification for the NC DETECT system had always been
to provide early warning and thus information to protect against bioterror-
ist attacks or emerging infections,*
between 2001 and 2003 the NC DETECT
system was being used to enhance situation awareness of known threats.
For example, in 2003, the system was actively monitored to try to detect
imported cases of severe acute respiratory syndrome (SARS) although only
one case of SARS was diagnosed in North Carolina. In an attempt to dem-
onstrate the value of a system like NC Detect, in 2003 the Division of Public
Health attempted to replicate the data gained from the system from nonpar-
ticipating emergency departments in order to monitor the health effects of
Hurricane Isabel. The manual collection of data demonstrated the value of
the NC DETECT system since the manual collection of data was very time
consuming and costly. By 2007, with record heat scorching North Carolina,
the NC DETECT system was fully in place and ready to monitor a public
health situation across the state in real time.
16.4 “Exactly What You Go to School For”
In the summer of 2007, Rhonda Roberts, a 27-year-old with a master's degree
in epidemiology and biostatistics from the University of South Carolina, was
an employee of the North Carolina Division of Public Health. Roberts was
an example of the many Americans who had moved to North Carolina from
other parts of the United States since the early 1990s. Like many of these
* The mandate states that the purpose of the system is to track “threats that may result from (i)
a terrorist incident using nuclear, biological, or chemical agents or (ii) an epidemic or infec-
tious, communicable, or other disease.”
