Biology Reference
In-Depth Information
1994). Upon further review of this event, researchers noted that early indicators
regarding this outbreak included increased demands in antidiarrheal medica-
tions noticed by a pharmacist on April 1 and increased diarrhea-related calls
to local nurse hotlines on April 2 (Rodman, Frost, and Jakubowski 1998). An
important lesson learned from the Milwaukee cryptosporidiosis outbreak is
that the most crucial sources of data may not always be anticipated or obvious.
To improve international response to disease outbreaks, the WHO established
the Global Outbreak Alert and Response Network (GOARN). The GOARN
interlinks with a large number of existing networks worldwide to collect dis-
ease information and provide alertness and readiness to the global health com-
munity in the case of any disease outbreak (Heymann and Rodier 2001). The
procedure for outbreak alert and response has the following four phases: (1)
collection of reports or rumors of new outbreaks, (2) verification of the collected
data, (3) communication of the confirmed facts with national-level partners,
and (4) coordination of international assistance when required (Heymann and
Rodier 2001). Although the GOARN system represents an important first step
toward effective disease control and management, public health professionals
and organizations still need useful surveillance tools and systems that can help
them access and interpret this information in an accurate and timely manner.
Biosurveillance
involves the process of detecting and categorizing diseases
and disease outbreaks in people, animals, or plants by monitoring elements
in the environment that may cause these diseases. In turn,
biosurveillance
systems
are designed to collect existing health-related data and analyze this
information for the purpose of detecting disease cases, disease outbreaks,
and environmental conditions (e.g., contaminated drinking water in the local
area) that increase susceptibility to diseases (Fricker, Hegler, and Dunfee
2008). For example,
Biosense
is an initiative of the United States Centers for
Disease Control and Prevention (CDC) intended to “improve the nation's
capabilities for conducting real-time biosurveillance and enable health
situation awareness through access to existing data from healthcare orga-
nizations across the country” (CDC 2007). Another biosurveillance system
called
ESSENCE
(Electronic Surveillance System for the Early Notification
of Community-Based Epidemics) was developed by the U.S. Department of
Defense to detect both naturally occurring outbreaks of disease and poten-
tial bioterrorism attacks (Gilmore 2002).
Biosurveillance systems that can support early detection and real-time
interpretation of information represent a critical front line of defense for
modern epidemic and disease control. However, the effectiveness of biosur-
veillance systems such as Biosense and ESSENCE will greatly depend upon
how well their design supports their user's situation awareness (SA). In
this chapter, we argue that enhancing the user's SA is an important design
consideration for systems targeted at improving detection and response to
disease outbreaks. We first discuss the important role that SA plays in bio-
surveillance. We then present guidance for developing SA-oriented solu-
tions for optimizing the utility of biosurveillance systems. Our approach
