James Wilson, V, MD, (ISIS Center, Georgetown University), IceAxe5@aol.com
The frequency of biological events relevant to national security is increasing, and current US disease surveillance systems have demonstrated failure to detect these events in a timely fashion. Examples include the HIV/AIDS pandemic, the escape of Rift Valley Fever from Africa, the foot and mouth disease pandemic, West Nile virus translocation to the US, post-9/11 anthrax attacks, SARS, and recently, the translocation of monkeypox to the US. The clear and present danger to the US spans human, animal, and plant infectious disease. Current biosurveillance by the United States is heavily focused on peri-event markers for epidemic activity gleaned almost exclusively from human medical surveillance data. These peri-event markers (e.g., positive biosensor detection per BioWatch) typically provide responders lead-time to response on the order of days. Surveillance systems are ,stovepiped, across multiple agencies with no integrative alerting capability, contributing to the lack of rapid, timely alerting. Much of the current expenditure in biodefense research is focused on response capability without balanced consideration of enhancing the current national surveillance capability. Indications and Warnings (I&Ws) provide the capability to alert US responders of an imminent biological event weeks to months in advance and thus are considered pre-event markers. In effect, I&Ws have the potential to ,prime, the national response infrastructure by alerting agencies of an evolving threat that could ultimately be catastrophic. Sources of I&Ws include human, veterinary, zoological park, and insect vector surveillance; media; internet and telecommunication traffic; commerce; economic indices; ,farm to fork, agricultural and food production surveillance; and ground climatological and remotely sensed environmental indices. Retrospective analyses of major biological events such as West Nile Virus and SARS have revealed multiple I&Ws were present weeks to months in advance in multiple disparate data sources but were unable to be recognized and utilized properly by the national response community. Key obstacles to I&W research, development, and integration include lack of recognition by the homeland security and public health communities due to the disparate data sources needed for the analysis. Monitoring I&Ws requires robust situational awareness by the analyst and broad capability to cross multiple traditional mission statements and scientific disciplines. Further, data security and assurance is complex when considering the number of data streams involved that are unclassified, proprietary, and classified. Once I&Ws enter the classified environment, it is difficult to mobilize the information in a timely fashion to local responders. However, solutions are currently being investigated. Integration of I&Ws in the biosurveillance strategy is a critical need for US biosecurity. Given the increased frequency of bioevents over the past 20 years, an integrative strategy that spans the human and agricultural biodefense concerns is a necessity.