Biosurveillance for Early Detection - BioWatch (Efficacy and Limitations)

Biosurveillance for Early Detection – BioWatch (Efficacy and Limitations)

 

Author: Manisha Samy

 

            It is of no wonder why early detection of an anthrax attack is beneficial in reducing mortality rates as well as preventing a disastrous disturbance in the system. Fear, terror, panic, shortages of emergency response, etcetera can all wreak havoc during a bioterrorist attack. Early detection can allow ample time for communicating necessary emergency response without undue stress. Necessary pharmaceuticals can be deployed ahead of time and preventative measure can be taken. In a best case scenario, the attack can be halted, through evacuation for example, before the anthrax attack has time to infect individuals. Early detection has also been modeled in reducing mortality significantly by allowing timely treatment after exposure as modeled by Bravata et al. There are four primary modes of detection methods including syndromic surveillance, alternative surveillance systems, laboratory surveillance and environmental surveillance (Kman).

Syndromic Surveillance: Syndromic Surveillance is driven by suspicion. Health departments are able to recognize increases in disease incidences before any formal diagnoses by monitoring “nonspecific, prediagnostic indicators for disease outbreaks in near real-time” to provide early warning of infectious diseases in communities (Kman). The 2001 anthrax attacks were detected through syndromic surveillance (Shea).

Alternative Surveillance Systems: The CDC has taken syndromic surveillance a step further through systems such as the Early Aberration Reporting System (EARS), which uses nontraditional public health data sources including school absentee rates, over-th-counter medication sales, 911 calls, and ambulance data in order to monitor indicators of disease (Kman). The 2007-2008 flu season marked a novel approach in epidemiological surveillance as Google Inc developed an incident report through monitoring health-seeking behavior of millions of users per day through queries made using search engines (Kman). Biosurveillance has taken a whole new turn with the ever-growing processing powers of Silicon Valley. Biocomputation seems to have a bright future in future bioterrorism attacks.

Laboratory Surveillance:  In joint efforts, the CDC, FBI, and the Association of Public Health Laboratories (APHL) established the Laboratory Response Network (LRN) of 120 labs in 1991 with the mission to “maintain an integrated network of laboratories that are fully equipped to respond to acts of chemical or biological terrorism, emerging infectious diseases, and other public health emergencies” (Kman). The LRN is also largely responsible for creating a set of standard protocols for handling, identifying, and reporting potential biological agents within a national security context (Kman).

Environmental Surveillance: Remote detection systems and point detections systems are two categories of environmental surveillance. Remote detection systems monitor for potential through observing aerolized masses or clouds and informing the appropriate public health personnel whilst point detection systems are those that sample an environmental source for quick diagnosis (Kman). BioWatch is one of the primary biosurveillance systems put into place for anthrax detection.

Issues with BioWatch:

BioWatch was introduced in 2003 by the Department of Homeland Security with the goal of detecting large releases of biological weapons through aerosol release through 500 sensors located in 31 urban areas throughout the Unites States (Shea). Already, the BioWatch presents the issue of only being able to detect large mass biological attacks rather than low to mid-scale attacks. Furthermore, critics are wary over claims that sensors can detect indoor or underground releases such as within the subway system (Shea). When considering that, according to the White House, 14% (or $38 million) of the Biological Countermeasures budget will be spent on the BioWatch program, a huge predicament presents itself (Shea). Although the location of the sensors are not of public knowledge, the fact that all of them are located in urban areas only presents an equity issue for those people who live in rural areas. Also, there is no hard evidence that the next bioterror attack will necessarily occur in a rural setting. The point of these attacks is to catch our country off guard, not fall into its surveillance methods. Spending 14% of our countermeasure budget just on large-scale aerosol biological weapon detection in urban areas does not seem to be the optimal use of the budget. The detection capability of BioWatch is too narrow for the amount of funding it receives. Perhaps using part of the BioWatch funding on vaccination countermeasures may prove to be more useful.

 

Putting it all together:

 

It seems to me that although all four of these biosurveillance systems seem necessary and useful, they are too disjointed. Using all four avenues of detection in a more collaborative manner may provide more value to public health officials. Transparency amongst federal and private biosurveillance systems may also reduce any false-positive alarms of a bioterror attack, or even better, may counter a false-negative bioterror attack.

 

___

Nicholas E. Kman and Daniel J. Bachmann, “Biosurveillance: A Review and Update,” Advances in Preventive Medicine, vol. 2012, Article ID 301408, 9 pages, 2012. doi:10.1155/2012/301408

Shea, Dana A., and Sarah A. Lister. "The BioWatch Program: Detection of Bioterrorism."The BioWatch Program: Detection of Bioterrorism. Congressional Research Service Report No. RL 32152, 19 Nov. 2003. Web. 29 May 2013.