House Panel Discusses Development of Computerized Disease Surveillance Systems

Wanting to improve the federal government's ability to respond to a large-scale bioterrorist attack, members of the House Energy and Commerce Subcommittee on Oversight and Investigations on Nov. 1 heard several proposals for bolstering the nation's disease surveillance system using computers, USA Today reports. The government currently relies on physicians to notify health departments -- in writing -- about certain diseases, including anthrax. The doctor who diagnosed the first case of the anthrax last month -- in American Media Inc. editor Bob Stevens, who later died -- alerted health officials about the presence of the bacteria, possibly saving other lives. But according to subcommittee Chair James Greenwood (R-Pa.), the current system is antiquated and might not work in the event of a greater bioterrorist attack. "It is the equivalent of relying on the Pony Express in the age of the World Wide Web," he said, adding, "The anthrax outbreak is our fire bell in the night. We may not get another warning." Some of the early-warning systems under consideration include:

• The CDC's National Electronic Disease Surveillance System, or NEDSS, will be launched in 20 states next year. NEDSS is a "kind of electronic vacuum" that looks for disease trends by examining medical records, lab test results and "local vital statistics." Critics, however, say the system is "too complex" for doctors to use.
• Sandia National Laboratories, the University of New Mexico and the state's health department have developed a Web-based system called RSVP that allows doctors to enter details about "perplexing case[s]" into a Web site and then receive advice on how to treat the patient. The system also "automatically notifies the local health department."
• North Carolina-based Quintiles, which compiles insurance claims data for pharmaceutical companies, says it can "tap into" this system to track disease outbreaks (Sternberg, USA Today, 11/2).

Panel Suggests Gov't Vaccine Center
Meanwhile, a federal commission recommended on Nov. 1 that the government create its own facility to "develop and produce vaccines to combat bioterrorism," the Los Angeles Times reports. "The private sector is unlikely to be the answer to some of the more difficult vaccine issues," the bipartisan panel, which was appointed by Congress in 1999 and is headed by Virginia Gov. Jim Gilmore (R), wrote, adding, "Direct government ownership or sponsorship is likely to be the only reasonable answer for producing vaccines for certain bio-organisms -- anthrax and smallpox being at the top of the list." The Department of Defense estimated this summer that building a vaccine plant and operating it for the next 25 years would cost $1.56 billion. BioPort Corp. is currently the only producer of the anthrax vaccine; HHS is in the process of securing roughly 300 million doses of the smallpox vaccine by next year. For comprehensive public health information from the CDC on anthrax and other bioterrorism issues, please visit www.bt.cdc.gov.

Appointment News
In related news, HHS Secretary Tommy Thompson on Nov. 1 appointed Retired Army Major Gen. Philip Russell as "special adviser on vaccine development and production." Dr. Donald Henderson, who led the effort to eradicate smallpox and is advising Thompson on bioterrorism, was appointed as director of the new Office of Public Health Preparedness (Ornstein, Los Angeles Times, 11/2).