San Francisco

A system designed to track attacks involving bioweapons could also monitor the worldwide spread of infectious disease, its developers say.

Al Zelicoff, a disease surveillance expert at Sandia National Laboratory in New Mexico, presented evidence supporting the idea to a meeting of disease surveillance experts at Stanford University in Palo Alto, California, on 11 May.

The US government funded the Rapid Syndrome Validation Project (RSVP) to monitor background levels of illness against which a bioterrorist attack would stand out. “If you don't know what the noise is in a community, you sure can't find a signal above it,” Zelicoff says.

At the moment, monitoring relies on clinicians to report dangerous diseases, he adds. But often they fail to do so, because most see so few cases of the maladies that they do not recognize them. As a result, outbreaks can take several weeks or more for epidemiologists to spot (see News Feature, page 232).

RSVP, which has been in use at the University of New Mexico hospital in Albuquerque since November, does not require a diagnosis. Instead, the physician enters into a computer terminal the details of any patient with one of six syndromes, such as acute respiratory distress syndrome, influenza-like illness or acute hepatitis.

The information goes over the Internet to a server in Zelicoff's office, where software identifies combinations of symptoms likely to indicate a dangerous illness. These details are then forwarded to the New Mexico state epidemiologist.

This rapid reporting already appears to have this year averted two outbreaks of hepatitis A. In both cases, the physician ordered blood tests to determine the type of hepatitis only after prompting from a state official notified by RSVP.

The physicians using RSVP also prescribed far fewer antiviral drugs for flu this year than last, probably because they got immediate information on whether or not there was any flu in their patient's community.

A major private health organization in New Mexico plans to adopt RSVP, Zelicoff says, and he is also seeking funding to try the system in other countries, where any doctor with an Internet link could potentially join it.