Julie A. Pavlin

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Concern regarding the use of biological agents (bacteria, viruses, or toxins) as tools of warfare or terrorism has led to measures to deter their use or, failing that, to deal with the consequences. Unlike chemical agents, which typically lead to severe disease syndromes within minutes at the site of exposure, diseases resulting from biological agents have(More)
The deliberate use of microorganisms and toxins as weapons has been attempted throughout history. Biological warfare has evolved from the crude use of cadavers to contaminate water supplies to the development of specialized munitions for battlefield and covert use. The modern development of biological agents as weapons has paralleled advances in basic and(More)
INTRODUCTION The paucity of outbreak data from biologic terrorism and emerging infectious diseases limits the evaluation of syndromic surveillance systems. Evaluation using naturally occurring outbreaks of proxy disease (e.g., influenza) is one alternative but does not allow for rigorous evaluation. Another approach is to inject simulated outbreaks into(More)
The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and(More)
Syndromic surveillance refers to methods relying on detection of individual and population health indicators that are discernible before confirmed diagnoses are made. In particular, prior to the laboratory confirmation of an infectious disease, ill persons may exhibit behavioral patterns, symptoms, signs, or laboratory findings that can be tracked through a(More)
BACKGROUND Many infectious disease outbreaks, including those caused by intentional attacks, may first present insidiously as ill-defined syndromes or unexplained deaths. While there is no substitute for the astute healthcare provider or laboratorian alerting the health department of unusual patient presentations, suspicious patterns may be apparent at the(More)
BioSense is a US national system that uses data from health information systems for automated disease surveillance. We studied 4 time-series algorithm modifications designed to improve sensitivity for detecting artificially added data. To test these modified algorithms, we used reports of daily syndrome visits from 308 Department of Defense (DoD) facilities(More)
With the spread of avian influenza, use of automated data streams to rapidly detect and track human influenza cases has increased. We performed correlation analyses to determine whether International Classification of Diseases, Ninth Revision (ICD-9), groupings used to detect influenzalike illness (ILI) within an automated syndromic system correlate with(More)
INTRODUCTION The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE II) is a prototype syndromic surveillance system for capturing and analyzing public health indicators for early detection of disease outbreaks. OBJECTIVES This paper presents a preliminary evaluation of ESSENCE II according to a CDC framework(More)
S i119 entered by the BCDS into a database and analyzed using descriptive statistics and graphing techniques. Daily values are analyzed using a variation of the Shewhart control chart method. Graphs have four components: (1) daily data plotted for each syndrome, (2) an average of all values plotted to date, (3) upper and lower confidence levels (99.7%) for(More)