Laboratory-Guided Detection of Disease Outbreaks: Three Generations of Surveillance Systems

Abstract

Abstract Context.—Traditional biothreat surveillance systems are vulnerable to incomplete and delayed reporting of public health threats. Objective.—To review current and emerging approaches to detection and monitoring of biothreats enabled by laboratory methods of diagnosis and to identify trends in the biosurveillance research. Data Sources.—PubMed (1995 to December 2007) was searched with the combined search terms “surveillance” and “infectious diseases.” Additional articles were identified by hand searching the bibliographies of selected papers. Additional search terms were “public health,” “disease monitoring,” “cluster,” “outbreak,” “laboratory notification,” “molecular,” “detection,” “evaluation,” “genomics,” “communicable diseases,” “geographic information systems,” “bioterrorism,” “genotyping,” and “informatics.” Publication language was restricted to English. The bibliographies of key references were later hand searched to identify articles missing in the database search. Three approaches to inf...