Harvard Hospital To Ready Nation for Biological Threats

Amid heightened concerns over biological and chemical attacks on the U.S., the Centers for Disease Control (CDC) last week announced that it awarded the Harvard Consortium-Harvard affiliated hospitals and research facilities-$1.2 million to develop a nationwide plan for monitoring and controlling potential epidemics.

A version of the plan, developed locally by Harvard Medical School epidemiologist Richard Platt, is already operating in the Boston metropolitan area.

"[The system] works by counting the number of people who seek care because they might have the earliest manifestations of biological agents," Platt said.

Platt hopes his system will alert the public to not only biological attacks, but also to epidemics that arise naturally.

"The signals that we're looking for won't be limited to bioterrorism," Platt said. "The best we can do is notice clusters of symptoms."

Each day, the program electronically collects data submitted to health care plans and researchers track clusters of illnesses above regional norms.

Since doctors do not need to file additional paperwork, the system should prevent delays in the count, said Platt.

"We're looking for the syndromes which are early manifestations of bioterrorism," Platt said. "For example, lower lung ailments are the earliest manifestation of [inhaled] anthrax."

Unlike the current system in New York City, which relies on emergency room reports and ambulance dispatches, Platt's program focuses on personal physicians' initial reports on their patients who present with the earliest symptoms of more serious diseases.

"This system is complimentary," said Stephen L. Solomon, the CDC's acting director of the Division of Health Care Quality Promotion. "There are a number of other systems in place and in development. This allows us to track outpatients also."

By actively seeking out diseases in their earliest phases, the CDC hopes to contain their spread, enhance patient treatment and, ultimately, save as many lives as possible.

"Our hypothesis is that the very earliest sign of a problem might be people calling their primary care doctor or going to see their primary care physicians for treatment," Platt said.

By collecting information from all the hospitals in a given area, the CDC hopes to uncover outbreaks as they unfold, rather than learning of them after the fact, as has often been the case in the past.

"The demonstration program will include a rapid response capability to notify public health officials of unusual occurrences as soon as the information becomes available," Julie L. Gerberding, director of CDC, said in a press release.

The pilot program will connect 20 million patient records in all 50 states and will become the blueprint for a national surveillance system if successful, according to a CDC press release.

"The purpose of this is to look at the feasibility of applying this methodology to other locations throughout the country," Solomon said.

Despite the sharing of patient information, strict confidentiality will be maintained, according to Platt.

"The health plans are going to keep all clinical information," Platt said. "What they're going to pass along are simply counts indicating the number seeking treatment within a specified area."

If Platt's group determines that certain individuals are at risk or have been exposed after evaluating collected data, the patients will be notified through their health care providers, ensuring their privacy, according to Platt.