Graduation Year


Document Type




Degree Granting Department

Public Health

Major Professor

Ph.D., Jacqueline A. Cattani.


Baseline, Automated, Epidemiology, Biodefend, Alert, Syndromes


The threat of bioterrorism forces the public health infrastructure to focus attention on overall issues related to challenges posed by emerging and re-emerging infectious diseases. There is a crucial need to strengthen existing surveillance systems and to validate real-time approaches to surveillance that can provide timely alerts of epidemics whether they occur naturally or through a bioterrorism attack. The purpose of this study is to implement and evaluate a bioterrorism syndromic surveillance system called BioDefend[trademark], to determine if the system could detect a potential epidemic/bioterrorism attack within 24-36 hours, more rapidly than it would be identified by routine health surveillance. This sentinel surveillance study was conducted in theme parks, theme park referral hospitals and clinics, and a military hospital and clinics in the Central Florida area.

A six-month period of baseline data collection was completed at all surveillance sites for the purposes of serving as the comparison for the test period. The test period comsisted of five months and served to validate the system. The baseline was also used to identify normal illness trends and seasonality patterns so that thresholds could be established on which to determine significant syndromic aberrations. The web-based reporting system enabled near real-time data entry. The syndromic and demographic information then was processed in an automated analysis system to provide a mechanism for alerting surveillance sites when significant rises in reported syndromes and/or clinic/hospital daily visits exceeded the established thresholds. A pocket PC/phone device enabled staff to receive notification of alerts 24/7.