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Last Updated

20 Nov 2002

Source: Boston Globe, November 20, 2002.

Hospitals plan link to detect bioterror

By Stephen Smith, Globe Staff

LAS VEGAS - Ten hospital emergency rooms in the Boston area are close to establishing an early warning network designed to detect disease outbreaks and bioterrorist attacks.

The network would scour patient records for evidence of such potential bioterrorism agents as anthrax, smallpox, and plague by tracking unusual spikes in fever, chills, and sniffles - symptoms that might otherwise be dismissed as isolated cases of the flu or other routine infections.

The pending agreement was revealed at BioSecurity 2002, a Harvard-organized conference of health, military, and private security authorities.

Two Boston hospitals, Children's Hospital and Beth Israel Deaconess Medical Center, already have a system in place that looks for suspicious patterns among emergency room patients. The creator of that system, Dr. Kenneth Mandl of Children's, said yesterday that the eight additional hospitals will probably join early next year.

The network of Boston ERs represents the latest example of a growing movement in public health to collect up-to-the-minute data on patients and to show patterns that individual physicians could never hope to discern.

''From the doctor's point of view, it's just a patient with the flu,'' said Mandl, who declined to identify the eight hospitals likely to join the network until the agreement was complete.

The creation of the network - whose cost, beyond computer programming time, would be minimal - would give Boston one of the most comprehensive systems in the nation for monitoring bioterrorist attacks and outbreaks of viral and bacterial illness. It would join a system designed by another Harvard Medical School physician, Dr. Richard Platt, which is monitoring tens of thousands of patients in health maintenance organizations.

Platt's model is being tested nationally through an initiative paid for by the US Centers for Disease Control and Prevention.

New York public health authorities have been using a similar system since 1998, when teams of paramedics began reporting the conditions of patients on a daily basis. That network was expanded after the Sept. 11 terrorist attacks.

''We're looking for something we hope isn't there,'' said Dr. Farzad Mostashari, an assistant New York health commissioner who investigated last year's anthrax attacks as well as outbreaks of West Nile virus. ''These are insurance policies.''

The military has a medical surveillance system of its own. Last January, it detected something strange at the Marine Corps recruit depot in San Diego: In a matter of days, 150 recruits had gastrointestinal illness, far more than expected in a January week, although none of the base's health authorities reported any surge.

Disease investigators found that Norwalk virus was sweeping the base.