Bioterrorism and Influenza Surveillance Network

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DESCRIPTION (provided by applicant): The Wisconsin Bioterrorism and Influenza Sentinel Surveillance Network [BISSEN] Background: The ability to conduct sentinel surveillance for infections resulting from bioterrorism and other emerging infections is becoming an essential function of the health care system in the United States. There is little evidence in existence, however, to inform public health officials on how to engage in primary care--or on how to engage primary care clinicians--for purposes of surveillance. Building short-term or "drop-in" surveillance for bioterrorism as an add-on to existing practice-based research network (PBRN) function or to an existing nationwide influenza surveillance program may be an efficient and effective means to detect unusual events. Research Questions: Does participation in a PBRN enhance physician response to "drop-in" surveillance protocols for emerging infectious diseases and bioterrorism? Does participation by primary care physicians in an existing influenza sentinel surveillance program enhance response to "drop-in" surveillance protocols for emerging infectious diseases and bioterrorism? Experimental Design: Subjects are 120 physicians. Thirty family physician members of the Wisconsin Research Network (WReN), 30 Wisconsin Influenza Sentinel Clinician Program (WISCP) physicians, and 60 family physician members of the Wisconsin Academy of Family Physicians (WAFP) will be recruited to participate in two future episodes of "drop-in" surveillance with web-based reporting. One surveillance protocol will entail reporting the numbers and age categories of patients with acute diarrhea during a four-week period. The second protocol will involve reporting specific, HIPAA-compliant data on individual cases of acute rash illness during a two-week surveillance period. Outcome Measures: Primary outcome measures include the median rates of protocol compliance by each group of physicians for each type of protocol. The rate of participation will allow comparison of WReN physicians to WISCP physicians and family physicians engaged in organized collection of data (WReN+WISCP) to nonaffiliated physicians. Secondary outcomes will emerge as physician attitudes from a post-hoc meeting at which selected high- and low-responders from each group will be invited to interact with public health surveillance personnel. Significance: The results of this exploratory study will provide key information to public health officials, PBRN directors, and influenza surveillance coordinators as to the appropriate clinicians to recruit for bioterrorism and emerging infection surveillance. Since numerous PBRNs exist across the nation and most states have some level of influenza surveillance, the results should be generalizable to a wide geographic area. Moreover, the results will inform those interested in creating surveillance protocols on features that will enhance participation of clinicians, thus improving efforts to conduct surveillance for emerging public health threats.