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Watching For Signs Of Bird Flu

North Carolina system aims to provide early warning of a deadly outbreak.
As the United States and other countries prepare for a possible global pandemic of avian flu, North Carolina has deployed what officials are calling "a 24-hour public-health radar system" to give early warning of disease outbreaks or acts of bioterrorism.

North Carolina is the first state to roll out a statewide public-health-monitoring system that collects "chief complaint" data from all hospitals that have 24-hour emergency-room departments, says Dr. Leah Devlin, North Carolina's state health director. The North Carolina Hospital Emergency Surveillance System was developed over the last 18 months through a $3.4 million, five-year federal grant.

Of the 109 emergency departments in North Carolina, 61 hospitals have implemented the system, and nearly all the rest are in "late testing" stages, she says. The system will be fully implemented in all ERs by April. "This has been a very rapid rollout," Devlin says.

The United States has only a patchwork of monitoring systems, leaving it vulnerable to an outbreak. While some other states, including New York, are collecting and analyzing real-time symptom data from ER departments, most of those efforts have been limited to hospitals in certain hot spots, such as densely populated New York City, Devlin says.

At North Carolina emergency departments, information about patients' chief complaints--such as flulike symptoms, neurological disturbances, and gastrointestinal problems--are entered into the system via a secure Web connection. That data gets downloaded every 12 hours using software from Solucient LLC to systems at the state's public-health department, where it's analyzed for unusual patterns.

If the North Carolina analysis red-flags an unusual event, public-health officials use software provided by MercuryMD Inc. to electronically investigate further, Devlin says. The MercuryMD software lets officials electronically access hospital lab and other reporting systems that contain additional information, such as diagnoses and test results.

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