System tracks disease; links labs, health care centers

The National Center for Infectious Diseases (NCID) plans to use part of a $26 million boost in its fiscal 1997 budget to build a computer system to track emerging infectious diseases that are fatal and becoming resistant to modern drugs.

The Clinton administration is lobbying strongly for what it calls "a global surveillance system," which would connect health care centers, hospital laboratories, clinics and medical research centers nationwide so that emerging diseases can be detected earlier, tracked more closely and contained more effectively.

"Our aim, very simply, is to put the necessary structures into place - both electronic and physical - to build a nationwide system of infectious-disease surveillance," Vice President Gore said in a speech last month to the National Council for International Health, where he announced the program.

The Clinton administration has requested a $26 million bump in the NCID's fiscal 1997 budget, more than a 140 percent hike from fiscal 1996. Most of the increase would go to upgrade the laboratories and state health clinics and hospitals, including providing an undetermined amount of computer and telecommunications equipment and software to link hospitals and public-health professionals.

"What this is about is getting better, smarter and more powerful public-health sources," said Bob Pinner, special assistant for surveillance at NCID, which is part of the Centers for Disease Control and Prevention in Atlanta.

Hospital databases are full of data on diseases but are not linked. The NCID would help link the systems, while ensuring confidentiality and security, so that cases could be collected and rates calculated.

The additional funds also would be used to increase the number of regional infectious-disease centers from four to 10. The new centers, which CDC officials call "population centers," would be involved in expanding the surveillance system.

Last week, in the appropriations bill that includes the Department of Health and Human Services, the House Appropriations Committee sent a bill to the floor that gives $20 million of the $26 million the administration requested for NCID.

"We support what the CDC is trying to do," a member of the Appropriations Committee said. "We would have given more, but Clinton's request was $7 billion over the budget allocation."

A Four-Pronged Plan

The computer surveillance system is just part of a four-pronged plan the NCID is implementing to better detect and track emerging diseases such as the highly contagious and deadly Ebola virus; the Hantavirus, which attacks the lungs and was first discovered in the Southwest; and new, drug-resistant pneumococal diseases, such as a new strain of tuberculosis and bacterial pneumonia, which is resistant to penicillin.

Other parts of the plan include applied research, development of prevention strategies and development of public health infrastructure in state and local health departments.

The total cost of the plan is $125 million, which will be funded incrementally over several years.

The NCID also is discussing standards for case reporting, including setting standards for data fields and whether the Internet or some other means for disseminating data will be used.

The surveillance system will be similar to other CDC computer systems but more focused on emerging diseases. CDC operates CDC Wonder, which provides a single point of access to CDC reports, guidelines and public health data, and CDC Information Network for Public Health Officials, which links federal, state and local public-health providers so that public health information can be distributed more easily.