Currently,
diseases of public health importance are reported once a
diagnosis is in hand, generally requiring laboratory testing. However,
even with the best of laboratory reporting, the data is received well
after the patient is into the clinical course of illness (and
infectiousness to others if the disease happens to be
communicable). Alternatively, in the setting of a truly novel
disease (such as SARS, monkeypox, Hantavirus, cryptosporidiosis – all
of which have unexpectedly stuck in the United States), laboratory
resources, in general, do not permit diagnosis since testing protocols
and reagents are not available for new disease entities.
Once public
health has received enough information to perform an
analysis, it has few—if any—channels for rapidly communicating
information to clinicians and other end-users of the data they have
assembled and analyzed. Finally, most existing syndromic
surveillance systems collect data only from hospitals and do not
collect or use veterinary data. Since the vast majority of
serious infectious diseases affecting the human population are zoonotic
in origin (including, for example, novel subtypes or influenza), robust
human disease surveillance requires equally robust veterinary
surveillance.
As but one more
example that underscores the latter point: the
hemorrhagic E.Coli outbreak of 2006 in the US went for many weeks
before disparate public health entities even became aware of its
existence. As hundreds of people were hospitalized across the
country with life-threatening illness (resulting in at least 6 deaths
though the true mortality figures may never be known due to the
complete lack of a systematic, affordable disease surveillance system
across the US), more time passed as California agricultural officials
struggled to find the source of the outbreak. Most of us would
regard this as a public health failure, and in any case unacceptable in
the 21st century when rapid communication among physicians,
veterinarians, wild-life observers and public health officials is not
only possible but now proven with a disease reporting system called
SYRIS.
Dr. Zelicoff is
a former Senior Scientist at Sandia
National
Laboratories (http://www.sandia.gov),
where he became internationally known for his work on
counter-terrorism, specifically as applied to the problem of biological
weapons. He is the inventor of the Sydrome Reporting Information
System (SYRIS)
which is being tested in multiple public health offices
around the US. SYRIS gathers clinical data from a wide variety of
sources and medical communities around the country, including from:
physicians, veterinarians, animal control and environmental health
officials, coroner's offices, laboratories, school nurses, and EMS
professionals (see on-line video below). The software includes
simple but highly flexible
GIS software implementing a mapping-based (or "visual") approach to
data analysis as well as standard statistical techniques so that public
health officials can rapidly evaluate data and provide near real-time
alerts and advice to clinicians.
SYRIS can also
be used as an emergency management tool in the setting
of terrorist attack with non-conventional weapons. Several states
are currently evaluating SYRIS for both this use and routine public
health practice. The
Center for the Study of Bioterrorism and Emerging Diseases at St. Louis
University is
currently evaluating SYRIS as well. The Center is funded, in
part, by a bioterrorism research grant from the Centers for Disease
Control (www.cdc.gov).
SYRIS code is
copyrighted and owned by ARES Corporation
(with whom
Dr. Zelicoff is under contract as a Senior Scientific
Consultant; please note in the
interest of full disclosure that Zelicoff has NO financial interest in either ARES
Corporation OR SYRIS. He is under contract to develop, improve
and promote disease surveillance software systems for ARES).
You may request
an on-line demo of SYRIS by
contacting Dr. Zelicoff at ARES' Albuquerque office:
- by e-mail at: azelicoff@arescorporation.com
-
by phone: 1-505-272-7102
He will arrange
to personally demonstrate the software and discuss its
implementation in public health offices and clinics. You can read
the SYRIS Manual on the main SYRIS
web page (see
left hand side of the web page) and several background documents on
SYRIS including a summary of the experience in West Texas, an
epidemiologically complicated, mixed urban and rural area that is also
near the Mexico border. Documentation available for public
use includes:
A detailed
paper on the four-year experience with SYRIS is available here (written
6/06 and being revised for submission to a refereed journal.)
Several video
demonstrations of SYRIS (in Windows Media Player or .wmv format) can be seen
by clicking on the links below:
Feel free to
contact Dr. Zelicoff with any questions you may have.
E-mail is often the easiest way to reach him, and he responds quickly
(even on weekends and holidays).
My special thanks
to
Jim Stadnyck of Point of View
Photography for design of this webpage and much inspiration.
[Webpage last updated
2/8/07]
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