Norovirus and Surveillance

There's an interesting article about the norovirus outbreak in Boston (it also seems to be nationwide). At this point, over half a percent of all the residents of Boston have gone to the emergency room due to this virus--which means even more have been sick.

First, as always, wash your damn hands! Now, onto the public health. What's interesting is that Massachusetts has installed a real-time surveillance system to deal with bioterrorism and biopreparedness (i.e., avian flu--got that, Fumento?). But as the biosecurity 'community'* is beginning to learn, you can't separate biosecurity from routine public health (italics mine):

Sophisticated, real-time disease-tracking systems had been in the works for years, but the terrorist attacks of Sept. 11, 2001, as well as the arrival of anthrax-laden letters a month later, caused researchers to expedite development of the networks. Initially, the tracking systems, known as syndromic surveillance networks, were trumpeted for their potential to detect bioterror attacks.

But since dozens of public and private health agencies activated the networks, specialists have increasingly recognized that the first-generation systems now in operation may be better suited for identifying large outbreaks of gastrointestinal and respiratory illnesses.

"Diseases that tend to have explosive onset with a large number of cases early on do show up quite nicely," said Dr. James Nordin , a clinical investigator at HealthPartners Research Foundation in Minnesota, which runs a tracking system in the Twin Cities.

Norovirus is one of those diseases. And the consequences are seen in hospitals like Boston Medical Center , where ER doctors have treated a steady stream of patients.

"We have seen a large number of cases of what appears to be a sudden onset and intense, short-lived diarrhea, nausea, and some abdominal pain," said Dr. Jonathan Olshaker , Boston Medical's emergency department chief. "Although if you're going through it, it doesn't seem short-lived."

To protect ourselves against bioterrorism, we need a strong, well-funded public health infrastructure. No amount of Peter Pan conservatism is going to change that because the norovirus (and potentially, far worse things) doesn't care that Karl Rove cleaned up in the 2002 midterm elections or that George Bush is the Decider. Logistics, infrastructure, and planning matter.

*I hate using the word "community" to describe a demographic group, but it beats the hell out of 'folks.'