title: SARS Surveillance Project--Internet-enabled multiregion surveillance for rapidly emerging disease.
abstract: BACKGROUND
  On March 15, 2003, CDC requested health-care and public health agencies to conduct surveillance for severe acute respiratory syndrome (SARS). The SARS Surveillance Project (SARS-SP) was established to rapidly implement multiregional SARS surveillance in emergency departments (EDs) by using existing Internet-based tools.
  
  
  OBJECTIVE
  The objectives of SARS-SP were to 1) disseminate and update SARS screening forms for ED triage, 2) establish surveillance for SARS syndrome elements by using Regional Emergency Medicine Internet (REMI), 3) expand surveillance to multiple regions, and 4) evaluate the usefulness of Internet tools for agile surveillance during a rapidly emerging global epidemic.
  
  
  METHODS
  SARS-SP developed, distributed, and updated an Internet-based triage form to identify patients for infection control and public health reporting. EDs then were invited to report visit frequencies with various SARS syndrome elements to local public health authorities by using the REMI Internet application (first in one metropolitan area, and later in four). After pilot-testing in one metropolitan area, the surveillance system was implemented in three others.
  
  
  RESULTS
  Active syndromic surveillance was established by health departments in Milwaukee, Wisconsin; Denver, Colorado; Akron, Ohio; and Fort Worth, Texas. A total of 27 EDs reported syndrome frequencies from >146,000 patient encounters.
  
  
  CONCLUSIONS
  ED and public health partners reported being satisfied with the system, confirming the usefulness of Internet tools in the rapid establishment of multiregion syndromic surveillance during an emerging global epidemic.
authors.affiliation: Milwaukee Health Department, 3061 N. Marietta Avenue, Milwaukee, Wisconsin 53211, USA. sfoldy@sbcglobal.net
authors.forename: Seth L
authors.initials: SL
authors.lastname: Foldy
authors.forename: E
authors.initials: E
authors.lastname: Barthell
authors.forename: J
authors.initials: J
authors.lastname: Silva
authors.forename: P
authors.initials: P
authors.lastname: Biedrzycki
authors.forename: D
authors.initials: D
authors.lastname: Howe
authors.forename: M
authors.initials: M
authors.lastname: Erme
authors.forename: B
authors.initials: B
authors.lastname: Keaton
authors.forename: C
authors.initials: C
authors.lastname: Hamilton
authors.forename: L
authors.initials: L
authors.lastname: Brewer
authors.forename: G
authors.initials: G
authors.lastname: Miller
authors.forename: E
authors.initials: E
authors.lastname: Eby
authors.forename: R
authors.initials: R
authors.lastname: Coles
authors.forename: K
authors.initials: K
authors.lastname: Pemble
authors.forename: C
authors.initials: C
authors.lastname: Felton
mesh_terms: D021821:Communicable Diseases, Emerging / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D004636:Emergency Service, Hospital; D006801:Humans; D020407:Internet; D011159:Population Surveillance / Q000379:methods*; D011635:Public Health Administration; D040442:Public Health Informatics; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control*; D014922:Wisconsin