title: Simulated anthrax attacks and syndromic surveillance.
abstract: We measured sensitivity and timeliness of a syndromic surveillance system to detect bioterrorism events. A hypothetical anthrax release was modeled by using zip code population data, mall customer surveys, and membership information from HealthPartners Medical Group, which covers 9% of a metropolitan area population in Minnesota. For each infection level, 1,000 releases were simulated. Timing of increases in use of medical care was based on data from the Sverdlovsk, Russia, anthrax release. Cases from the simulated outbreak were added to actual respiratory visits recorded for those dates in HealthPartners Medical Group data. Analysis was done by using the space-time scan statistic. We evaluated the proportion of attacks detected at different attack rates and timeliness to detection. Timeliness and completeness of detection of events varied by rate of infection. First detection of events ranged from days 3 to 6. Similar modeling may be possible with other surveillance systems and should be a part of their evaluation.
authors.affiliation: HealthPartners Research Foundation, Minneapolis, Minnesota 55440-1524, USA. james.d.nordin@health-partners.com
authors.forename: James D
authors.initials: JD
authors.lastname: Nordin
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goodman
authors.forename: Martin
authors.initials: M
authors.lastname: Kulldorff
authors.forename: Debra P
authors.initials: DP
authors.lastname: Ritzwoller
authors.forename: Allyson M
authors.initials: AM
authors.lastname: Abrams
authors.forename: Ken
authors.initials: K
authors.lastname: Kleinman
authors.forename: Mary Jeanne
authors.initials: MJ
authors.lastname: Levitt
authors.forename: James
authors.initials: J
authors.lastname: Donahue
authors.forename: Richard
authors.initials: R
authors.lastname: Platt
mesh_terms: D000881:Anthrax / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D023482:Bioterrorism; D015991:Epidemiologic Measurements; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008910:Minnesota; D008962:Models, Theoretical; D016012:Poisson Distribution; D011159:Population Surveillance / Q000379:methods*; D013029:Space-Time Clustering; D013997:Time Factors