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1.  Utility of the ESSENCE Surveillance System in Monitoring the H1N1 Outbreak 
Online Journal of Public Health Informatics  2010;2(3):ojphi.v2i3.3028.
The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) enables health care practitioners to detect and monitor health indicators of public health importance. ESSENCE is used by public health departments in the National Capital Region (NCR); a cross-jurisdictional data sharing agreement has allowed cooperative health information sharing in the region since 2004. Emergency department visits for influenza-like illness (ILI) in the NCR from 2008 are compared to those of 2009. Important differences in the rates, timing, and demographic composition of ILI visits were found. By monitoring a regional surveillance system, public health practitioners had an increased ability to understand the magnitude and character of different ILI outbreaks. This increased ability provided crucial community-level information on which to base response and control measures for the novel 2009 H1N1 influenza outbreak. This report underscores the utility of automated surveillance systems in monitoring community-based outbreaks. There are several limitations in this study that are inherent with syndrome-based surveillance, including utilizing chief complaints versus confirmed laboratory data, discerning real disease versus those healthcare-seeking behaviors driven by panic, and reliance on visit counts versus visit rates.
doi:10.5210/ojphi.v2i3.3028
PMCID: PMC3615770  PMID: 23569593
H1N1; swine flu; surveillance
2.  Electronic public health surveillance in developing settings: meeting summary 
BMC Proceedings  2008;2(Suppl 3):S1.
In some high-income countries, public health surveillance includes systems that use computer and information technology to monitor health data in near-real time, facilitating timely outbreak detection and situational awareness. In September 2007, a meeting convened in Bangkok, Thailand to consider the adaptation of near-real time surveillance methods to developing settings. Thirty-five participants represented Ministries of Health, universities, and militaries in 13 countries, and the World Health Organization (WHO). The keynote presentation by a WHO official underscored the importance of improved national capacity for epidemic surveillance and response under the new International Health Regulations, which entered into force in June 2007. Other speakers presented innovative electronic surveillance systems for outbreak detection and disease reporting in developing countries, and methodologies employed in near-real time surveillance systems in the United States. During facilitated small- and large-group discussion, participants identified key considerations in four areas for adapting near-real time surveillance to developing settings: software, professional networking, training, and data acquisition and processing. This meeting was a first step in extending the benefits of near-real time surveillance to developing settings. Subsequent steps should include identifying funding and partnerships to pilot-test near-real time surveillance methods in developing areas.
PMCID: PMC2587694  PMID: 19025678
3.  Syndromic Surveillance: Adapting Innovations to Developing Settings 
PLoS Medicine  2008;5(3):e72.
The tools and strategies of syndromic surveillance, say the authors, hold promise for improving public health security in developing countries.
doi:10.1371/journal.pmed.0050072
PMCID: PMC2270304  PMID: 18366250
4.  Developing open source, self-contained disease surveillance software applications for use in resource-limited settings 
Background
Emerging public health threats often originate in resource-limited countries. In recognition of this fact, the World Health Organization issued revised International Health Regulations in 2005, which call for significantly increased reporting and response capabilities for all signatory nations. Electronic biosurveillance systems can improve the timeliness of public health data collection, aid in the early detection of and response to disease outbreaks, and enhance situational awareness.
Methods
As components of its Suite for Automated Global bioSurveillance (SAGES) program, The Johns Hopkins University Applied Physics Laboratory developed two open-source, electronic biosurveillance systems for use in resource-limited settings. OpenESSENCE provides web-based data entry, analysis, and reporting. ESSENCE Desktop Edition provides similar capabilities for settings without internet access. Both systems may be configured to collect data using locally available cell phone technologies.
Results
ESSENCE Desktop Edition has been deployed for two years in the Republic of the Philippines. Local health clinics have rapidly adopted the new technology to provide daily reporting, thus eliminating the two-to-three week data lag of the previous paper-based system.
Conclusions
OpenESSENCE and ESSENCE Desktop Edition are two open-source software products with the capability of significantly improving disease surveillance in a wide range of resource-limited settings. These products, and other emerging surveillance technologies, can assist resource-limited countries compliance with the revised International Health Regulations.
doi:10.1186/1472-6947-12-99
PMCID: PMC3458896  PMID: 22950686
Electronic biosurveillance; Software development; Public health; Disease outbreak; Resource-limited settings

Results 1-4 (4)