The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks

Abstract

The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program’s ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia.

Translating Predictions of Zoonotic Viruses for Policymakers

“…We found that experts from federal ministries, reference laboratories, and uniformed services had insights on emerging pathogens. Partnerships across national agencies in Africa, such as militaries, have aided in developing surveillance programs for emerging zoonotic diseases (Witt et al 2011;Kronmann et al 2013). Modelers could approach these experts to refine their models.…”

Epidemiological surveillance methods for vector-borne diseases

“…An example of such a large research network is the EDENext project on the biology and control of vector-borne infections in Europe (87). In another, more narrowly focused research effort, the United States Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS), has developed the RVF prediction project (52) into a worldwide 'predictive surveillance' programme, aimed at the prediction and detection of emerging disease outbreaks, with a particular focus on VBDs such as RVF, JE, leishmaniosis and chikungunya fever (88). Since next-generation sequencing (NGS) technologies became available for metagenomic studies, their use in concert with traditional surveillance methods has allowed for the more rapid discovery and characterisation of new and potentially emerging pathogens from hosts, vectors and reservoirs (89).…”

Socio-Ecological Dimensions of Infectious Diseases in Southeast Asia

“…Several experiments and applied research projects, for example, in the fi eld of surveillance programs, have implemented such integrative approaches, merging together ecological and epidemiological data in multidisciplinary information systems (Witt et al 2011 ). How do these various actors understand the patterns of zoonotic disease emergence and the interactions between environment and health?…”