A survey of usage protocols of syndromic surveillance systems by state public health departments in the United States

Lori Uscher-Pines, Corey L. Farrell, Jacqueline Cattani, Yu Hsiang Hsieh, Michael D. Moskal, Steven M. Babin, Charlotte A. Gaydos, Richard E. Rothman

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective: To broadly describe current syndromic surveillance systems in use throughout the United States and to provide basic descriptive information on responses to syndromic system signals. Methods: Cross-sectional survey (telephone and e-mail) of state epidemiologists in all 50 states and the District of Columbia. Results: Forty-one states participated in the survey for a response rate of 80 percent. Thirty-three states (80%) had at least one syndromic surveillance system in addition to BioSense operating within the state. Every state with an urban area at highest risk of a terrorist attack reported monitoring syndromic surveillance data, and a state's overall preparedness level was not related to the presence (or lack) of operational syndromic surveillance systems. The most common syndromic surveillance systems included BioSense (n = 20, 61%) and RODS (n = 13, 39%). Seventy-six percent of states with syndromic surveillance initiated investigations at the state level, 64 percent at the county level, and 45 percent at both the state and county levels. Conclusions: The majority of states reported using syndromic surveillance systems, with greatest penetration in those at highest risk for a terrorist attack. Most states used multiple systems and had varied methods (central and local) of responding to alerts, indicating the need for detailed response protocols.

Original languageEnglish (US)
Pages (from-to)432-438
Number of pages7
JournalJournal of Public Health Management and Practice
Issue number5
StatePublished - Sep 2009


  • Outbreak investigation
  • Response protocol
  • State epidemiologist
  • Syndromic surveillance

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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