IN AN unprecedented move, the US government is planning to spend $150 million on a system that will help developing countries track potentially devastating disease outbreaks.
But some countries may reject the offer because the system can also spot the telltale signs of illicit bioweapons research.
The scheme is part of the Global Pathogen Surveillance Act which the US Congress is expected to pass shortly. It will pay for training in public health and epidemiology in developing countries, plus new diagnostic equipment.
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But it will also pay for computers that doctors in developing countries can use to log serious disease symptoms on a central database. If an unusual cluster of similar symptoms emerges, public health experts will be able to alert doctors in the area, help with diagnosis, prevent further spread and make sure labs are not needlessly overwhelmed with tests.
The plan鈥檚 success will hinge on just how open some governments are prepared to be about disease. A cluster of symptoms might reflect a natural epidemic 鈥� or an accident at a secret weapons lab. Countries may not be eager to participate if an outbreak lays them open to accusations of meddling in bioweapons.
The system, dubbed the Rapid Syndrome Validation Project (RSVP), was developed at the Sandia National Laboratory in New Mexico. Doctors use it to report on patients who are seriously ill with one of six syndromes: flu-like illness, fever with rash, fever with brain infection, bloody diarrhoea, respiratory distress or hepatitis. The RSVP system then plots reported cases on a map and tells local health officials when changes are statistically significant.
RSVP鈥檚 developer, Al Zelicoff, says the system concentrates on symptoms, rather than specific diseases, because diagnosing a disease takes time 鈥� and doctors can get it wrong. 鈥淏ut doctors are very good at spotting symptoms, and know when they are serious,鈥� he says. In tests along the US-Mexico border, RSVP spotted an unusual outbreak of influenza A in babies, preventing inappropriate treatment in many cases.
RSVP also transmits the mapped notifications to the whole network which means everyone knows about serious outbreaks.
In the past, some nations have been reluctant to tell the world about their diseases. In 1998, Malaysia tried to suppress information about a lethal enterovirus outbreak the previous year, even when Taiwan asked for help with a similar infection. And in 1994 an outbreak of plague in Surat, India led to widespread panic as rumours flourished in the absence of reliable official information.
David Heymann, head of infectious diseases at the World Health Organization in Geneva, warns that no surveillance system will work unless it guarantees confidentiality. The WHO鈥檚 Global Outbreak Alert and Response Network releases no information until an outbreak is investigated. But Zelicoff says the WHO鈥檚 system is too slow, and too fraught with political pressure. He says that by limiting reports to symptoms 鈥� 鈥渂loody cough鈥�, say 鈥� rather than an attempted diagnosis such as 鈥減ossible anthrax鈥�, RSVP depoliticises the reporting system. 鈥淚t will catch on once governments know it will help protect their people,鈥� says Zelicoff.