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One of the compelling forces behind this special theme issue on “Geospatial Applications in Disease Surveillance” is the current attention on health care reform in the United States. An initiative to improve the delivery of health care services is the electronic exchange of health information (Friedman & Parrish, 2011; Roski & McClellan, 2011). The goals of the national health information exchange (HIE) are to expedite the delivery of health information and increase health care access (Cebul et al., 2011; Romano & Stafford, 2011). Disease surveillance is an application of electronic health information exchange that is designed to monitor and respond to disease outbreaks.
Currently, there is a large body of published research in medical geography and spatial epidemiology (Boulos, 2004; Cheung et al., 2008; Cromley & McLafferty, 2012; Meade, 2010). Accordingly, there is also a good collection of work on biosurveillance, as it pertains to public health (Brownstein et al., 2009; Horst & Coco, 2010; Lombardo et al., 2003). However, there is very little published research addressing the requirements and development of a pro-active, spatio-temporal, disease surveillance system that incorporates the health and environmental factors necessary for a rapid response to and recovery of a disease outbreak. The contents of this issue present a number of geographic solutions towards this goal in disease surveillance, since such a system entails the integration of many moving parts across multiple scales, and the interdisciplinary coordination of many different governance bodies.
At the most basic level, disease surveillance refers to a system designed to monitor disease in a community by detecting patterns of data that are indicative of an outbreak (Jiang & Cooper, 2010). An infectious disease threat, combined with a concern over man-made biological or chemical events, prompted the World Health Organization (WHO) to update their International Health Regulations (IHR) in 2005 (WHO, 2005). The new 2005 IHR is a legally binding instrument for all 194 WHO member countries that significantly expanded the scope of reportable conditions and is intended to help prevent and respond to global public health threats. Electronic disease surveillance systems, such as those used in syndromic surveillance, have great potential to improve health security (CDC, 2007; Chretien et al., 2008; Soto et al., 2008). Epidemiologists using electronic disease surveillance have the potential to detect irregular disease activities earlier than traditional laboratory-based surveillance, as well as monitor the health of their community in the face of a known threat.
Syndromic surveillance is a type of real-time surveillance system that relies on the detection of clinical aspects of disease before confirmed diagnoses are made (Bradley et al., 2005; Cakici et al., 2010; Mandl et al., 2004). A more sophisticated form of disease surveillance is a system that manages “health-related data and information for early warning of threats and hazards, early detection of events, and rapid characterization of the event so that effective actions can be taken to mitigate adverse health effects” (CDC, 2010). A fully developed disease surveillance system is able to manage the following three aspects: detection, response, and recovery. In this paper, I argue that the skills and experiences of professional geographers are essential to the field of disease surveillance. The following sections will briefly describe the current landscape of disease surveillance, and discuss how geographic knowledge is crucial to the understanding and response to disease outbreaks.