DOD Bolsters Biosurveillance Diagnostics, Monitoring

By Cheryl Pellerin
American Forces Press Service

WASHINGTON, Aug. 29, 2012 – Defense Department officials routinely work to protect the nation from terrorist attacks and weapons of mass destruction. But today they’re bolstering defenses against an older threat that emerges from animals and insects and arises in people as infectious diseases.

Last month, the White House issued the first U.S. National Strategy for Biosurveillance, a process defined as gathering, analyzing and interpreting data related to disease activity and threats to human and animal health for early warning and detection.

Andrew C. Weber, assistant secretary of defense for nuclear, chemical and biological defense programs, told American Forces Press Service that DOD is expanding its ability to detect and even forecast infectious disease outbreaks that endanger global health security.

“The vision,” he said, “much like we do with the weather, is to have a global [disease]-detection and information-sharing system that will allow us to know when a storm is forming before it forms, and when it’s coming toward the border.”

At DOD, elements of such a system are already in development, he said, including a new generation of disease diagnostics.

“Just like with [information technology], what used to be a computer capability that took up an entire building is now in your [smartphone],” Weber explained. “Diagnostic technologies also are evolving from what used to take an entire laboratory complex at the national level to what we call point-of-care or point-of-need diagnostics.”

Physicians -- and at some point, individuals -- will be able to use such handheld devices to identify an illness and immediately report the data to a global monitoring system, he added, “so we can understand normal and background [signals] but also an emerging biological threat.”

Traditional disease detectors have been limited to eight or 10 threat agents, Weber said.

“Now, with multiplex technologies, we can monitor and do point-of-care diagnostics for routine diseases [such as influenza], not just extremely rare diseases that we worried about during the Cold War,” he added.

DOD plans to field some capabilities soon, Weber said, “and the technology is moving so quickly that within the next couple of years we will have fielded new and more mobile systems that cover more diseases. We call this the Next-Generation Diagnostics Program.”

DOD has increased diagnostics funding through its biodefense program, the assistant secretary said. Some work is implemented by the Defense Threat Reduction Agency’s chemical and biological technologies directorate, which also is the Joint Science and Technology Office of the Chemical and Biological Defense Program, and some by the Joint Program Executive Office for Chemical and Biological Defense.

In October 2009, Weber himself ushered the Chemical and Biological Defense Program into the biosurveillance business by signing a memorandum to the secretaries of the military departments announcing that emerging infectious diseases would be part of the chemical and biological defense mission.

At DTRA and JTSO, Nancy Nurthen is a science and technology manager in the chemical and biological technologies directorate’s diagnostics, detection and disease surveillance division.

The move within the Chemical and Biological Defense Program to include work on emerging infectious diseases, she told American Forces Press Service, was “huge.”

“That put us into the space of emerging infectious diseases rather than just looking at traditional bio-warfare agents,” she said.

Today, Nurthen and her DTRA and JSTO colleagues are working on new diagnostics and gearing up for the mid-October launch of a new effort called the Biosurveillance Ecosystem.

“Traditional diagnostics provide information too late to make any actionable decisions,” Nurthen said. “People need quicker lab results. What we’re looking to do specifically is highlight a list of diseases and target the point-of-need diagnostics to be a yes/no [indicator] for those specific diseases, maybe multiplex for up to three different diseases on the diagnostic.”

Such diagnostics, she said, could be used if an early signal of possible disease was picked up through an informal source such as social media.

“Because [the diagnostics] are simple to use and very low cost,” Nurthen said, “we could deploy them to get an early potential confirmation of what’s happening and have earlier warning, earlier confirmation, and an ability to make better decisions faster.”

Results from the diagnostics will be one of the data streams that move through the new Biosurveillance Ecosystem, a global system that Nurthen says will dramatically accelerate disease detect-identify-respond capabilities.

The global system, based on commercial cloud technologies, will assemble social networks of experts who use the ecosystem’s tools and information. It also will augment and integrate existing human and animal systems and data and harness commercial and emerging technologies to quickly implement an initial operational capability, she said.

Its data streams will include open-source information, social media, point-of-need diagnostic data, and DOD, interagency national and international surveillance systems and data repositories.

“One of the biggest challenges we’re looking at now is how to make that diagnostic result available through the ecosystem,” Nurthen said.

Analysts would get a somewhat simplistic result from the diagnostic, but would use the ecosystem to compare it to a baseline, she added.

“They’d take the space-and-time tag off the diagnostic -- where and when it was reported -- and look at baseline data for that area, look at current outbreaks for that area, look at social media discussions or hot topics for that area, and put a little more confidence to the result,” she explained.

“Potentially,” Nurthen said, “the [analysts] could push back information to the person who sent the result, saying, ‘You may want to go see a doctor,’ ‘You may want to consider these nonmedical interventions,’ and so forth.”

She said both efforts -- the point-of-need diagnostics and the ecosystem -- are scheduled to begin in mid-October.

“From the start date,” Nurthen said, “eight months down the road we will have an initial demonstration of the ability to receive a result from the diagnostic to the ecosystem. Then about a year and six months down the road, we look to have a full demonstration of the capabilities.”