Emergency call centers collect and distribute data likely to be relevant to biosurveillance. Railroad and trucking call and dispatch centers hold data regarding the contents of shipments and their status, including adverse events such as spills. Among the databases used by 911 call centers, CAD databases are the most useful and immediately relevant to public health authorities, because they can provide information collected in real time from the scene of an incident, and if appropriately linked to GIS, geographic information. The data often include observations by trained observers and so are generally reliable. These systems cover a wide area of the United States, since E911 with CAD is widely deployed in this country. Systems currently being deployed use modern database technology, so access does not present unduly difficult technical challenges.
Creating a technical connection to 911 and other databases access is feasible and not very difficult, as recent installations demonstrate, but there are legal and cost considerations. The budgets of the organizations that operate these systems do not provide funding for developing interfaces to outside entities, so governments must be prepared to support the necessary software and hardware modifications. Other systems that may contribute information of use to biosurveillance are commercial emergency call centers. Poison information centers collect large amounts of information from callers about poisoning incidents, and this information can be readily extracted from their databases. However, truly useful nationwide biosurveillance using poison center data awaits the linking of these centers in a network, as well as new developments in automating toxidromes surveillance and recognition.
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