Sales of OTC products are among the most highly available types of biosurveillance data that we discuss in this section of the book. At present, OTC sales data are available as daily counts of sales for each GTIN by store, with a one-day delay from time of sale. We expect the one-day delay to gradually improve as more retailers migrate their national data warehouses to real time. For example, Wal-Mart has developed real-time sales analysis and communication with its suppliers

2 As discussed in detail in Chapter 32, the GTIN product coding standard greatly facilitated construction of the NRDM and its ongoing maintenance.

3 See Chapter 33 Architecture for more information on web services.

4 We note that the CDC's BioSense system collects national data from two laboratory companies, the military healthcare (within the U.S.), and the Veteran's Administration healthcare system. BioSense at present provides these data only through the BioSense interface.

to minimize inventory costs (Kalakota and Robinson, 2003). Market basket and customer loyalty-card data have great potential for biosurveillance, but are not available at present.

Sales of OTC products are also among the most heavily studied types of biosurveillance data that we discuss in this section of the book. The available evidence strongly suggests that OTC sales are an early indicator of outbreaks of influenza, other annually recurring infectious respiratory diseases, cryp-tosporidiosis, and gastroenteritis due to E. coli, Salmonella, and rotavirus. The most promising categories include pediatric electrolytes, flu remedies, chest rubs, "cough, cold, sinus, and allergy'' medications, diarrhea remedies, thermometers, pedi-atric cough syrup, and pediatric antifever medications.

The National Retail Data Monitor is a data utility for OTC sales data. It facilitates the communication of OTC sales data from retailers to biosurveillance organizations. It is one model for collecting biosurveillance data of national scope and providing them to biosurveillance organizations.

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