Syndromic Surveillance

SurveillanceTo the Editor: As public health practitioners directly involved in constructing, maintaining, and interpreting syndromic disease surveillance systems, we offer the following comments on the Buehler et al. article, "Syndromic Surveillance and Bioterrorism-related Epidemics" (1).In general, this article was well-crafted.It reviewed the potential for syndromic surveillance to detect various diseases of bioterrorism, specifically an anthrax event based on the inhalational anthrax cases of 2001.However, the reader may conclude that hospital-based syndromic surveillance is potentially ineffective and unproven.Buehler et al. describe how, within 18 hours, a presumptive diagnosis of anthrax would prompt a full-scale response.We think that functional syndromic surveillance can respond to the rapid onset of hospital-based disease.To isolate and positively identify Bacillus anthracis from a blood culture would take ≈48 hours.