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Objective: Prompt detection of infectious disease outbreaks and rapid introduction of mitigation strategies is a primary concern for public health, emergency and security management organizations. Traditional surveillance methods rely on astute clinical detection and reporting of disease or laboratory confirmation. Although effective, these methods are slow, dependent on physician compliance and delay timely, effective intervention. To address these issues, syndromic surveillance programs have been integrated into the health care system at the earliest points of access; in Ontario, these points are primary care providers, emergency departments (ED), and Telehealth Ontario. This study explores the role of Telehealth Ontario, a telephone helpline, as an early warning system for detection of gastrointestinal (GI) illness. Methods: Retrospective time-series analysis of the National Ambulatory Care Reporting System (NACRS) ED discharges and Telehealth Ontario data for GI illness from June 1, 2004 to March 31, 2006. Results: Telehealth Ontario recorded 184,904 calls and the NACRS registered 34,499 ED visits for GI illness. The Spearman rank correlation coefficient was calculated to be 0.90 (p Conclusion: Telehealth Ontario call volume fluctuation reflects directly on ED GI visit data on a provincial basis. Telehealth Ontario GI call complaints are a timely, novel and representative data stream that shows promise for integration into a real-time syndromic surveillance system for detection of unexpected events. Key words: Syndromic surveillance; bioterrorism; gastrointestinal illness; Telehealth Objectifs: La detection precoce d'epidemies de maladies infectieuses et l'introduction rapide de strategies d'attenuation representent une preoccupation de premier plan pour les organismes de sante publique, de secours et de gestion de la securite. Les methodes de surveillance traditionnelles s'appuient sur la detection clinique et le signalement astucieux de maladies ou sur leur confirmation en laboratoire. Meme si ces methodes sont efficaces, elles sont lentes, dependent du bon vouloir du medecin et retardent l'intervention efficace et opportune. Pour aborder ces questions, les programmes de surveillance syndromique ont ete integres aux systemes de soins de sante dans les premiers points d'acces. En Ontario, ces points sont les fournisseurs de soins primaires, le service des urgences et Telesante Ontario. Dans cette etude, nous explorons le role de Telesante Ontario, une ligne d'aide telephonique, comme systeme d'avertissement precoce pour la detection des maladies gastro-intestinales (GI). Methodes: Nous avons effectue une analyse retrospective des series chronologiques des conges du service des urgences du Systeme national d'information sur les soins ambulatoires (SNISA) et des donnees de Telesante Ontario sur les maladies GI, du 1er juin 2004 au 31 mars 2006. Resultats: Telesante Ontario a enregistre 184 904 appels et le SNISA a recu 34 499 visites aux urgences concernant les maladies GI. Nous avons calcule le coefficient de correlation de rang a 0,90 (p Conclusion: Les fluctuations du volume d'appels a Telesante Ontario refletent directement les donnees sur les visites aux urgences a l'echelon provincial concernant les maladies GI. Les appels concernant les maladies GI effectues aupres de Telesante Ontario representent un filon de donnees representatif, nouveau et opportun qui laisse entrevoir l'avenir d'un bon oeil en ce qui concerne leur integration dans un systeme de surveillance syndromique en temps reel pour la detection d'evenements inattendus. Mots cles: surveillance syndromique, bioterrorisme, maladies gastrointestinales, Telesante Ontario La traduction du resume se trouve a la fin de l'article., International terrorist activities have highlighted our lack of preparedness for biological attacks and have focused the attention of local and national health resources on methods to enhance detection of an [...]

When the anthrax mailers penned the message, 'YOU CAN NOT STOP US. WE HAVE THIS ANTHRAX,' the threat included a chilling nuance that remains largely unrecognized. 'ARE YOU AFRAID?' asked [...]

We used unpublished reports, published manuscripts, and communication with investigators to identify and summarize 49 anthrax-related epidemiologic field investigations conducted by the Centers for Disease Control and Prevention from 1950 [...]

In October 2001, two envelopes containing Bacillus anthracis spores were processed at the Washington, D.C., Processing and Distribution Center of the U.S. Postal Service; inhalational anthrax developed in four workers [...]

The biological attacks with powders containing Bacillus anthracis sent through the mail during September and October 2001 led to unprecedented public health and law enforcement investigations, which involved thousands of [...]

During an investigation conducted December 17-20, 2001, we collected environmental samples from a U.S. postal facility in Washington, D.C., known to be extensively contaminated with Bacillus anthracis spores. Because methods [...]

After inhalational anthrax was diagnosed in a Connecticut woman on November 20, 2001, postexposure prophylaxis was recommended for postal workers at the regional mail facility serving the patient's area. Although [...]

Molecular subtyping of Bacillus anthracis played an important role in differentiating and identifying strains during the 2001 bioterrorism-associated outbreak. Because B. anthracis has a low level of genetic variability, only [...]

The bioterrorism-associated human anthrax epidemic in the fall of 2001 highlighted the need for a sensitive, reproducible, and specific laboratory test for the confirmatory diagnosis of human anthrax. The Centers [...]

In October 2001, the greater New York City Metropolitan Area was the scene of a bioterrorism attack. The scale of the public response to this attack was not foreseen and [...]

After public notification of confirmed cases of bioterrorism-related anthrax, the Centers for Disease Control and Prevention's Emergency Operations Center responded to 11,063 bioterrorism-related telephone calls from October 8 to November [...]

On November 11, 2001, following the bioterrorism-related anthrax attacks, the U.S. Postal Service collected samples at the Southern Connecticut Processing and Distribution Center; all samples were negative for Bacillus anthracis. [...]

After the 2001 anthrax bioterrorism incidents, public health officials became concerned about bioterrorist threats of smallpox. The Centers for Disease Control and Prevention (CDC), along with interested partners, developed a [...]

In 2001, the intentional release of anthrax spores in the eastern United States increased concern about exposure to anthrax nationwide, and residents of Idaho sought assistance. Response from state and [...]

Dispatches from the front: On May 30, after the opening of 'The Interventionists: Art in the Social Sphere' at Mass MOCA, in North Adams, Massachusetts, some fifty artists gathered outside [...]

Rep. Jo Bonner (R-AL) 'and several staff' were 'quarantined in his Mobile district office' 1/4 'after someone sent a threatening letter' containing a 'bag of powder.' Bonner's other office in [...]