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Accomplishments for Core Goal #5: Biosurveillance

Biosurveillance Image


The State of Maryland established a focus on early detection, surveillance, and situational awareness to mitigate the threat of both naturally occurring and human-caused biological hazards.  This includes increasing surveillance of key public health indicators and monitoring sensor data for chemical or radiological releases or aberrations.  The State’s build-out and expansion of its automated computer biosurveillance system to include more information from more partners has improved its ability to respond to disease and virus outbreaks such as the 2009 H1N1 pandemic.

  • Collecting real-time patient condition data from all 46 acute care hospitals in Maryland. Maryland is among the first states in the nation to connect all of its acute care hospitals to a public health syndromic biosurveillance system called ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics). The Maryland Department of Health (MDH) began anonymously tracking patient symptoms reported in emergency room visits from selected hospitals in 2005. By 2009, all 46 acute care hospitals in the State were reporting data to ESSENCE and that data was proven to be a leading indicator in the H1N1 influenza pandemic. That same year, ESSENCE was able to show increases in influenza activity before the first H1N1 influenza case had been confirmed. More recently, MDH has used ESSENCE to track the spread of asthma, carbon monoxide poisoning, and other public health threats.

Map showing ESSENCE Reporting

  • All 24 public school systems in Maryland report daily school absenteeism data to ESSENCE.  School absenteeism provides a more complete analysis of potential public health events, especially during influenza season, because children are often the first carriers of new viruses. In late 2011, the State partnered with Allegany, Carroll, and Harford County Public Schools to begin anonymously reporting elementary school absenteeism data to ESSENCE. The first day of the 2012-2013 school year marked the very first that every public school in Maryland reported absenteeism data to ESSENCE.

Participating Accute Care Hospitals

  • Collecting real-time over-the-counter drug sales data from more than 300 retail pharmacies in Maryland. Since 2010, approximately 300 pharmacies across the State’s 24 counties have reported anonymous sales data for over-the-counter medications and thermometers to ESSENCE providing a representative data sample of the population. Sales of thermometers and cold medications can be used to indicate the emergence of seasonal flu or more serious public health threats. MDH continues to expand the number of data elements collected through ESSENCE in order to further refine its ability to detect an outbreak.
    • The Maryland Department of Health built a new Public Health Laboratory. Opened in the summer of 2014, the new laboratory allows MDH to perform testing for high consequence pathogens that can be transmitted by aerosol (e.g., pandemic influenza event and white powder bio-threat events). The laboratory design incorporates an open, flexible concept, which allows lab spaces to be easily reconfigured as testing missions evolve. The lab also has room for trainings and an all-hazards receipt facility to process specimens from threat events.