Syndromic Surveillance in California

One state's less-than-stellar experience tracking disease
By Katherine Eban

As spinach tainted with a deadly Escherichia coli made its way last year from a California farm through 26 states, sickening more than 200 people and killing three, a bill to advance symptom monitoring was making far slower progress through the California state bureaucracy. To some public-health experts, it was déjà vu all over again, on two counts: a tidal wave of symptoms that no one saw, until it was too late; and a possible solution encountering bureaucratic resistance.

Since 2003, two statewide commissions on emergency preparedness had advised that California urgently needed electronic systems for syndromic surveillance and disease reporting. A report by the Little Hoover Commission in 2003 noted that in California, only one-fifth of "reportable" diseases and conditions are actually reported to public health officials. "When a California food...

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