April 4, 2003
BIRMINGHAM, AL — When doctors at a Toronto travel clinic began seeing the first cases of what appeared to be the new disease called SARS (severe acute respiratory syndrome), they quickly logged on to a secure Web site to inform colleagues around the world that potential cases were showing up in Canada. Using the electronic database, health care professionals in Toronto — as well as Singapore and other areas where SARS has appeared — are able to compare notes about experiences in treating patients with the unusual virus, to monitor what kinds of control measures are being used, and to garner some ideas about the spread of the disease.
The Web site and electronic database is called GeoSentinel and it was initiated in 1995 by the International Society for Travel Medicine and the U.S. Centers for Disease Control and Prevention. As a global surveillance network of travel and tropical medicine clinics, its goal is to identify and track outbreaks like SARS. Dr. David Freedman, director of the Travel Medicine Clinic at UAB (University of Alabama at Birmingham), is co-director of GeoSentinel.
“The concept of GeoSentinel is that travel and tropical medicine clinics are ideally situated to effectively detect emerging infections and to track ongoing trends in travel-related morbidity,” Freedman said. “The existing public health infrastructure is primarily laboratory-based and faces bureaucratic and political constraints in many countries. With an online network of physicians from around the globe, we can bypass those constraints and, with today’s technology, identify outbreaks in real time.”
GeoSentinel is currently comprised of 26 travel/tropical medicine clinics located in the United States, Canada, Europe, Asia and Australia, and more than 1,500 ISTM members in 65 countries.
GeoSentinel uses a two-tiered approach to surveillance. First, through the 26 clinic sites, surveillance involves ongoing monitoring of patient data that allows the linkage of travel-related infections with geographic destinations. Second, network members participate in informal communication about unusual cases.
When urgent requests for enhanced surveillance and notification in outbreak situations occur, the network allows for rapid electronic dissemination of alerts to assist in connections with appropriate local or national public health or health care groups. Responses can involve the clinic sites, the larger number of network members and more than 500 medical providers on the ISTM listserv (TravelMed).
The continual surveillance has aided in the development of detailed data on trends, risk factors, outcomes and geographical patterns of disease, and the development of educational priorities for medical specialists in travelers’ health. In turn, this has driven research to define the most significant health risks and to rank the relative efficacy of existing preventive measures.
In the future, GeoSentinel hopes to build on the ‘network of networks’ concept by increasing its partnerships with national and global entities and networks, expand its geographic coverage with additional sites in strategic locations and expand its demographic coverage with additional sites with key populations including military, diplomatic, missionary and commercial patient populations.
“These goals will help us to improve the efficiency of our communications and help us to identify, track, treat and ultimately decrease health risks to travelers,” Freedman said.