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Feb 9 2010 UNCLASSIFIED
Vision and Mission
• Vision: to provide relevant, timely, actionable, and comprehensive health surveillance information and support to the Armed Forces for military and military-associated populations
• Mission: to promote, maintain, or enhance the health of military and military-associated populations– Acquire, analyze and interpret, recommend, and
disseminate information– Develop, refine and improve standardized surveillance
methods– Serve as focal point for sharing health surveillance
products, expertise and information– Delineate roles, responsibilities, and mutually supporting
relationships among the Armed Forces health surveillance activities
Armed Forces Health Surveillance Center
Feb 3 2010 UNCLASSIFIED
AFHSC Operating Structure
DIRECTOR Armed Forces Health Surveillance Center
Dep Dir, AFHSC/Director, GEIS
DoD Serum Repository
AFHSC HQ Support
Science Advisor Executive Officer Resource Mgr Chief, Information Officer
Chief, Data and AnalysisChief, Communications, Standards,
& TrainingChief, GEIS Operations
Data Management
Epidemiology/Analysis Surveillance Operations
& CommunicationsSurveillance Standards
& Training
AI/PISurveillance
GEISCore
LiaisonsUSPHS
DHSWHO
Feb 9 2010 UNCLASSIFIED
• Vision: Successfully develop, implement, support, and evaluate an integrated global emerging infectious disease surveillance and response system that supports the AFHSC and promotes preparedness in US Forces, the Military Health System and the Global Public Health community.
• Mission: Contribute to Force Health Protection and Global Public Health by centrally coordinating a global system of partners that conduct emerging infectious disease surveillance and response; training and capacity building; research, innovation and integration; and assessment of value added in a timely, efficient, comprehensive and communicative manner.
“Partnering in the Fight against Emerging Infections”
Division of GEIS Operations(DOD GEIS)
Strategic Goals and Priority Pillars
AR
D
GI
DR
O
ST
I
RI = Respiratory Infection
GI = Gastrointestinal Infection
FVBI = Febrile and Vector-borne Infection
AR = Antimicrobial Resistance
STI = Sexually Transmitted Infection
AFHSC/DOD-GEIS
Assessment and Communication of Value AddedResearch, Innovation and Integration
Surveillance and ResponseTraining and Capacity Building
RI
GI
AR
ST
I
FV
BI
Force Health Protection
Feb 9 2010 UNCLASSIFIED
AFHSC Global Network
DOD’s Unique Assets – Overseas Presence with OCONUS Labs
Peru
Kenya
Egypt
Thailand
Indonesia
Navy Hub
Air Force Hub
WRAIR, NMRC
AFIP
Germany KoreaKorea
Feb 9 2010UNCLASSIFIED
Predictive Surveillance Benefit
WHO World Health Report 2007
Feb 9 2010 UNCLASSIFIED
Predictive Surveillance Model
Feb 9 2010 UNCLASSIFIED 8
b
Eco-climate trend and condition characterization and surveillance
Insect vector characterization and pathogen transmission surveillance
Animal host/reservoir characterization and pathogen transmission surveillance
Human conditions/activities characterization for association with disease outbreaks; Human case surveillance
Eco-climate anomaly critical-point detection and analysis
Vector signal of critical-point detection for pathogen transmission
Animal signal of critical-point detection for pathogen transmission
Community or clinic signal of critical-point detection of human infection
Advisory on emerging eco-climate conditions conducive to outbreaks
Alert on vector transmission threat that promotes targeted, pre-emptive vector and/or animal interventions
Prediction of human risk based on animal disease and transmission threat to promote targeted pre-emptive public health interventions
Early alert of human disease outbreak, for timely control interventions
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Predictive Surveillance TimelineEven
tA
ctio
n
Hu
man
illn
ess
Hu
man
ou
tbre
ak
an
d r
esp
on
se
Hu
man
case
rep
ort
ed
Con
verg
en
ce o
f V
ect
or
en
vir
on
men
t /
Clim
ate
req
uir
em
en
ts
Eco
/clim
ate
even
t or
an
om
aly
Vect
or
d
ete
cted
An
imal/re
serv
oir
ill
ness
Com
pete
nt
vect
or
cross
es
ab
un
dan
ce
th
resh
old
Retr
osp
ect
ive d
ata
Th
reat
p
red
icit
ion
Eco
/clim
ate
an
aly
sis
Ris
k ale
rt
Ris
k ad
vis
ory
An
imal/re
serv
oir
case
rep
ort
ed
Weath
er/
vect
or
surv
eill
an
ce
Weeks/Months
Feb 9 2010 UNCLASSIFIED
Continuous Remote SensingEco/Climate Anomalies
A Anyamba, NASAFeb 9 2010 UNCLASSIFIED
Ground Truthing
J Small, NASA
UnclassifiedFeb 9 2010
Ground Truthing
T Klein, J Grieco, A Anyamba,K Linthicum
USAMRU-K Mosquito samplings sites
Feb 9 2010 UNCLASSIFIED
Country / Region
Alert to Outbreak (months)
2008South Africa
2 – 3
2007: Sudan 4 - 5
2006:East Africa
4
Predictive Surveillance RVF Outbreaks 2006-2008
In pressA Anyamba, NASAFeb 9 2010UNCLASSIFIED
Refining the RVF Model
Feb 9 2010 14UNCLASSIFIED
Anyamba et al, PNAS, 106(3)955 (2009).
Climatic Factors: heavy and widespread
rainfall
Coastal Flood Plain
Aedes species followedby Culex in large number
Culex species –Important secondaryvector in RVF
Mosquito Map
TaxonomicTaxonomic
++Point occurrencePoint occurrence
++EnvironmentalEnvironmental
Mosquito Mosquito Distribution Distribution ModelsModels
Foley, et al. J Med Ento, 46 (3) 2009
Feb 9 2010 UNCLASSIFIED
Animal Reservoir
Feb 9 2010 UNCLASSIFIED
Human Disease Surveillance
Data management
OUTBREAK
RESPONSE
Absenteeism
Radiology
DiagnosticLabs
Poison Control
Prescriptions
Physician OfficeVisits
NurseCall
Center
Over theCounterSales
Data sources detection reporting
S Lewis, JHU/APL
Feb 9 2010 UNCLASSIFIED
AFHSC Template
Feb 9 2010 UNCLASSIFIED 1
Feb 9 2010 UNCLASSIFIED 1
NASA-GSFC: A Anyamba, J Small, J Pinzon, CJ Tucker, E Pak
USDA: K Linthicum
WRBU: D Foley, P Rueda, R Wilkerson
USUHS: P Masuoka, J Grieco, N Achee
USAMRU-K: J Cook, D Schnabel KEMRI: R Sang
AFRIMS: J Richardson, J Pavlin
65th Medical Brigade: T Klein
JHU/APL: S Lewis, B Feighner, A Buczac
Acknowledgements
