Changes in the Reportable Disease Surveillance Process in the US Army

Background: Historically, the US Army has relied on limited passive reporting of diseases, which in turn has restricted the response by public health officials. Most reportable medical conditions have not been investigated for detailed risk factor information. In addition, lab confirmation of reportable conditions has been limited to the judgment of the reporting agency. Methods: Changes in the disease reporting process have been implemented by having preventive medicine departments of regional medical commands investigate all reportable medical conditions and confirm each. Reporting and investigation forms have been created based on CDC guidelines and state health department investigations. In addition, a new reportable medical surveillance database was created that will allow real time surveillance for reportable medical events. Outbreak/cluster responses and data interpretation are now conducted by the Disease Epidemiology Program at US Army Center for Health Promotion and Preventive Medicine. Results: Thirty investigation forms, disease fact sheets, and investigation protocols have been developed for investigation of reportable conditions. Detailed case definitions and lab conformation guidelines have been created for standardization throughout the Army Medical Command. The pilot web-based surveillance system is has shown is be a useful tool for near real-time data collection. Conclusions: Changes in the reportable disease process is a large undertaking that requires agreement from multiple agencies, as well as participation for several key sources. Training for investigative techniques as well as lab confirmation process is critical to the success of the new reportable disease process in the US Army.