Treatment Facilities around the world.  GEIS recog 

conduct rigorous, in depth respiratory disease surveil 

nized that an ideal system to detect the full spectrum

lance at military training centers.

of emerging infections outbreaks would be a system

of systems integrating other potentially useful civilian

Timely, comprehensive, and consolidated clinical and

and military data from nurse hotlines, intensive care

epidemiologic characterization of deaths in military

units, pharmacies, laboratories, and veterinary sur 

personnel is a core public health function that did

veillance sources.  To this end early in FY 2001 the

not exist before investments made by DoD GEIS.

GEIS group at WRAIR partnered with the Johns

Emerging infectious diseases, such as hantavirus

Hopkins Applied Physics Lab and several other

pulmonary syndrome, new strains of influenza,

institutions and obtained a grant of more than $10

Legionnaires disease, and even rare cases of adenovirus

million from the Defense Advance Research Projects

infection in recruits, may present as rapidly progressive

Agency (DARPA) to develop a prototype integrated

and unexplained fatal illnesses.  While DoD GEIS

civil military health indicator surveillance system for

has supported mortality surveillance for several

the NCA called ESSENCE II.

years, in FY 2001 significant advances were made

to resource and systematize the effort, including the

A key step taken during FY 2001 to reconstitute and

assignment of a dedicated active duty epidemiologist

unify the DoD network of laboratories providing

to the Office of the Armed Forces Medical Examiner

public health laboratory services was directed towards

at the AFIP.  

developing an on line DoD Directory of Military

Public Health Laboratory Services.  This directory, to

Due to the size of the U.S. military presence on the

be managed by Armed Forces Institute of Pathology,

Korean peninsula, the need for maximal military

would include public health services that have been

readiness, and the spectrum of disease threats there,

provided by a highly competent but uncoordinated

DoD GEIS has made a specific commitment to provide

and in some cases generally unknown collection of

18th MEDCOM with resources to support activities

DoD clinical, research, and veterinary laboratories

that go beyond the standard military medical surveil 

around the world.

lance program.  During FY 2001, initiatives focused

on development of an integrated malaria and Japanese

Surveillance and respiratory diseases continue to be

encephalitis vector surveillance system, rodent borne

an important focus of the DoD GEIS program.  A

disease surveillance for areas of high risk, and tick 

highlighted effort is the ongoing operation and

borne disease surveillance to support risk analysis and

expansion of the tri service DoD Influenza Surveillance

identify potential human threats.  Close collaborations

System under the leadership of the Air Force Institute

with the South Korean government and academic

for Environmental, Safety, and Occupational Health

institutions have been cultivated over the last several

Risk (AFIERA).  Seventeen sentinel sites, 49 non 

years and are helping obtain valuable current incidence

sentinel sites, and multiple DoD overseas labs submitted

data on South Korean military and civilian populations.

3702 specimens for analysis during FY 2001.  The

impact of the DoD influenza surveillance program

Internationally, DoD GEIS, largely through the over 

continued in that one of its viral isolates from Panama

seas medical research laboratories, conducted substantial

was chosen as one of three strains included in the

collaborations with institutions in 34 countries around

2000/2001 vaccine, 70 million doses of which are

the world.  The work focused on surveillance for

distributed to Americans.  The Naval Health Research

drug resistant malaria, antibiotic resistant enteric

Center (NHRC) in San Diego provided an outstanding

organisms, influenza, and unexplained febrile illness.

complement to the AFIERA efforts through application

A variety of innovative tools for surveillance have

of a variety of specialized laboratory capabilities to

been implemented, such as the Early Warning Outbreak

3