A Successful Year for EWORS

EWORS (Early Warning Outbreak Recognition System), a disease outbreak detection and

surveillance system, was developed by NAMRU 2 in Jakarta, Indonesia, to fill a gap in

regional surveillance capabilities.  The software is now being used in Indonesia, Cambodia,

Vietnam, and Laos.  EWORS is intended to identify suspected clusterings of like, syndromic

cases and possible disease outbreaks.  EWORS's emphasis on establishing baseline measures

for trend analysis to differentiate outbreaks from non outbreak disease is unique.  The system

provides for timely and accurate dissemination of information that can then lead to effective

intervention measures such as investigative and containment activities.  One advantage of

EWORS is that users do not need analytical training, which is lacking in many rural areas

in southeast Asia, for recognizing a potential outbreak. Whether such a finding warrants

investigation or intervention is made at a higher level.

The Indonesia Ministry of Health, partners with NAMRU 2 in this project, has already

benefited from using EWORS.  During a diarrheal disease outbreak in 2001, Ministry of

Health staff used EWORS to detect the outbreak, the information collected with EWORS

allowed Ministry of Health officials to design and execute a comprehensive public health

outbreak investigation, and the results of the outbreak investigation provided sufficient

information so that effective intervention measures could be implemented.  EWORS can

be used by the Indonesian Ministry of Health as a national disease outbreak detection

and surveillance system.  Thus, EWORS meets a key aim of the DoD GEIS program, which

is to develop a program that is affordable, user friendly, effective, and acceptable as an integral

and permanent component of the national public health program.

Major EWORS successes in FY 01:

Recognized four large outbreaks in Indonesia. 

Provided early detection of incipient dengue hemorrhagic fever outbreak

cases in Bali, allowing for timely procurement of essential blood products

and preventing possibly hundreds of cases. 

Contradicted rumors of a cholera epidemic during severe flooding in

Cambodia, thus saving scarce resources for other interventions. 

Uses more than 500,000 case entries, from some of the most remote and

economically depressed areas of southeast Asia, for instant inclusion into

standardized trend analyses. 

Was awarded a provisional U.S. patent. 

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