Using an Intelligent Database for the Early Detection of Outbreaks

Background: A relational database has many features that could make it useful as a decision-support system for health professionals involved in the surveillance of outbreaks. A relational database can store an unlimited amount of data. Most computer-users are familiar with queries, a relatively simple and straightforward method of "zooming-in" on information. An "intelligent database" could be designed to include only information useful for the early detection of outbreaks and to classify that information in a comprehensive and systematic way. Methods: An intelligent database was envisioned as a map of the knowledge domain of all diseases that could present as outbreaks. The content would include emerging infectious diseases, bioterrorism, chemical weapons, occupational diseases, foodborne illnesses, zoonoses, and other communicable diseases. The system would include these features: 1.) All information will be comprehensively collected by a physician; 2.) All information will be systematically indexed using categories and a vocabulary that is structured and unambiguous; 3.) All information will be stored in a computer-based relational database with a graphical user interface that will enable users to sort and filter hundreds of records instantaneously. Results: The prototype application was developed in Microsoft Access. All information is bi-directional, i.e., the user can see all the symptoms associated with a disease or see all diseases associated with a symptom. The same structured vocabulary is used both to display information about a disease and to query the database. Each disease profile shows initial symptoms, incubation period, signs and symptoms, and associated high-risk activities. For infectious diseases, the application shows where the disease occurs in the world; how it is diagnosed in the laboratory; its source from patients, water, soil, or animals; the route of entry; and the insect vectors and animal reservoirs. Of the 201 diseases, 156 are infectious diseases. Queries by one or more criteria are available for 135 findings, 17 syndromes, 102 jobs, 101 activities, 39 epidemiological factors, and 16 regions of the world. Conclusion: A relational database is an effective tool to develop and update a decision-support system for outbreaks. Such a database could help medical and public health professionals participate in a surveillance system for the early detection of outbreaks.

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