EMERGEncy ID NET: An emergency department-based emerging infections sentinel network

Acute infectious disease presentations among many at-risk patient groups (e g, uninsured, homeless, and recent immigrants) are frequently seen in emerg ency departments. Therefore EDs may be useful sentinel sites for infectious disease surveillance. This article describes the background, development, and implementation of EMERGEncy ID NET, an interdisciplinary, multicenter, ED-based network for research of emerging infectious diseases. EMERGEncy ID NET was established in cooperation with the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) as part of the CDC's strategy to expand and complement existing disease detection and cont rol activities. The network is based at 11 university-affiliated, urban hos pital EDs with a combined annual patient visit census of more than 900,000. Data are collected during ED evaluation of patients with specific clinical syndromes, and are electronically stored, transferred, and analyzed at a c entral receiving site. Current projects include investigation of bloody dia rrhea and the prevalence of Shiga toxin-producing Escherichia cell, animal exposures and rabies postexposure prophylaxis practices, seizures and preva lence of neurocysticercosis, nosocomial ED Mycobacterium tuberculosis trans mission, and hospital isolation bed use for adults admitted for pneumonia o r suspected tuberculosis. EMERGEncy ID NET also was developed to be a mecha nism for rapidly responding to new diseases or epidemics. Future plans incl ude study of antimicrobial use, meningitis, and encephalitis, and considera tion of other public health concerns such as injury and national and intern ational network expansion.