Development of a new fleet disease and injury surveillance capability using ESSENCE.

Historically, disease and illness (D&I) surveillance on U.S. Navy vessels relied on weekly data updates and required manual data processing. Established surveillance approaches for fixed military hospitals and clinics were not designed to be applied to the highly mobile populations aboard ships. This paper describes the development of a new surveillance capability through utilization of the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). The pilot program successfully instituted a near real-time D&I surveillance system defined for shipboard operations. Following initial data and system assessment, an operational surveillance strategy was developed and implemented at the Navy's 4 regional Navy Environmental and Preventive Medicine Units responsible for global fleet assets. Despite early implementation challenges, preventive medicine users reported that the fleet ESSENCE system was effective in identifying potential outbreaks, with sufficient efficiency for daily surveillance. This new capability using in-theater data in ESSENCE enables unprecedented, near real-time D&I surveillance for the U.S. Navy fleet. While currently targeting gastrointestinal and respiratory illness trends, the infrastructure has flexibility to add new modules in response to fleet and preventive medicine requirements.