Early warning infectious disease surveillance

The Early Warning Infectious Disease Surveillance program (EWIDS) is part of the Cooperative Agreement on Public Health Preparedness and Response for Bioterrorism administered by the Centers for Disease Control and Prevention (CDC). The purpose of EWIDS is to develop and implement a program to collaborate with states or provinces across international borders, to provide rapid and effective laboratory confirmation, and to expand surveillance capabilities. Prior to September 11, 2001, funds were not allocated to states for improving cross-border epidemiologic and laboratory surveillance activities that would increase cross-border preparedness. States were required through the Cooperative Agreement to self-report data twice a year in progress reports to the Division of State and Local Readiness Management Information System (MIS). An analysis of self-reported activities was conducted to determine the activities that states most frequently chose to implement based on existing public health infrastructure along the U.S. borders, since analysis of preparedness activities on the border has not previously been conducted. This article discusses how states chose to address expanding infrastructure capacity with the EWIDS supplemental funding, the challenges that have prevented U.S. border states from addressing all suggested activities, and the importance of sustained funding for the investment of continued capacity building and collaboration with international partners.