Appendix B: Examples of a Biological Pathogen Detection, Verification, and Information Sharing

Information SourcesExamples of Initial Intelligence ReceivedVerification ProcessMethods of Information Sharing
Individual practitioner or healthcare facility labSuspected or confirmed sentinel case reported through local public healthPrivate sector, Laboratory Response Network (LRN), or HHS CDC laboratory confirmation may be requiredHealth Alert Network (HAN), National Public Health Information Coalition (NPHIC), Clinician Outreach and Communication Activity (COCA)
Individual facility, local or state health department surveillance systemsInflux of patients with similar symptoms indicating potential new disease pathogenPrivate sector, LRN, or HHS CDC laboratory confirmation may be required
Epidemiologic investigation to confirm patterns of similarity
HAN, National Incident Coordination Conference Line (NICCL), COCA, National Poison Data System
Identification of novel or atypical pathogen in FSLTT, or private sector laboratoryIndividual not originally suspected; “unexpected” diagnosis received through secondary testingPrivate sector, LRN, or HHS CDC laboratory confirmation may be requiredHAN, COCA, NPHIC, Public Affairs Conference Line (PACL), NBIS Protocol
Novel emerging infection reported under IHR from overseas sourceNew pathogen or pathogen of concern evolving in a situation in which spread to U.S. is possibleMultiple international partners as well as international assistance provided by U.S. Government (USG)HAN, COCA, NPHIC, PACL, National Biosurveillance Integration System (NBIS) Protocol
Zoonotic outbreak identified by private sector, SLTT, or federal providers or laboratoriesZoonotic pathogen identified in an animal population with potential for causing human diseaseUSDA, HHS CDC, SLTT, National Animal Health Laboratory Network (NAHLN), or private sector laboratory confirm all possibleHAN, COCA, NPHIC, PACL, NBIS Protocol
Law enforcement intelligenceCredible threat of deployment of pathogen of concernLaw enforcement investigations paired with public health expertiseLaw Enforcement Sensitive (LES) Bulletin, NSC Process, NICCL
Public mediaAnnounced release of pathogen of concernMultiple entities/processes at various levels potentially involvedNSC Process, NICCL, follow-on HAN, NPHIC, PACL
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