Routinely assess the timeliness and completeness of your reportable disease surveillance system, especially for naturally occurring illnesses and conditions mimicking those resulting from a terrorist action.

Ensure the existence of systems to provide ongoing disease surveillance and epidemiology training for public health, clinical, and other healthcare professionals and to develop subject matter expertise within the public health system.

Evaluate and improve the timely and complete reporting of outbreaks of illness and/or key categories of cases of reportable diseases, such as influenza, invasive bacterial diseases, vaccine preventable diseases, vectorborne diseases, and food- and waterborne diseases.

Assess capacities associated with monitoring dermatological conditions/rash illnesses and develop plans to improve this component of the surveillance system.

Educate and provide feedback to reporting sources in your jurisdiction about notifiable diseases, conditions, syndromes and their clinical presentations, and reporting requirements and procedures, including those conditions and syndromes that could indicate a terrorist event.

With local public health agencies, develop or enhance case investigation protocols, response procedures, legal or regulatory provisions, or communication and information dissemination that improve the effectiveness of the public health epidemiologic response.

Evaluate and improve the timely and effective response to key cases of urgent public health importance (for example meningococcemia), outbreaks of disease, and urgent public health interventions such as IG administration following group exposure to hepatitis A or mass immunization in a meningococcal epidemic.

Develop and evaluate surveillance to rapidly detect influenza-like illness (ILI) and distinguish possible bioterrorism-caused illness from other causes of ILI.

Develop and evaluate surveillance for encephalitis and meningitis or unexplained critical illnesses or deaths. Link clinical reports and laboratory test results.

Develop and evaluate surveillance for indicators of terrorist events, including hospital admissions, hospital beds occupied (or available), intensive care unit admissions, or emergency department visits.

Develop or acquire information and fact sheets about bioterrorism, other infectious disease outbreaks, other public health threats and emergencies, and other relevant technical information for public use in a terrorist event.

Identify physicians and other providers with key bioterrorism-related skills (for example, those who have seen and treated smallpox).

Achieve an around-the-clock capacity for immediate response to reports of urgent cases, outbreaks, or other public health emergencies, including any events that suggest intentional release of a biological agent.

Assess the adequacy of local public health response to outbreaks of disease and other public health emergencies.

In coordination with your public health laboratory, develop and implement a strategy to ensure laboratory testing (in clinical or public health laboratories) for rapid or specific confirmation of urgent case reports.

Regularly provide relevant public health information to key partners through an appropriate Web site and/or a jurisdiction-wide newsletter.

Enhance relationships with infection control professionals through development of a formal public health network or support of state activities that build relationships between the health department and the Association of Professionals in Infection Control.

Enhance relationships with infectious disease physicians by participating in infectious disease rounds and conferences, supporting an infectious disease society or network, or supporting a health department-based infectious disease fellow.

Enhance relations with medical schools, nursing schools, and schools of public health through joint sponsorship of conferences, teaching, assisting in curriculum development and offering health department electives to students and residents.

Enhance relations with law enforcement agencies, the business community, and the National Guard by establishing designated points of contact and through cross-training in each discipline and/or joint sponsorship of conferences.