Limiting the effects of bioterrorism-related and emerging infectious disease outbreaks requires the rapid and accurate identification of the earliest victims.  This is difficult because the early clinical manifestations of many bioterrorism-related and emerging infectious diseases are similar to more common acute infectious diseases.  Since rapid diagnostic tests for bioterrorism-related and emerging infectious diseases are not widely available, victims may not be identified for several days after their symptoms first appear.  As a result, public health departments have recently instituted syndromic surveillance systems to detect prodromal cases of bioterrorism-related and emerging infectious diseases at the earliest possible time.  These systems rely on indicator data types of events preceding a clinical diagnosis that suggest an increased probability of bioterrorism-related and emerging infection diseases, such as constellations of medical signs and symptoms in patients seen in clinical settings.  Despite these efforts, little progress has been made toward identifying specific sets of clinical characteristics that maximize our ability to identify detect outbreaks of bioterrorism-related and emerging infectious diseases.  The primary goal of this research project is to improve the rapid and accurate identification of victims of bioterrorism-related and emerging infectious diseases in clinical settings to enhance the early detection of bioterrorism-related or emerging infectious disease outbreaks.  Dr. Kyriacou is conducting several research projects to identify the clinical predictors for bioterrorism-related and emerging infectious diseases and to create syndromic algorithms to improve their rapid and accurate detection in the emergency department setting.