Signals Come and Go: Syndromic Surveillance and Styles of Biosecurity

Abstract

This paper follows the development of a novel biosecurity technology known as ‘syndromic surveillance’. By monitoring new sources of nondiagnostic health information (911 calls, ER triage logs, pharmaceutical sales), syndromic surveillance produces new ‘territories of intelligibility’. But the implemention of syndromic systems—and the opening up of these new territories—poses a problem of interpretation. What is significant in nondiagnostic data flows? In fact, the development of a national syndromic system in the United States attracted criticism from local public health experts, who complained about the costs of ‘false positive’ or insignificant detections. This exposes a disjuncture between two interpretative frameworks, two styles of governing biosecurity: public health (a responsibility for maximal population health) and preparedness (a concern for disaster-scale events). At stake are new norms and forms of securing life.