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Journal of Dental Research
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*Biodefense and Bioterrorism
*Mouth Disorders
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Biomaterials & Bioengineering

Detection of Disease Outbreaks by the Use of Oral Manifestations

M.H. Torres-Urquidy1,2,*, G. Wallstrom1 and T.K.L. Schleyer2

1 Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, 3501 Terrace St., Suite 339, Pittsburgh, PA 15213, USA;
2 Center for Dental Informatics, School of Dental Medicine, University of Pittsburgh

Correspondence: * corresponding author, mit7{at}pitt.edu

Oral manifestations of diseases caused by bioterrorist agents could be a potential data source for biosurveillance. This study had the objectives of determining the oral manifestations of diseases caused by bioterrorist agents, measuring the prevalence of these manifestations in emergency department reports, and constructing and evaluating a detection algorithm based on them. We developed a software application to detect oral manifestations in free text and identified positive reports over three years of data. The normal frequency in reports for oral manifestations related to anthrax (including buccal ulcers-sore throat) was 7.46%. The frequency for tularemia was 6.91%. For botulism and smallpox, the frequencies were 0.55% and 0.23%. We simulated outbreaks for these bioterrorism diseases and evaluated the performance of our system. The detection algorithm performed better for smallpox and botulism than for anthrax and tularemia. We found that oral manifestations can be a valuable tool for biosurveillance.

Key Words: bioterrorism • dental informatics • dental public health • early detection • oral manifestations

Journal of Dental Research, Vol. 88, No. 1, 89-94 (2009)
DOI: 10.1177/0022034508327546
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