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The first recognition of a bioterrorist attack may be sick patients. Recognition and subsequent notification of an attack at the earliest possible moment will assist in rapidly instituting protective measures. New methods of medical surveillance can assist with rapid detection. Syndromic surveillance is the use of newly created or pre-existing databases to track the health of communities. The data can include medical and non-medical information, but typically contains non-specific indicators of health status. These systems are currently being tested and fielded in multiple locations, and nationwide systems are being developed in the United States. Retrospective and prospective analyses have demonstrated the ability of the data to detect disease outbreaks, but the systems have yet to be proven to lead to more effective interventions.