Johns et al. BMC Public Health 2011, 11(Suppl 2):S3 http://www.biomedcentral.com/1471-2458/11/S2/S3 Table 1 Diseases and agents investigated throughout 2009 among AFHSC-GEIS global partner laboratories and institutions Disease or Agent Adenovirus Campylobacter Chikungunya Cholera Cyclospora Dengue fever Hepatitis (viral) Influenza Pandemic (2009) H1N1 Seasonal Influenza Avian Influenza (H5N1) Malaria Norovirus Rickettsiosis Rift Valley fever Salmonella typhi Group A Streptococcal (GAS) pneumonia Syphilis Unknown etiology Conjunctivitis Gastrointestinal syndrome Respiratory syndrome Hemorrhagic syndrome Vampire bat bites Total Number of Outbreaks 1 1 1 4 1 4 3 42 4 2 1 1 1 1 1 1 1 1 2 1 1 1 76 Page 3 of 9 support, epidemiologic consultation and laboratory diagnostic support. In 27 (36 percent) of the outbreaks, personnel were provided for field support, 44 (59 per- cent) outbreaks received epidemiologic or clinical con- sultative support, and laboratory diagnostic and testing support was provided to 68 (91 percent) of the out- break support requests. Many AFHSC-GEIS partner responses were a combination of the above and 27 (36 percent) of the outbreak investigations provided a fully comprehensive response effort with support from all three categories. Respiratory disease outbreaks Beginning in 2006, the DoD’s global disease surveillance network has worked to enhance the existing surveillance infrastructure to prepare for a potential influenza pan- demic. The goals of these expansion efforts included broadening the network to monitor and detect increas- ing numbers of avian (H5N1) influenza outbreaks around the world and identify new infectious disease threats [10]. This expansion of capacity and function was both appropriate and fortuitous as AFHSC-GEIS network partners at NHRC and USAFSAM were the first in the world to detect the novel influenza A/H1N1 strain in April 2009 in San Diego, California, and San Antonio, Texas. This rapid detection during the end of the influenza season allowed the appearance of this novel strain to be identified and reported as a Public Health Emergency of International Concern by the CDC, a WHO Figure 1 Global Snapshot of Emerging Infectious Diseases and Respiratory Diseases Outbreaks. October 2008 to September 2009.