Kant and Krishnan BMC Public Health 2010, 10(Suppl 1):S11 http://www.biomedcentral.com/1471-2458/10/S1/S11 concerned state, district, and national level health oﬃcials. These are then investigated and veriﬁed. Veriﬁed events are conveyed to appropriate authority for further action. About a thousand health alerts have been detected since July 2008. This process increases the sensitivity of the oﬃcial surveillance system, and may provide early warning of occurrences of new clusters of diseases in advance of oﬃcial notiﬁcation, as the media is often the ﬁrst to know of potential cases [4]. Call centre The telecommunication industry is one of the fastest growing industries in India. The total telephone sub- scription base is approaching 600 million [8]. The overall tele-density is over 50 percent, and urban tele-density has reached 100 percent. Subscriptions are growing by nearly 20 million new subscribers per month. Tele-density is expected to go up to 84 percent by 2012 [1]. Ready access to telephone systems by the general population is rapidly increasing. Citizens themselves could be a good source of disease outbreak information. With this in mind, a 24x7 call centre was established in February 2008 with a toll free number (1075) to receive disease alerts. The call centre has multiple language calling and answering capabilities, and any person speaking one of the major regional languages is welcome to call in with information about outbreaks/unusual events. The information is relayed to the appropriate District or State Level Surveil- lance Units, as well as to Central Outbreak Monitoring Cell at the IDSP, which monitors the action taken by the concerned district. Since its inception, more than 200,000 calls have been received, and more than 150 were conﬁrmed health alerts [5,6]. Mechanism of data collection and transmission Data is collected and reported on a weekly basis under the IDSP. When health workers at sub-centres suspect a case, they ﬁll out Form-S (suspect case). The doctors at Primary Health Centres, Community Health Centres and Hospitals ﬁll form P (probable case/presumptive case). The cases that are conﬁrmed by the laboratory ﬁll up Form L (lab-conﬁrmed case). Data managers receive these completed forms from various centres, and data compilation and analysis is done at the district, state and national levels. Cases representing and unusual or rising trends are investigated by a Rapid Response Team (RRT) to diagnose and control the outbreak. Major hospitals and Infectious Disease Hospitals are also required to report surveillance data. Eighty-ﬁve percent of all districts are now reporting weekly data to IDSP [5,6]. Video conferencing To ensure preparedness and enhance the quality of disease surveillance, regular video conferences are organized by Page 3 of 4 central surveillance unit of IDSP to discuss outbreak investigations and veriﬁcation and control measures with various State Surveillance Oﬃcers, District Surveillance Oﬃcers and the Rapid Response Teams. Additionally, project review and monitoring for diﬀerent aspects of the IDSP is undertaken periodically. Video conferencing facilities are also used for training purposes [5,6]. Distance learning For eﬃcient functioning of the surveillance system train- ing of various IDSP functionaries is an on-going process. Educational satellite (EDUSAT) classrooms are available at State Headquarters, District Headquarters, Medical Colleges, Premier Institutions and Infectious Disease Hospitals [5,9]. The communication network is also used to manage live virtual classrooms for training, e-learning, and interactive electronic discussions, among other things. Training for data managers and data entry operators and refresher courses and continuing education sessions are held regularly. Further training of epidemiologists and data managers can help build analytic capacity at district levels. Appropriate e-modules have been developed. Scanners have been provided to convert the x-ray pictures and paper reports into soft copies so that they could be electronically transmitted and also used for teaching purposes. Use of communication network during the H1N1 pandemic The call centre received 35,000 calls related to H1N1. The video conferencing facilities were used for training of medical oﬃcers in clinical management, infection control practices and laboratory support. The network also facilitated prompt receipt of test results. Conclusions Appreciable progress has been made in putting together the infrastructure and development of skills to make the ICT network functional in disease surveillance pro- gramme. As previously mentioned, 776 out of 800 sites have been networked, 738 sites have videoconferencing facilities, about 850,000 sub-centres send weekly report on syndromes, about 150,000 Primary Health Centres, Community Health Centres, and hospitals send list of probable cases. Facilities for distance education have also been established. There are other areas which still need to be addressed, including encouraging private sector reporting, strengthening skills for data use and analysis at all levels, enhancing the convergence of information and communication technology with other national health programmes, improving media scanning and veriﬁcation, and making data transmission all-inclusive by incor- porating, mobile, text, voice, email and fax. Abbreviations CDC, Centers for Disease Control and Prevention; EDUSAT, Education Satellite; ICT, Information and Communication Technology; IDSP, Integrated Disease