What is NBS?

The National Electronic Disease Surveillance System (NEDSS) Base System (NBS) is a CDC-developed integrated information system that helps local, state, and territorial public health departments manage reportable disease data and send notifiable disease data to CDC. NBS provides a tool to support the public health investigation workflow and to process, analyze, and share disease-related health information. NBS also provides reporting jurisdictions with a NEDSS-compatible information system to transfer epidemiologic, laboratory, and clinical data efficiently and securely over the Internet.

Built and maintained by CDC, NBS integrates data from many sources on multiple public health conditions to help local, state, and territorial public health officials identify and track cases of disease over time. This capability allows public health to provide appropriate interventions to help limit the severity and spread of disease.

NBS facilitates the adoption of national consensus standards used across public health and healthcare—including vocabulary standards such as LOINC, SNOMED, and RXNORM and messaging standards such as HL7—and helps local, state, and territorial public health departments use standards when sending information to CDC about notifiable diseases and conditions.

Who Uses NBS?

Currently, 27 health departments (21 states; Washington, DC; CNMI; Guam; Puerto Rico; RMI; and U.S. Virgin Islands) use NBS to manage public health investigations and transfer general communicable disease surveillance data to CDC.

Map of Health Departments currently using NBS

NBS is also currently operating in the following U.S. territories:

  • CNMI
  • Guam
  • Puerto Rico
  • RMI
  • Virgin Islands

Note: Mississippi is using NBS for COVID-19 only.

How NBS Data Guide Public Health Actions

NBS supports surveillance for any type of condition. However, it is primarily used for state reportable and nationally notifiable conditions, most of which are infectious diseases. Public health reporting jurisdictions, the Council of State and Territorial Epidemiologists, and CDC work together to determine the list of conditions on an annual basis. Currently, more than 140 different diseases and conditions are tracked through NBS.

Data collected for surveillance purposes are used primarily at the local and state level to guide public health action. A subset of the data collected are sent to CDC to support surveillance at the national level. The data are used to

  • identify cases of illness that affect public health,
  • prevent additional cases of disease,
  • ensure that appropriate interventions such as treatment are implemented,
  • help make policy and funding decisions,
  • evaluate interventions and programs, and
  • monitor the incidence of disease over time.

Evolution of the System

The primary goal of the first release of NBS was to support the electronic processes involved in state reportable and notifiable disease surveillance, investigation, and analysis and replace the functionality supported by the National Electronic Telecommunications System for Surveillance (NETSS). CDC started development of NBS in 2001, and the first version of the application went live in the state of Nebraska in January 2003. Since then, the system has evolved into a modern disease surveillance, case management, and case notification system. It serves as a reference implementation of the NEDSS standards and living laboratory for testing implementation of best practices in public health surveillance systems.

National Electronic Disease Surveillance System

Integrated surveillance information systems in reporting jurisdictions that are based on the National Electronic Disease Surveillance System architectural standards are primary data sources for the National Notifiable Diseases Surveillance System (NNDSS). Jurisdictions use these information systems to create and send standards-based case notifications to CDC for NNDSS.

NBS provides a NEDSS-compatible data system for use by local, state, and territorial public health departments. It helps public health departments with

  • integration of multiple diseases into one surveillance system to improve programmatic processes and reduce costs associated with supporting multiple systems;
  • reportable disease surveillance by improving information sharing between healthcare providers and health departments and between health departments and CDC; and
  • electronic laboratory reporting to improve public health disease reporting.