Technical Updates

We Welcome Hawaii, Our 50th State to Join NSSP!

We’re pleased to announce that Hawaii is now onboard, and its first emergency department facility is in production. More facilities will soon follow.

At the time of this posting, all 50 states, the District of Columbia, and Guam have production-ready feeds. This achievement is largely due to NSSP’s collaboration with staff in state health departments and the support provided by the highly engaged NSSP Community of Practice. These collaborations established a strong foundation for data collection and sharing that has been essential during the pandemic.

AMC Successfully Updated in July

The BioSense Platform Access & Management Center version 1.5.5 was installed on July 22, 2021, adding two new privilege levels to Master Facility Table (MFT) user access. These privileges allow users to view or view and edit MFT records. In addition, advisory/warning messages were added for user and user group management for site administrators.

Getting Started with the Rnssp Package

Rnssp hex sticker

Last month we released Rnsspexternal icon, an R package that lets you access ESSENCE via a secure and easy-to-use interface. Rnssp simplifies R code and streamlines the data pull. Before Rnssp, users relied primarily on the keyring R library to pull data from the ESSENCE application programming interfaces (APIs). This is still an option, but the Rnssp library adds another more secure method to access the ESSENCE APIs that should become your “go-to” method.

A newly published document—How to Use the ESSENCE APIs With the Rnssp Packageexternal icon—will take you step-by-step through loading Rnssp and explain how to use it to access ESSENCE APIs. The document provides the code for using seven APIs (time series data table, time series png image, table builder results, data details [line level], summary stats, alert list detection table, and time series data table with stratified historical alerts/ESSENCE2).

Related links:
Introduction to the Rnssp packageexternal icon
The Rnssp Online Documentationexternal icon
How to Use RStudio with ESSENCE APIsexternal icon
The Rnssp Github repositoryexternal icon


UPDATE: Change in Availability of Laboratory Test Results

On August 5, 2021, NSSP notified the syndromic surveillance community that CDC would no longer update SARS-CoV-2 test results from laboratories C, D, E, or F in ESSENCE. Data from these laboratories are available through the COVID Electronic Laboratory Reporting (CELR) data in HHS Protect.

Laboratory B continues to send SARS-CoV-2 test results to CDC, which are added to ESSENCE daily. There are also no changes to the data sent by Laboratory A, which will continue to include both orders and results for SARS-CoV-2, as well as tests for other reportable health conditions and drugs of addiction. Laboratory A data update throughout the day.

CDC is making this change, in partnership with the laboratories, to reduce the reporting burden on laboratories and to streamline COVID-19 data collection.

When commercial SARS-CoV-2 testing began in March 2020, data sent from these laboratories to CDC represented a substantial proportion of all testing in the United States and provided a view of trends in test volume and positivity that was not yet available in many states. These early laboratory data feeds sent directly to CDC have been replaced by the more comprehensive CELR system. Data from the four laboratory feeds that NSSP is discontinuing now represent <5% of tests nationwide.

The NSSP team appreciates laboratories C, D, E, and F for their critical partnership during the early stages of the response. NSSP will continue sharing data from Laboratories A and B with its health department partners.

How can NSSP help banner

NSSP Resources for Hurricane Preparedness and Response

There’s no way to predict if hurricane season will include a storm the size of Hurricane Harvey or back-to-back storms as destructive as Hurricanes Irma and Marie. In preparation, all sites need an emergency response plan that considers the hazards that could impact the community. This year, planning should also consider the need to protect communities from COVID-19.

NSSP has standard operating procedures that it uses before, during, and after a hurricane or other emergency response. These procedures are designed to ensure that all sites have adequate surveillance resources—and if not, the NSSP team will try to fill those gaps or connect your team with others in the surveillance community who have the expertise you may seek.

What can NSSP do for your site?

Syndromic surveillance can serve as the cornerstone for surveillance efforts. Sometimes syndromic surveillance is the only data source that can be set up quickly to monitor the health needs of people who seek care in emergency shelters or in neighboring states. If you have questions or concerns about planning for or conducting syndromic surveillance during a hurricane response, please contact us at

emergency response checklist

To maintain situational awareness and communication during a hurricane response, NSSP will provide summaries to officials involved in the CDC response effort. If your site, state, or local public health jurisdiction is in the path of an approaching severe weather system and has data feeds connecting with NSSP, the NSSP team will contact these site administrators before the storm response to

  • clarify roles and responsibilities for response communications;
  • offer to provide hands-on assistance with ongoing surveillance, monitor ESSENCE dashboards, or share reports that can be locally generated; and
  • ask if CDC response summaries or other communications can be coordinated with state and local activities on the site’s behalf.


To ensure adequate technical support is available, the NSSP team will do its best to support your needs. Some sites have few resources and seek technical and analytic support from NSSP analysts, whereas other sites conduct all surveillance activities and analyses and simply pass data to NSSP upon request. If you see gaps or can identify ways in which the NSSP team can help, please contact us at The NSSP teams can build dashboards, monitor activities, set up user groups for data sharing, and provide analytic support.

To respect state-owned data and facilitate data requests, NSSP will work with site administrators to identify the data they need and are willing to share. During past responses, most sites have given NSSP access to site-level data to improve situational awareness and better coordinate response efforts. CDC NSSP will comply with existing usage agreements and, in collaboration with the site, will use program tools to create rules that govern data sharing that can be easily deactivated after the response.

To prepare for the next emergency, NSSP encourages and sometimes facilitates after-action meetings. This keeps data at the forefront of response discussions. Use this after-action meeting to identify processes that need improvement and potential collaborations for the next response effort.

For example, team members from NSSP and the Assistant Secretary for Preparedness and Response (ASPR) held an after-action meeting to discuss their 2018 collaboration after Hurricane Michael struck the Florida Panhandle. ASPR deployed Disaster Medical Assistance Teams (DMATs) to support hospitals providing medical services to people displaced by flooding and storm damage. The DMAT data provided insight into the health impacts of the event and response—in near real-time. Data were made available to CDC’s Emergency Operations Center and to affected public health partners. During this after-action meeting, the teams discussed IT support, exportation of batch versus new or updated records, message structure and quality, staff training, requirements for general response support, and opportunities to test code and response processes.1

  1. National Syndromic Surveillance Program (NSSP): NSSP Update–February 2019 [Internet]. Atlanta: CDC; 2019 [cited 2021 Aug 12]. Available from:
Hurricane Preparedness Resources


  • For program support, please email
  • To onboard new facilities, set up ad hoc data streams, or get answers to technical questions, please submit a ticket to the NSSP Service Desk at syndromicsurveillance.orgexternal icon (an account is required).
  • Slack “#severe-weather” channel. Access to and participation in the NSSP CoP Slack Workspace is limited to staff from federal agencies and to state, territorial, local, and tribal health departments. To join the Slack Workspace, please complete this form.external icon


  • NSSP Severe Weather Dashboard: The intent of this dashboard is to monitor potential health impacts of hurricanes, tropical storms, and winter storms (Figure 1). The dashboard is available for download in the NSSP–ESSENCE Library and can be accessed by NSSP participants.
NSSP-Severe Weather Dashboard

Figure 1.The NSSP–ESSENCE dashboard can be used to monitor the potential health impacts of hurricanes, tropical storms, and winter storms. The dashboard is available to program participants via The myESSENCE tab, “NSSP Severe Weather: Winter Storms, Hurricanes, and Tropical Storms,” and is available for download from the myESSENCE library. This dashboard provides a broad surveillance overview of many potential outcomes associated with severe weather events including winter storms, hurricanes, or tropical storms. The dashboard includes conditions such as food and waterborne disease, infectious disease, chronic conditions, and injuries.


Examples of state-developed materials:

Hurricane preparedness links:

Syndromic surveillance:

Did you like this article? If so, you might want to read “Prepare, Respond, Recover…NSSP Assists Emergency Response Efforts.”

Page last reviewed: September 24, 2021