The 2010 Department of Homeland Security (DHS) Quadrennial Homeland Security Review states “ultimately Homeland Security is about effectively managing risks to the Nation’s security.” With risk defined as the likelihood and consequences of potential unwanted events, managing risks from naturally-occurring, accidental, or deliberate biological events such as emerging infectious disease or bioterrorism is difficult to accomplish through activities that attempt to reduce these events’ likelihood of occurrence. Although much is being done to prevent these types of events, such events could and do still occur. Instead, activities that mitigate these risks largely focus on reducing, managing, or limiting the consequences of biological events once they begin to occur. Surveillance plays an import role in early detection of such events, allowing an early response, limiting the spread and effects of such events. Doing this effectively requires the earliest possible warning that an event is occurring, as well as continuing shared situational awareness throughout the event, to enable effective decision making regarding what actions should be taken.