In the last quarter of 2009, tropical storms Ketsana, Pharma and Santi poured the heaviest rainfall on Metro Manila in more than 40 years. This caused massive flooding in the National Capital Region and Region IVA. A few weeks later, the world's biggest leptospirosis outbreak reported more than 200 deaths and 3 000 cases in various hospitals around the country. The Global Outbreak Alert Response (GOARN) investigated the outbreak, and recommended that an integrated information system in emergencies be established, for it would provide early warning for potential disease outbreaks. Surveillance in Post Extreme Emergencies and Disasters or SPEED was conceptualized to provide real time health information reporting after a disaster.