Surveillance - Ongoing systematic collection, analysis, and interpretation of data- integrated with the
timely dissemination of data to those responsible for preventing and controlling disease
Uses of Surveillance Data - 1.) Facilitate timely response to outbreaks
2.) Helps to ascertain impact of diseases (ex- increase of babies with syphillas due to connection with
opioid use)
3.) Help support and evaluate effectiveness of control measures (make decisions based on data) (ex- pre
and post plan for gonnerria rates)
The Surveillance Network - The patient
Physician/diagnostic laboratory
The hospital/clinic
County health department
State health department
Centers for disease control and prevention in USA
World Health Organization (WHO)
Two Main Types of Surveillance - 1.) Passive Surveillance - fill out forms
2.) Active Surveillance - investigate
Passive Surveillance - -Routine submission of reports to state, federal health agencies
-Relatively inexpensive, covers large areas
-Provides critical information for monitoring a community's health
-Data quality and timeliness difficult to control
National Notifiable Diseases - -National Electronic Disease Surveillance System (NEDSS) -counted and
identified
-Currently ~55 infectious diseases are officially reportable to the CDC (Measles, Malaria, TB, Cholera)
,Active Surveillance - -County, state, federal agents contact clinics for information about specific diseases
-Provides info rapidly, but is time consuming and expensive (have to follow up on leads)
Syndromic Surveillance - -Use of health-related data that may precede diagnosis
-Newer type of passive surveillance
-Clinical data is symptom-related
-Non-clinical data may also be used
Purposes:
-Rapid response to an outbreak/bioterror event
-Monitor progression of a disease outbreak (while still just a few cases)
-Good for controlling outbreaks
ex) Poison control center calls, unexplained deaths (20 dead birds), many 911 calls of same type,
school/work absenteeism, over-the-counter meds, internet based illness reporting
Dissemination of Data - Health Alert Network (HAN)
-CDC program
-Coordinates communication between local and national public health programs and helps to
disseminate warnings
-Internet based repository of news and information
Publication of Surveillance Data - -CDC publishes a weekly bulletin - Morbidity and Mortality Weekly
Reports
-Presentation of data depends on disease
--ex) simple #cases, #cases/100,000 population, #cases/region/year vs. an established goal, #cases
compared to the same data previous years, #cases in a given age groups (ex STD's)
Infectious Disease USA: CDC
Global Infectious Diseases: WHO
, Global Surveillance - The International Health Regulations
-Provides a legal framework to require all countries to detect and contain infectious disease outbreaks
-Global rules to enhance national, regional, and global public health security
International Health Regulations - All countries required to develop and maintain:
-Surveillance
-Reporting
-Response mechanisms at local, regional, and national levels
Outbreaks of certain diseases must be reported to WHO within 24hrs (China did not do this in SARS
outbreak)
WHO Reportable Diseases - Smallpox, polio, influenza (seasonal and new human strains), SARS -->
always notifiable
-Other highly contagious and deadly diseases (cholera, yellow fever, meningitis)
Public Health Emergencies of International Concern:
-Ebola (2014)
-Zika virus (2016)
Chief Sources of Reports to WHO - 1.) Routine surveillance from individual countries
2.) GPHIN (Global Public Health Information Network)
3.) ProMED (Program for Monitoring Emerging Diseases)
4.) GOARN (Global Outbreak Alert and Response Network)
GPHIN (Global Public Health Information Network) - -Operated by Public Health Agency of Canada
-Scans global news & web, filters & sorts, review for relevancy --> Early Warning System
ProMED (Program for Monitoring Emerging Diseases) -mail - -Operated by International Society for
Infectious Diseases
-Information resources: media, official reports, subscriber submissions
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