How Outbreaks of Infectious Disease are Detected: A Review of Surveillance Systems and Outbreaks

Abstract

To learn how outbreaks of infectious disease are detected and to describe the entities and information systems that together function to identify outbreaks in the U.S., the authors drew on multiple sources of information to create a description of existing surveillance systems and how they interact to detect outbreaks. The results of this analysis were summarized in a system diagram. The authors reviewed a sample of recent outbreaks to determine how they were detected, with reference to the system diagram. The de facto U.S. system for detection of outbreaks consists of five components: the clinical health care system, local/state health agencies, federal agencies, academic/professional organizations, and collaborating governmental organizations. Primary data collection occurs at the level of clinical health care systems and local health agencies. The review of a convenience sample of outbreaks showed that all five components of the system participated in aggregating, analyzing, and sharing data. The authors conclude that the current U.S. approach to detection of disease outbreaks is complex and involves many organizations interacting in a loosely coupled manner. State and local health departments and the health care system are major components in the detection of outbreaks.

Control and eradication of Classic Swine Fever in wild boar

“…The initial detection of cases or events suggesting the occurrence of disease can be characterized by the sensitivity and specificity of the applied diagnostic measures (see Table 5). Apart from the efficiency of diagnosis of individual cases, the sampling strategy in terms of sample volume and distribution over space, time and population strata, as well as the methodology of collation, analysis and communication of generated data have to be considered (Doherr and Audigé, 2001;Salman, 2003;Buehler et al, 2004;Dato et al, 2004;Klinkenberg et al, 2005;Feliziani et al, 2005). (1982) using the value for infinite population size without correcting for sensitivity and specificity as conservative upper limit ** Combined sensitivity (Se s ) and specificity (Sp s ) of both methods fever measurement and rRT-PCR only on febrile animals were calculated using the following equations (Thrusfield, 2005).…”

Oportunidad de la sistematización de la vigilancia de Dengue en Paraguay, su estacionalidad y las características de los casos en menores de 15 años, 2010-2012

“…Esto difícilmente puede lograrse con la información que rutinariamente registran los sistemas de vigilancia convencionales, los cuales generalmente dependen del reporte manual de los casos desde que el médico u otro personal de salud atienden al paciente, hasta que otro personal procesa las estadísticas. Esta sería la ventaja fundamental de la utilización de los sistemas automatizados para la (14,15) detección de alertas .…”

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“…Such delays diminish the window of opportunity to mount effective response measures and are likely to be costly to society 1 . For example, it was estimated that a one-week delay in the implementation of control measures for SARS in Canada resulted in a 2.6-fold increase in the mean epidemic size and a four-week extension of the mean epidemic duration 2 .…”