Communicable Disease Suveillance & Control

• What is public health surveillance?

  The ongoing, systemic collection, analysis, and interpretation of health-related data essential to planning, implementation and evaluation of public health practice
• Fill in the blanks (Surveillance loop)

  A) Event

  B) Data

  C) Information

  D) Action

  
• What are the different ways to conduct public health surveillance?

  Comprehensive vs Sentinel

  Active vs Passive

  Case-based vs Syndromic

  Voluntary reporting vs Statutory reporting
• Comprehensive vs Sentinel surveillance

  Comprehensive (all providers report)

  -> used for low frequency and/or more severe diseases that require timely public health follow up (e.g. notifiable disease)

  • better coverage
  • time/resource intesinsive
  • tricky to maintain data quality

  Sentinel (a subset of providers report)

  -> used for high frequency and/or less severe diseases (e.g. seasonal influenza)

  • cheaper
  • can still get good data if sites are well selected
  • can't detect cases outside of selected sites/groups
  • may not be representative of wider population
  • not useful for rare conditions
• Active vs Passive

  Active (you go get data)

  • often quicker
  • more control over data
  • better data quality & completeness
  • time/resource intensive

  Passive (data comes to you)

  • cheaper
  • can help improve data quality over time
  • less timely & complete
  • limited control over what is collected
• Case-based vs syndromic

  Case-based (diagnoses & tests)

  • targets a specific disease
  • easier to interpret
  • fewer false positives
  • less timely
  • some cases won't get diagnosed/tested

  Syndromic

  • reports collections of symptoms rather than physician diagnosed or lab confirmed disease
  • early warning system
  • efficient use of existing data
  • less specific
  • difficuly to interpret
• Voluntary vs statuatory reporting 


  Voluntary (data is helpful but not legally required)

  • e.g. norovirus outbreaks in hospital

  Statutory (legal obligation to report)

  • e.g. notifiable diseases
  • more complete data
  • more representative
  • easier to interpret trends
  • time consuming to set up
  • when/how to enforce?
  • impact of confidentiality on care-seeking (e.g. STIs)
• Give 5 notifiable diseases.

  Acute meningitis

  COVID-19

  Malaria

  TB

  Rabies
• Who do you report notificable diseases to?

  UK Health Security Agency
• How do you report a notifiable disease?

  Urgent diseases should be reported by phone ASAP

  Non-urgent diseases can be reported by email within 3 days
• What is an outbreak?

  More cases of a particular disease than is expected in a given area, or among a specific group of people, over a particular period of time
• What is an Outbreak Control Team (OCT)?

  A milt-agency group established to coordinate the investigation & control of an outbreak
• What are the roles of an OCT?

  Detect - review information & decide if outbreak is occuring

  Investigate - sources, cases, epidfemiological study

  Control - advise on treatment, contact tracing, vaccination etc.

  Prevent - final outbreak report, share good practice, future training
• Disease control = breaking the chain of infection by controlling the source, interrupting transmission and protecting the susceptible population