Active surveillance, including the use of a Remote Surveillance Trailer in Folsom CA, involves actively searching for cases, either through a notification system or through a systematic protocol, such as calling all health departments. Surveillance is the process or system for tracking cases of risk factors, medical conditions, cases of diseases, adverse events, etc. It is often used to track the incidence of a disease or the side effects of drugs or vaccines. The two basic types of surveillance are active and passive. Passive surveillance is the collection of data from those who voluntarily report it, such as hospitals, healthcare providers, parents, or health departments. Active surveillance involves actively searching for cases, either through a notification system or through a systematic protocol, such as calling all health departments in a region during a disease outbreak.
In the specialized area of biological terrorism surveillance, syndromic surveillance refers to the active surveillance of syndromes that may be caused by potential agents used by biological terrorists and sometimes refers to alternative measures, such as increasing the use of over-the-counter medications or increasing calls to emergency departments. Laboratory tests quickly confirmed that the disease was Ebola hemorrhagic fever, which normally kills more than 50 percent of infected people (Heymann, 200). Public health surveillance was difficult for several reasons. Because the disease was serious and rapidly lethal, rural residents feared being stigmatized if the government learned of cases in their area.
Some went to traditional healers; others fled as soon as they realized they had been exposed, causing outbreaks in two other districts. Gulu was a politically unstable area, and some villages were difficult to reach because of rebel activity or bandits. The Ugandan government mobilized its armed forces to help find cases and invited WHO, CDC and other international teams to help. Patients infected with the Ebola virus require intensive medical and nursing care to control bleeding, diarrhea and fever.
Some patients bleed easily and all of their secretions can be very infectious. Hospitals in Gulu desperately lacked supplies to control the simultaneous spread of infection among so many patients. Despite this situation, Ugandan health workers selflessly cared for the sick. By January 23, 2001, a total of 425 cases had been registered, the largest outbreak of Ebola on record.
Only 53 percent of the patients had died, much lower than the 88 percent recorded in the 1976 Ebola outbreak in the Democratic Republic of Congo (formerly Zaire) and other previous epidemics (report of an international WHO commission). Unfortunately, 22 health workers were infected. Because the team from the Uganda Ministry of Health established active surveillance across the country, the other two outbreaks, which began when infected Gulu residents fled to distant villages, were quickly detected and controlled. International observers commented: “National notification and surveillance efforts led to the rapid identification of these outbreaks and effective containment (CDC 200). In active surveillance, the organization receiving the information takes direct steps to collect it.
This can also occur by reviewing medical and laboratory records, interviewing people who are involved in investigating an outbreak, or screening high-risk populations. Surveillance activities are essential to detect diseases that can be prevented with vaccines and to obtain information to help control or address a problem. However, the full and accurate notification of cases depends on many factors, such as the source of the notification, the timeliness of the investigation, and the integrity of the data. In addition, several methods are used to carry out surveillance to gather information, depending on the incidence of the disease, the specificity of the clinical presentation, available laboratory tests, control strategies, public health objectives, and the stage of the vaccination program.
For diseases that can be prevented by vaccination, passive surveillance is the most common method, although active surveillance may be necessary in special surveillance situations. Active surveillance is usually short-term and generally requires more funding than passive surveillance. Surveillance activities can be passive or active. In passive surveillance, the health department passively receives reports of potential injuries or illnesses.
Think of this as waiting for reports about the illness to come to you. Many routine surveillance activities are passive, such as systems that track communicable diseases, cancer, and injuries. Epidemiologists collect case reports sent to them by healthcare providers, laboratories, schools, or other entities that are required by law to report this information. In active surveillance, on the other hand, epidemiologists actively search for cases of illness.
For example, during an outbreak of salmonellosis associated with a specific source (for example, a restaurant), epidemiologists may contact health care providers in the area and ask each of them for a list of patients treated with symptoms similar to those of salmonellosis. These patients are then contacted to see if they were exposed to the suspected source (in this case, the restaurant).). National surveys, such as the National Health and Nutrition Examination Survey (NHANES), iii, are also considered active surveillance. The advantage of active surveillance is that it generally provides more complete data, while passive surveillance depends on other people (who have many functions other than reporting diseases) to report cases.
The disadvantage of active surveillance is that it requires more resources, with greater personnel and financial requirements, iv. To use surveillance information to its full potential, it must be collected and stored in an accurate and consistent manner. For example, the polio surveillance system for acute flaccid paralysis in the Western Hemisphere detected no cases in July 2000. Foodborne disease (FBD) surveillance, for example, is divided into four different levels of surveillance.
Public health surveillance systems play an essential role in preventing and controlling the spread of diseases within and outside national borders. Reportedly, developing countries are the weakest link in the global surveillance framework, although they bear the greatest burden of disease, of old emerging and reemerging pathogens and of pathogens resistant to drugs (U. The most common systems used for disease surveillance include notifiable disease reporting at the national level; medical, hospital or laboratory surveillance; and population-based surveillance. Public health surveillance is a tool for estimating the health status and behavior of populations served by ministries of health, ministries of finance, and donors.
Administrators or donors at the national level can also improve the quality of information by sponsoring national scientific monitoring and quality assurance networks, linking funding to the provision of adequate data, and conducting regular surveys to confirm the results of local reports. Managers who decide to use public health surveillance as a management tool must recognize that they will need to provide political support and human and financial resources. The United States carries out numerous surveillance activities that involve directly collecting data from individual residents, usually through questionnaires, although NHANES also includes data on physical exams and laboratory data. India, with its decentralized system, complex cultural and demographic dynamics, and wide variability in the sophistication of public health institutions, provides another model for strengthening national surveillance.
In general, the most comprehensive surveillance systems at the state and local levels include multiple sources of information. Unfortunately, most developing countries have limited surveillance systems for non-infectious diseases; instead, existing data systems (for example, vital records, automobile accident records, or insurance claim data) are potential sources of surveillance data. Considerable attention has been devoted to the rapid and complete production of surveillance data, and corresponding resources have been dedicated to surveillance. GAO 200 that links existing regional, national and international networks of laboratories and medical centers into a surveillance network (Figure 53,.
