Those who investigate reports of notifiable diseases typically collect the minimum information needed to complete a basic investigation: patient name, patient demographics, and clinical history. Alternatively, notification of a case of Hantavirus pulmonary syndrome does not require such an immediate response and, in the state of Illinois, may be reported within a 7-day time frame. For example, when a diagnosis of invasive meningococcal disease occurs, the case typically must be reported within 24 hours so that prophylaxis can be promptly administered to close contacts and outbreaks can be quickly investigated to determine whether administration of meningococcal vaccine is needed. Reporting must occur within a determined time frame that varies for different diseases and is based on the immediacy of the need for the action. A list of reportable conditions is usually readily available from local and state health departments. When a diagnosis of a reportable or “notifiable” infectious disease is made, physicians and other health care providers including infection control practitioners and hospital microbiology laboratories are required to notify their state health department by telephone, fax, mail, or by secure, Internet-based systems. States have their own public health laboratory(ies) that assist in infectious disease monitoring activities by providing infrequently performed or expensive tests that might otherwise be unavailable at the local hospital.
Hence, surveillance is information for action. Diseases that are reportable are typically chosen for that status because notification of the local or state health department triggers an important action that needs to be performed. State legislation or regulations mandate that health care providers and laboratories report confirmed or probable cases of notifiable infectious diseases to their local or state health department, or both. It is the responsibility of health care personnel, with the help of public and private laboratories, to diagnose and report cases of notifiable infectious diseases. Thus it is important for all physicians to know the guidelines governing surveillance. The term “health care provider” is defined broadly in some jurisdictions and may include physicians, nurses, physician assistants, nurse practitioners, infection control practitioners, chiropractors, dentists, and others. Effective surveillance of disease in humans begins with the health care provider. All of these systems are currently being used to monitor West Nile virus activity, for example. Various systems have been developed to track disease in humans, in animals such as birds or horses, and in insect vectors such as mosquitoes. In the United States, the responsibility for disease surveillance is typically shared by health care professionals, public and private laboratories, local and state health departments, and public health officials from several governmental agencies and departments. Those unfamiliar with collection and analysis of infectious disease data may think it is merely “bean counting,” but it is a field of study where new and important trends are identified with local, national, and global significance. Such data guided and then confirmed global eradication of smallpox. Surveillance data have guided policies and programs, helped to marshal limited resources, and moved the world toward completely eradicating this disease that caused human suffering for generations. For example, polio has been eliminated from the United States and is on its way to being eliminated globally. Surveillance is the foundation upon which many of the public health successes we enjoy today are based. Despite the density of this definition, physicians must understand what it means if they are to contribute to the maintenance of public health. Surveillance is defined as the “ongoing, systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice”.
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