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Public Health Rep. 2004 Sep-Oct; 119(5): 464–471.
PMCID: PMC1497658

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.

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Selected References

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  • Berkelman RL. Emerging infectious diseases in the United States, 1993. J Infect Dis. 1994 Aug;170(2):272–277. [PubMed]
  • Borgdorff MW, Motarjemi Y. Surveillance of foodborne diseases: what are the options? World Health Stat Q. 1997;50(1-2):12–23. [PubMed]
  • Eisenberg MS, Bender TR. Botulism in Alaska, 1947 through 1974. Early detection of cases and investigation of outbreaks as a means of reducing mortality. JAMA. 1976 Jan 5;235(1):35–38. [PubMed]
  • Elbers AR, Moser H, Ekker HM, Crauwels PA, Stegeman JA, Smak JA, Pluimers FH. Tracing systems used during the epidemic of classical swine fever in the Netherlands, 1997-1998. Rev Sci Tech. 2001 Aug;20(2):614–629. [PubMed]
  • Rice SK, Heinl RE, Thornton LL, Opal SM. Clinical characteristics, management strategies, and cost implications of a statewide outbreak of enterovirus meningitis. Clin Infect Dis. 1995 Apr;20(4):931–937. [PubMed]
  • Slater PE, Costin C. Infectious disease and mortality surveillance in Israel in peace and war. Public Health Rev. 1992;20(3-4):280–284. [PubMed]
  • Wharton M, Price W, Hoesly F, Woolard D, White K, Greene C, McNabb S. Evaluation of a method for detecting outbreaks of diseases in six states. Am J Prev Med. 1993 Jan-Feb;9(1):45–49. [PubMed]
  • Nagaraja R, MacMillan S, Kere J, Jones C, Griffin S, Schmatz M, Terrell J, Shomaker M, Jermak C, Hott C, et al. X chromosome map at 75-kb STS resolution, revealing extremes of recombination and GC content. Genome Res. 1997 Mar;7(3):210–222. [PubMed]
  • Rep MH, Schrijver HM, van Lopik T, Hintzen RQ, Roos MT, Adèr HJ, Polman CH, van Lier RA. Interferon (IFN)-beta treatment enhances CD95 and interleukin 10 expression but reduces interferon-gamma producing T cells in MS patients. J Neuroimmunol. 1999 Apr 1;96(1):92–100. [PubMed]
  • Roush S, Birkhead G, Koo D, Cobb A, Fleming D. Mandatory reporting of diseases and conditions by health care professionals and laboratories. JAMA. 1999 Jul 14;282(2):164–170. [PubMed]
  • Olsen SJ, MacKinnon LC, Goulding JS, Bean NH, Slutsker L. Surveillance for foodborne-disease outbreaks--United States, 1993-1997. MMWR CDC Surveill Summ. 2000 Mar 17;49(1):1–62. [PubMed]
  • Perkins BA, Flood JM, Danila R, Holman RC, Reingold AL, Klug LA, Virata M, Cieslak PR, Zaki SR, Pinner RW, et al. Unexplained deaths due to possibly infectious causes in the United States: defining the problem and designing surveillance and laboratory approaches. The Unexplained Deaths Working Group. Emerg Infect Dis. 1996 Jan-Mar;2(1):47–53. [PMC free article] [PubMed]
  • Tsui Fu-Chiang, Espino Jeremy U, Dato Virginia M, Gesteland Per H, Hutman Judith, Wagner Michael M. Technical description of RODS: a real-time public health surveillance system. J Am Med Inform Assoc. 2003 Sep-Oct;10(5):399–408. [PMC free article] [PubMed]
  • Wagner Michael M, Robinson J Michael, Tsui Fu-Chiang, Espino Jeremy U, Hogan William R. Design of a national retail data monitor for public health surveillance. J Am Med Inform Assoc. 2003 Sep-Oct;10(5):409–418. [PMC free article] [PubMed]
  • Wagner Michael M, Dato Virginia, Dowling John N, Allswede Michael. Representative threats for research in public health surveillance. J Biomed Inform. 2003 Jun;36(3):177–188. [PubMed]
  • Drew WL, Mintz L, Miner RC, Sands M, Ketterer B. Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis. 1981 Feb;143(2):188–192. [PubMed]
  • Ashford David A, Kaiser Robyn M, Bales Michael E, Shutt Kathleen, Patrawalla Amee, McShan Andre, Tappero Jordan W, Perkins Bradley A, Dannenberg Andrew L. Planning against biological terrorism: lessons from outbreak investigations. Emerg Infect Dis. 2003 May;9(5):515–519. [PMC free article] [PubMed]

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