Global Infectious Disease Surveillance and Detection Assessing the Challenges–Finding Solutions: Workshop Summary (2007) / Chapter Skim
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4 Resource Needs and Opportunities
4 Resource Needs and Opportunities
Pages 213-232
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By way of conclusion, Hueston employs business strategic planning analysis to identify strengths, weaknesses, opportunities, and threats inherent in current approaches to addressing infectious diseases. Following Hueston's presentation, a panel discussion explored diverse perspectives on resource needs and opportunities for infectious disease surveillance, detection, diagnosis, and reporting.
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. On Location and in the Lab In contrast to the global perspective taken by LeDuc, panelists Marci Layton, Fernando Guerra, and Frances Downes offered local viewpoints on infectious disease surveillance and detection.
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Downes, Laboratory Director for the Michigan Department of Community Health, discussed opportunities for improving infectious disease surveillance from the perspective of the public health laboratory. Her contribution to this chapter, which summarizes her presentation, describes the creation and strengthening of laboratory networks, the removal of barriers to disease reporting by laboratories, the role of information technologies, and the incorporation of syndromic surveillance and disease diagnosis in the field.
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. Before I address these broad issues, however, I would like to introduce five technical impediments to the coordination of infectious disease surveillance across animal and public health.
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and Standardized Nomenclature for Veterinary Medicine (SNOVET) for veterinary medicine.
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Currently, coordination of disease surveillance, detection, diagnostics, and reporting is stymied by an overriding philosophical framework comprising our public health focus, our definition of health, our perspective on risk, our fascination with disease agents, our propensity to glorify emergency response, and our preoccupation with technology. A series of examples will help to illustrate these challenges: • Despite the fact that public health surveillance is all about populations, we tend to think in terms of the individual.
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• All too often we focus our infectious disease resources on the agent, ignoring the web of causation, including genetics, host immunity, and social and environmental factors. By focusing disproportionately on the agent, we fail to adequately track host and environmental risk factors that contribute to the emergence and reemergence of infectious diseases and we are lulled into the erroneous conclusion that successful risk management depends on identification of the specific agent.
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Public health involves identifying problems, setting priorities, formulating policies to address these priorities, promoting health and preventing illness, and providing access to health care. Achieving these lofty public health goals requires a very different paradigm characterized by a global perspective, a focus on health, an ecosystem approach (agent, host, environment)
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. Real-time surveillance of food products and their raw materials must be combined with quality control and food safety systems in processing and distribution, sensitive public health disease detection, prompt reporting, and rapid outbreak investigation.
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We need to imbue these emerging public health professionals with a commitment to transdisciplinary approaches. We also need to encourage them to embrace change and be adaptable in a world that will never be risk free.
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Looking at current disease surveillance, detection, diagnostics, and reporting systems, we can draw several conclusions from a brief SWOT analysis. The public health dilemmas of infectious diseases are global, not local.
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IMPROVING INFECTIOUS DISEASE SURVEILLANCE AND DETECTION: A PUBLIC HEALTH LABORATORY PERSPECTIVE Frances Pouch Downes, Dr.P.H. Michigan Department of Community Health The practice of infectious disease surveillance has co-evolved with the public health laboratory to address important health concerns with ever-advancing technologies. This ongoing partnership is essential to the continued improvement of surveillance systems.
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These include the creation and strengthening of laboratory networks; the acknowledgment and removal of barriers to disease reporting by laboratories; the adoption and adaptation of information technologies by and for laboratory use; and the extension of the laboratory–surveillance partnership to refine and validate syndromic surveillance and rapid field diagnosis of reportable diseases. Establishing Laboratory Networks Surveillance benefits from the collection of comprehensive data from diverse sources, and public health laboratories can play an instrumental role in facilitating and garnering support for this process.
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. Even simple efforts such as the development of educational materials or tools and presentations to remind laboratorians about the importance of their role in disease reporting, or the participation of public health laboratories in state and regional clinical laboratory professional organizations, can ultimately improve the completeness and timeliness of disease reporting.
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. Vacancies due to an inadequate pool of qualified candidates translate into less time available to prepare and ship isolates and specimens to public health laboratories, prepare and submit reports of reportable diseases to public health agencies, and participate in training on emerging health issues and disease reporting.
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format, which can create a message from the originating laboratory information system and transfer it to a surveillance information system that captures and stores disease surveillance data for case investigation and data analysis. Widespread adoption of electronic laboratory reporting would eliminate the current slow, labor-intensive practice of transcription of results from a laboratory information system to a paper form and submission by mail or reentering results to a web-based interface with the surveillance system.
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. Field Diagnosis Global public health surveillance and clinical patient care may benefit from easily performed microbe-specific rugged tests.
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2006. Coordination of disease surveillance, detection, diagnostics, and reporting.
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Approved Standard M24-A. Wayne, PA: National Committee on Clinical Laboratory Standards.
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