Page 112 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

110 Chapter 5
Abstract
Background: Timely notification of infectious diseases is essential for effective disease control and needs regular evaluation.
Aim: Our objective was to evaluate effects of statutory adjustments in the Neth- erlands in 2008 and effects of raising awareness during outbreaks on notifica- tion timeliness.
Methods: In a retrospective analyses of routine surveillance data, delays be- tween disease onset and laboratory confirmation (disease identification delay), between laboratory confirmation and notification to Municipal Health Services (notification delay) and between notification and reporting to the National In- stitute for Public Health and the Environment (reporting delay) were analysed for 28 notifiable diseases. We included 144,066 notifications between July 2003 and November 2017. Delays before (period 1) and after the law change (periods 2 and 3) were compared with legal timeframes. We studied the effect of out- break awareness in 10 outbreaks and the effect of specific guidance messages on disease identification delay for two diseases.
Results: Average notification delay decreased from 1.4 to 0.4 days across the three periods (six diseases; p < 0.05), reporting delay decreased mainly in period 2 (from 0.5 to 0.1 days, six diseases; p < 0.05). In 2016–2017, legal timeframes were met overall. Awareness resulted in decreased disease identification de- lay for three diseases: measles and rubella (outbreaks) and psittacosis (specific guidance messages).
Conclusions: Legal adjustments decreased notification and reporting delays. As disease identification delay dominates the notification chain, insight in patient, doctor and laboratory delay is necessary to further improve timeliness and monitor the impact of control measures during outbreaks.