Page 126 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

124 Chapter 5
Pc: PIR2=1/R
c: Not included, as number is too small. d: According reference 10, Vink et al.
Influence of alert systems on timeliness: signalling reports and (lab) inf@ct
Increased awareness through signalling reports and (lab)inf@cts contributed to a significant decrease in the median disease identification delay during the mumps outbreak starting in December 2009 (4 days), and for measles (6 days) and psittacosis (18 days). The median notification delay for Q fever decreased by 3 days after information was provided to professionals in June 2007, p < 0.05 (Figure 4). For the other outbreaks, disease identification time and notification delay did not change significantly after alerts were given.
Discussion
This study analysed delays in the notification and reporting chain of infectious diseases in the Netherlands in the period 2003–2017. We observed that legal adjustments for mandatory notification to the MHS and reporting to the RIVM led to shorter delays. We show that the law adjustment successfully reduced the reporting delay to the RIVM and that MHS are capable of swiftly adjusting their reporting methodology. In our opinion, the decrease of reporting delay observed in 2009 was mainly the result of legal adjustments, as the electron- ic reporting system between MHS to RIVM, in place since 2003, did not alter. However, the legal adjustments led to renewed attention towards monitoring delays, which in our opinion probably contributed as well. Nowadays, MHS fulfil the thresholds for legal timeframes, with at least 80% of cases reported in time in 2016–2017.
Notification delays
Notifications by physicians and laboratories to the MHS are now also timely. We observed a steady reduction in the median delay by 1 day every 2 years, already starting in period 1. While notification systems involving laboratories generally lead to more timely notifications than those involving only physicians [5], we observed a longer average notification delay for diseases notifiable for labora- tories than for diseases notifiable for physicians in period 1.