Page 129 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan
P. 129

Timeliness of infectious disease reporting, the Netherlands, 2003-2017 127
An international systematic literature review on publications on timeliness of notification systems, published between 2000 and 2017, revealed that notifi- cation delay at local level was evaluated most frequently [5]. Timeframes for notification varied between the included studies, but the most common prede- fined timeframe, either legal or defined for the study itself, was within 48 hours. Timeliness of notification systems was sufficient in only a minority of studies. Notifications by laboratories and by laboratories combined with notifications by physicians, as in the Netherlands, were related to more timely notifications [5,13]. Short delays, as those achieved in the Netherlands, are also observed in other European countries: both Germany and the UK have reported a majority of notifications arriving at LHD within 1 day [5,14-17].
Increased awareness during outbreaks and provision of guidance on labora- tory testing and notification criteria shortened disease identification and notifica- tion delays for some diseases. Although not applicable for all diseases, we demon- strate that disease identification can be expedited, which is especially important when reporting and notification delays have been minimised and the disease iden- tification delay dominates in the notification chain. This is particularly relevant for measles and mumps, but also in case of a newly emerging infectious disease.
Disease identification delays
The average across the median identification delays of the individual disease decreased in the third period by 1.5 day compared with period 1 and 2. Five dis- eases showed a significant decrease in period 3 compared with period 1, while four diseases showed a significant increase. We could not identify a clear trend and therefore not generate hypotheses on causes for the overall decrease in period 3. Insight in patient, doctor and laboratory delay would facilitate devel- oping hypotheses what factors would have attributed to changes in this delay.
Other timeframes
Disease-specific timeframes are still a concern. In the Netherlands, thresholds for notification within two incubation periods still are not met for bacterial pathogens causing gastrointestinal diseases such as enterohaemorrhagic Es- cherichia coli and STEC, shigellosis, and typhoid fever, which has been observed before [1]. In our opinion, this is related to a short incubation period in com- bination with patient delay in case of mild disease and doctor delay for not directly initiating laboratory testing. Timeframes for outbreak control involving total local delay (D1), were only met for hepatitis A, hepatitis B and measles, the latter meeting the timeframe for the first time in the period 2013–2017.
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