Page 192 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

190 Chapter 9
The research in this thesis was conducted with the goal to define a timeframe for evaluation of timeliness in notification and response systems for infectious disease control, and to investigate which elements facilitate effective prepared- ness in terms of notification systems, legal aspects, cooperation between stake- holders and costs involved. In the first section, we address the research ques- tions with regard to surveillance systems and in the second section the ques- tions with regard to response systems.
9.1. Section 1
Research question 1: What is the delay of infectious disease notifica- tion and reporting in the Netherlands?
The median notification delay of diseases notified to the MHS between 2013 until November 2017 is 0 days (range 0-6 days). The average across the medians per infectious disease is 0.4 day. In 2016 and 2017, 82.3% of cases were notified to the MHS within 1 working day. The median reporting delay to the RIVM in the period 2013 – 2017 is 0 days (range 0-1 day). The average across the medians per disease is 0.1 day.
Background
Notification of an infectious disease is the result of a chain of events from expo- sure until report at the public health services, either local, regional or national. To determine delays in infectious disease notification and reporting in the Neth- erlands, we developed a notification and response framework (Figure 1, page 8, this thesis). We defined notifications as legally obligatory notified cases or clus- ters of infectious diseases by physicians or laboratories to the Municipal Health Services (MHS). Notification delay (D3) was therefore defined as the time be- tween laboratory confirmation of an infectious disease and notification by the laboratory or treating physician to the MHS. Subsequently, MHS report notified cases to the RIVM. We defined reporting delay (D6) as the time between notifi- cation at the MHS and reporting at the RIVM.
According to the former Infectious Disease Act, valid between April 1999 and December 2008, physicians needed to notify ‘group B’ infectious diseases to the MHS within one working day (1). Laboratories needed to notify, anony- mously, group C diseases to the MHS. In order to facilitate timely notification and to decrease underreporting, laboratories subsequently were encouraged