Page 196 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

194 Chapter 9
The timeliness for reporting delays to the RIVM in the same period was also suf- ficient, with 98.4% timely reports almost reaching the ideal target of 100%. Only diphtheria and MRSA CA cases were not reported sufficiently in time (66.7% and 54.4%, respectively). As the notification of these diseases to the MHS was also delayed, they need attention in the monitoring of timeliness of notification and reporting delays by the MHS.
We conclude that notification and reporting delays met the legal time- frames in the period 2016-2017. A reduction in notification delay for some diseases is necessary. We recommend MHS to regularly evaluate notification timeliness and monitor notification procedures with laboratories and physi- cians in their region, with focus on rare diseases, diseases that need further laboratory testing, and diseases that were not incorporated in our studies. The four-monthly feedback reports on notification and reporting delays provided by the RIVM will facilitate MHS in this (7).
Research question 2: What is the most appropriate timeframe for timeliness of infectious disease notification for outbreak control? Are infectious diseases notified within this timeframe in the Netherlands?
We developed a model to determine the notification timeframe for outbreak control for six diseases using, amongst others, the disease specific distributions of serial interval and incubation period, and its reproduction number. Outbreak control notification delay was defined as the maximum delay within which the number of infections caused by secondary cases at the moment of notification was below one (PIR*R<1). During 2016-2017, hepatitis A, hepatitis B and measles were notified within this timeframe; mumps, shigellosis and pertussis were not.
Background
The aim of notification systems is early detection of outbreaks of infectious dis- eases. It enables public health authorities to initiate outbreak investigation and to install appropriate control measures (11). Public health surveillance systems need to be evaluated to ensure that public health threats are identified effi- ciently and effectively. Timeliness is one of the nine attributes of a surveillance system and is defined as the speed between steps in a surveillance system (12). A international standardized system for evaluation and comparing timeliness of surveillance systems does not exist, and outcomes of published evaluations are difficult to compare (13).