Page 212 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

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Chapter 9
identification, from disease onset until laboratory confirmation is the main delay (median 23 days in 2013-2017, average across the medians per dis- ease: 13.2 days), and did not change substantially in the period 2002-2017. Insight in and reduction of this delay is the next step to increase timeliness of notification, to reach disease specific timeframes or timeframes of two incubation periods and to provide real-time information on the effect of implemented response measures.
Notifications systems
- Timeliness of notification systems is better when laboratories are involved in notifying, either with or without physicians. Also in the Netherlands, the new Public Health Act, obliging both physician and laboratories to notify to the MHS instead of either one of them, contributed to a substantial reduc- tion in notification delay.
- Timeliness of notification systems is related to support by MHS to report- ers, through education, training, simplification of notification procedures and criteria, provision of feedback on notifications, periodically evaluation of notification procedures and analyses of delayed reports.
- Electronic (online) notification is not necessarily faster than convention- al notification; only in comparative studies electronic reporting was faster than conventional ways of reporting (phone, post, fax or e-mail).
Timeliness of response and facilitating elements in preparedness
- Provision of PEP to flight passengers who were in contact with a confirmed case of the 2009 pandemic influenza was too late to be effective, because of delay in disease identification, caused by patient, doctor and laboratory delay of the index patient.
- As the median delay between decision for referral and arrival of a possible Ebola patient in an academic hospital was 5 hours, enhanced preparedness for referral of possible cases was not yet sufficient in the Netherlands.
- The public health and curative sector need national guidelines for infec- tion prevention, and shared standardized criteria for contingency and blue- prints for regional and national coordination.
- Costs for preparedness and response of possible Ebola patients involved € 12.6 million (average) for the public health and curative sector.
- Through standardization of preparedness guidelines and coordination, fur- ther centralization of ambulance care and academic treatment centers is pos- sible and cost saving for VHF and other emerging highly infectious diseases.