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PubMed1995

Influenza in Madrid, Spain, 1991-92: validity of the sentinel network.

OBJECTIVES: The aim was, firstly, to study the validity of the sentinel network data by analysing the correlation between the weekly influenza cases detected by the network and the number of cases notified to the compulsory disease notification system and, secondly, to describe the epidemiology of the period 1991-92 in terms of the sentinel network data. DESIGN: The study design was descriptive. SUBJECTS: The population resident in the city of Madrid. MAIN RESULTS: There was a high correlation between the cases notified to the compulsory disease notification system and those listed by the sentinel network (r = 0.91, p < 0.001, r2 = 0.82). The epidemic activity during the period 1991-92 was centred approximately on week 48 in 1991 and week 6 in 1992 (24 November 1991-8 February 1992). Altogether 913 cases of influenza were notified through the sentinel network. The greatest number of cases occurred in people aged between 20 and 39 years. CONCLUSION: For the epidemiological surveillance of influenza it is necessary to develop systems that can quickly detect epidemic periods and provide information about populations at risk, in addition to systems that isolate and identify seasonal epidemic viruses. Both types of data will help the development of adequate public health policies. Sentinel networks provide these data and offer additional advantages such as lower cost.

Adolescent↗
PubMed2002

Comparison of causes of death using HEMO Study and HCFA end-stage renal disease death notification classification systems. The National Institutes of Health-funded Hemodialysis. Health Care Financing Administration.

Few data are available on the accuracy of death classification in patients with end-stage renal disease (ESRD). The National Institutes of Health-funded Hemodialysis (HEMO) Study allows the opportunity to compare cause of death recorded on the Health Care Financing Administration (HCFA) Death Notification Form 2746 with death classified by the HEMO Study. The HEMO Study cause of death is determined by trained HEMO Study Outcome Review Committee physicians. In this interim analysis, there were 220 deaths coded by both classification systems. Using the HEMO Study classification system, the most common cause of death was ischemic heart disease (20.4%), followed by arrhythmia and conduction problems (10.4%), cerebrovascular disease (8.6%), and non-access-related infections (7.7%). Using the HEMO Study final death classification as the reference standard, most differences in the two classification systems were related to coding of heart disease. Sensitivity for the HCFA classification ranged from 9.1% for congestive heart failure to 91.7% for malignancy, whereas specificity values were all greater than 78%. Positive predictive values ranged from 11.8% for other heart disease and conditions to 100% for malignancy and hepatobiliary disease, whereas negative predictive values were all greater than 85%. The kappa statistic between the two death classification systems ranged from 0.12 for congestive heart failure to 0.95 for malignancy. Studies using death classification from the HCFA ESRD death notification form for deaths secondary to either cardiovascular diseases or unknown causes should be interpreted cautiously.

Aged↗
PubMedDate not supplied

[The use of the capture- recapture method in evaluating the epidemiological meningococcal disease monitoring system in Tenerife, Spain (1999-2000)].

BACKGROUND: Meningococcal Disease is mainly monitored passively on the Canary Islands, the regular Compulsory Disease Notification channels being used. The objective of this study includes describing the qualitative and quantitative aspects of this system and evaluating the exhaustiveness, by means of the capture-recapture system, of three information sources. METHODS: This study covers the 1999-2001 period in Tenerife. The information was gathered from three sources: the Compulsory Disease Notification System, the Microbiology Laboratories and the hospital Minimum Basic Data Set. The Evaluation Protocols of the Monitoring System of the Atlanta Centers of Disease Control and Prevention were used. A log-linear model was used for estimating the number of cases. The calculations of the exhaustiveness and the 95% confidence intervals were done in the SPSS10 statistics package. RESULTS: The system was found to have an 84.9% sensitivity, and an 80.4% positive predictive value. The delay in notification (timeliness) fell within the 0.5-13-day range, averaging 3 days. The system was found to have a 76.6% overall acceptability. The exhaustiveness value was 98.1%. CONCLUSIONS: This disease is being monitored well, with a degree of sensitivity which would be revealing of a good notification level, also confirmed by its exhaustiveness. Although the positive predictive value is high, this could be indicative of the expeditious starting of antibiotic treatment which would hinder microbiological confirmation. The system is timely, affording the possibility of measures being taken for fast intervention.

Adolescent↗
PubMedDate not supplied

Timeliness of notification in infectious disease cases.

Records of notification in cases of eight infectious diseases in the "Servei Territorial de Salut Publica" of the Province of Barcelona, Spain, between 1982 and 1986 were reviewed. Time from onset of symptoms to notification, time from notification to completion of data collection, and time from onset to completion of the case investigation were analyzed. For the period from onset to notification, the shortest mean was registered for meningococcal infection (6.31 days) and the longest was for pulmonary tuberculosis (54.79 days). For time from notification to complete investigation, the shortest value was for pulmonary tuberculosis (12.20 days) and the longest for rickettsioses (35.79 days). Time from onset to completion of data collection was 22.87 days for meningococcal infection and 72.34 days for tuberculosis of other organs (probably because of the long period of time that elapses between the onset of the first symptoms and notification). It would appear that both physicians and the general population must be educated so that lay-men can identify early signs and symptoms of disease and physicians can realize that statutory notification of infectious diseases is strongly linked to community health care.

Communicable Disease Control↗
PubMed2002

Disease surveillance in rural communities is compromised by address geocoding uncertainty: a case study of campylobacteriosis.

This study illustrates the impact of address geocoding uncertainty on rural estimates of reportable disease incidence using campylobacteriosis as an example. After all cases of campylobacteriosis notified from 1993 to 1997 had been geocoded, the minimum and maximum disease notification rates were calculated for rural and urban areas of New Zealand. The estimated maximum rural rates were four times higher than estimated minimum rural rates, whereas estimated minimum and maximum urban rates varied minimally. The impact of address geocoding on the estimation of disease notification rates across Public Health Service Regions showed considerable variation. The relative proportions of ungeocoded notifications to rural notifications ranged from 1.3:1 to 10.2:1, reflecting the range of uncertainty in estimated rural rates of campylobacteriosis. Unless the reliability of captured rural address data is improved significantly, disease surveillance systems will underestimate rural rates of disease and limit small area analyses.

Campylobacter Infections↗
PubMed1999

Management of animal health emergencies: general principles and legal and international obligations.

The Eighth Round of the General Agreement on Tariffs and Trade led to the creation of the World Trade Organization and to the adoption of the Sanitary and Phytosanitary (SPS) Agreement, thus considerably changing the rules of international trade in animals and animal products. Animal health measures may result in trade restrictions, but governments accept that these restrictions may sometimes be necessary and appropriate to ensure food safety and animal health protection. The SPS Agreement acknowledges the rights of governments to adopt measure to protect human, animal and plant health. To ensure effective animal health protection, without unjustifiable discrimination, the operational procedures of Veterinary Services must be standardised, especially those concerning disease notification, epidemiological information, certification for international trade and management of animal health emergencies. Veterinary Services must be further supported by a proper legislative framework and adequate financial resources.

Animal Diseases↗
PubMed1997

Surveillance of foodborne diseases: what are the options?

Epidemiological data are needed for a variety of reasons, namely, informing public health authorities about the nature and magnitude of foodborne illnesses and their epidemiology, for the early detection of foodborne disease outbreaks, and for the planning, implementation and evaluation of food safety programmes. Thus, epidemiological surveillance of foodborne diseases is fundamental to any food safety programme. Various methods of foodborne surveillance may be utilized: (i) records for registration of deaths and hospital discharges; (ii) disease notification, (iii) sentinel surveillance, (iv) laboratory surveillance, (v) outbreak investigation and (vi) epidemiological research. This article reviews each method, its advantages and disadvantages, and its relevance for meeting the various objectives and needs.

Death Certificates↗
PubMed1990

Tuberculosis surveillance in the South Australian aboriginal community.

Tuberculosis (TB) is still a significant problem in Aboriginal people. There are higher rates of active TB and evidence of continuing transmission among this group. We sought to define the specific epidemiological risks and best methods of surveillance for TB in Aboriginal people in South Australia. We compared the incidence of active TB in Aboriginal people in South Australia with that of the total number of cases in non-Aboriginal people from 1978 to 1988, and studied the prevalence of infection in four Aboriginal communities in South Australia. Incidence rates of active TB were four times higher in South Australian Aboriginal people than the total South Australian rates. Specific age analysis revealed higher active disease notification rates in Aboriginal people aged 45-54 years and 55-64 years. The notification rate for Aboriginal men was almost three times the rate for women. Standardized incidence ratios of active TB cases for Aboriginal communities were higher in rural and traditional communities than in urban Aboriginal people. Infection prevalence, measured by tuberculin skin testing, varied from 7.7% to 30.8% in the different communities but did not correlate with the standardized incidence ratios. We conclude that (i) South Australian Aboriginal people are suffering a higher rate of active TB disease than the total South Australian community, and (ii) that the disease and infection rates vary between communities and between age and sex groups. The discrepancy between disease notifications rates, as measured by standardized incidence ratios, and infection prevalence requires further investigation. To improve TB control in Aboriginal people, programmes need to be altered to be more appropriate for this group.

Adolescent↗
PubMed2001

Cutaneous leishmaniasis in Israel in the era of changing environment.

BACKGROUND: Cutaneous leishmaniasis (CL) is a zoonotic disease, endemic and notifiable in Israel. The vectors are sandflies of the genus Phlebotomus, the hosts are mainly field rodents. The infective agents are Leishmania parasites. Ph. papatasi is the recognized vector of L. major, while Ph. sergenti is considered to be the vector of L. tropica. AIM: To increase awareness of leishmaniasis, enhance surveillance, and improve reporting. METHODS: Morbidity data were obtained from disease notifications reported to the Department of Epidemiology of the Israeli Ministry of Health. RESULTS: The annual number of reported CL cases during the period 1961-2000 varied between less than 10 to over 250, with rates varying between 0.13 to over 7 per 100,000. Two peaks, between 1967-1969 and 1980-1982, are clearly seen. These peaks reflect environmental changes caused by the introduction of non-immune people (mainly Jews) into the area of endemic foci, enhanced urbanization by expansion of settlements bordering this area, agricultural/industrial projects, and most probably the effect of Global Warming. Recently, an increasing trend in the prevalence of the disease has been reported also by the Palestinian Authority and countries in the Mediterranean basin, reflecting shared changes in modern demographic and environmental conditions. These factors include population growth and movements, as well as ecological changes. CONCLUSIONS: Cooperation of the Ministries of Health and Environment of the countries of the whole Middle East region in combating the vectors and the reservoirs in animal hosts are a major need.

Animals↗
PubMed2002

Meningococcal disease and meteorological conditions in Auckland, New Zealand.

OBJECTIVE: The purpose of the study was to explore and model the relationship between meteorological variables and meningococcal disease notifications in Auckland during an ongoing group B meningococcal disease epidemic. METHODS: An ecological study design was used to investigate the relationship between 1,097 notified cases of meningococcal disease from January 1992 to December 1998 among residents of Auckland's three health districts and various meteorological variables. Descriptive epidemiology and Poisson regression modelling were used to describe this relationship. FINDINGS: The study found that the occurrence of meningococcal disease varied with season, increased with high humidity and cooler temperatures and appeared to decline with prolonged periods of heavy rain. Poisson regression analysis showed a significant relationship between the expected number of cases developing meningococcal disease on a given day and season and temperature. DISCUSSION: The results of the modelling analysis provide the initial work for the future development of a predictive tool to forecast the magnitude and duration of the annual peak in meningococcal disease incidence using routine notification data and meteorological recordings, thus allowing for better management of the public health workload and interventions, and the appropriate timing of media campaigns.

Disease Notification↗
PubMedDate not supplied

[Diseases of Compulsory Notification (DCN) in Navarra. 2002].

Since 1998, the Epidemiological Survelliance System of Navarra has included the notification of 34 transmissible infectious diseases, to which are added epidemic outbreaks of any aetiology and cause. Reporting to the system is carried out on a weekly basis by every doctor who suspects, or diagnoses, any of these processes. In our autonomous community, Diseases of Compulsory Notification (DCN) are reported using standardised forms on a weekly basis to the Section of Infectious Diseases and Control of Outbreaks of the Public Health Institute. Notification is made by the doctors and/or paediatricians of Primary Care and by certain services of Specialised Care. Subsequently, the information is sent to the National Epidemiology Centre where data from the Autonomous Communities is centralised and diffused. The year 2002 marks the fifth year of the new Epidemiological Vigilance System. In these five years there have been 74,814 notifications of disease, 17,184 in the year 2002, which provides a balance of notification of 74.07% for this year. In 2002, under the heading of respiratory transmitted diseases, 24,870 cases of Inluenza were reported, Epidemic Index (EI: 0.80). 58% of total annual cases were reported in the first nine weeks of the year, with a maximum in week 4 when 3,277 cases were reported. 16 cases of Meningococcal Disease were reported to the system (EI: 1.07). All the cases were confirmed microbiologically and all appeared in a sporadic way. With respect to the causative serogroup, on 12 occasions Neisseria meningitidis serogroup B was isolated and in the 4 remaining cases serogroup C was isolated. One case was notified in infants of less than 2 years of age (Rate: 10.52 cases per 100,000), another case in children between 2 and 5 years (5.52 cases per 100,000), 5 cases in the age group of 6 to 19 years (Rate: 5.86 cases per 100,000) and the remaining nine cases in the age group of persons aged 20 years or over (2.2 per 100,000). 70 cases of Legionellosis were declared in 2002 (EI: 4.67), all but one under the clinical form of pneumonia. Twenty-two of the cases were presented in the context of two outbreaks with a community origin, which affected 17 and 5 persons respectively. Similarly, there was a notable increase in the declaration of cases of bacillary dysentery, with 6 cases (EI: 2.00), brucellosis, with 10 cases (EI: 1.67) and chickenpox, with 4,346 notified cases (EI: 1.61).

Communicable Diseases↗