Chapter 15 Surveillance and Outbreak Investigation
Objectives
1. Define public health surveillance.
DISEASE SURVEILLANCE
-Definitions and Importance
Disease Surveillance
The ongoing systematic collection, analysis, interpretation and dissemination of specific health data for use in
public health.
Surveillance is important because it generates knowledge of a disease or event outbreak patterns (including timing,
geographic distribution, susceptible populations).
Event
Event outbreak patterns (including timing, geographic distribution, susceptible populations).
Biological terrorism
Anthrax=most feared of all biological terrorism agents
It doesn’t degrade easily.
It can become aerosolized and it’s very easy to distribute.
It’s very virulent and can cause a lot of death quickly.
Chemical terrorism
-Purposes of Surveillance
Assess public health status
Define public health priorities
Plan public health programs
Evaluate interventions and programs
Stimulate research
Helps public health departments:
Identify trends and unusual disease patterns.
Set priorities for using scarce resources.
Develop and evaluate programs for commonly occurring and universally occurring diseases or events.
Link public health priorities with HP 2020 – see how it changes and new ones are added…. The reason is
surveillance data/
2. List types of surveillance systems.
TYPES OF SURVEILLANCE SYSTEMS
1. Passive System:
1. case reports are sent to local health departments by health care providers (i.e., physicians, nurses), or
laboratory reports of disease occurrence are sent to the local health department (data bases).
2. Active System:
1. nurse, as an employee of the health department, may begin a search for cases through contacts with local
health providers and health care agencies.
2. Nurses initiates the investigation
3. Sentinel System:
1. monitors key health events when information is not otherwise available or in vulnerable populations to calculate or
estimate disease morbidity.
2. Find sentinel spot: where did it begin?
4. Special Systems:
1. developed for collecting particular types of data and may be a combination of active, passive, and/or sentinel
systems.
5. Syndromic surveillance systems
1. a result of bioterrorism, these newer systems are being developed to monitor illness syndromes or events
2. Don’t act upon diagnoses, they act upon manifestations.
1. Lots of diarrhea going on or rashes. Not diagnosing it as measles, just noting that there are a lot
of rashes. Cases aren’t reported yet. Just the observations.
2. Chickenpox vs. Smallpox
1. Look very similar. Vesicular. Tell em apart-p. 488*** When chickenpox presents itself,
rash usually begins on the belly then goes out from there. Smallpox starts on face,
mouth, nose, lips area and goes out from there. Lesions same stage in all areas for
smallpox-it’s all bad. Intermittent healing with chickenpox wait for it to fall off.
2. Why? Eradicated conditions we don’t see anymore. Eradication means it’s gone
worldwide. We don’t see it anymore. Don’t know what it looks like. That’s why we
need to look at manifestations. Eradication vs. elimination***
3. Identify steps in planning, analyzing, interviewing, and evaluating surveillance.
4. Recognize sources of data used when investigating a disease/condition outbreak.
Data Sources for Surveillance
1. Cases reported by clinicians, health care agencies, and laboratories to state health departments
2. Death certificates
3. Administrative data (i.e., billing)
1. Find out what hospital billed for, like laboratory testing.
4. Sentinel surveillance system
1. http://www.ncbi.nlm.nih.gov/books/NBK11770/
5. Describe role of the nurse in surveillance and outbreak investigation to the national core competencies for public health nurses.
