Global capacity for emerging infectious disease detection.
The increasing number of emerging infectious disease events that have spread internationally, such as severe acute respiratory syndrome (SARS) and the 2009 pandemic A/H1N1, highlight the need for improvements in global outbreak surveillance. It is expected that the proliferation of Internet-based reports has resulted in greater communication and improved surveillance and reporting frameworks, especially with the revision of the World Health Organization's (WHO) International Health Regulations (IHR 2005), which went into force in 2007. However, there has been no global quantitative assessment of whether and how outbreak detection and communication processes have actually changed over time. In this study, we analyzed the entire WHO public record of Disease Outbreak News reports from 1996 to 2009 to characterize spatial-temporal trends in the timeliness of outbreak discovery and public communication about the outbreak relative to the estimated outbreak start date. Cox proportional hazards regression analyses show that overall, the timeliness of outbreak discovery improved by 7.3% [hazard ratio (HR) = 1.073, 95% CI (1.038; 1.110)] per year, and public communication improved by 6.2% [HR = 1.062, 95% CI (1.028; 1.096)] per year. However, the degree of improvement varied by geographic region; the only WHO region with statistically significant (α = 0.05) improvement in outbreak discovery was the Western Pacific region [HR = 1.102 per year, 95% CI (1.008; 1.205)], whereas the Eastern Mediterranean [HR = 1.201 per year, 95% CI (1.066; 1.353)] and Western Pacific regions [HR = 1.119 per year, 95% CI (1.025; 1.221)] showed improvement in public communication. These findings provide quantitative historical assessment of timeliness in infectious disease detection and public reporting of outbreaks.
Division of Health Sciences and Technology, HealthMap, Children's Hospital Informatics Program, Harvard-Massachusetts Institute of Technology Boston, MA 02215, USA.
Emily H
EH
Chan
Timothy F
TF
Brewer
Lawrence C
LC
Madoff
Marjorie P
MP
Pollack
Amy L
AL
Sonricker
Mikaela
M
Keller
Clark C
CC
Freifeld
Michael
M
Blench
Abla
A
Mawudeku
John S
JS
Brownstein
D003141:Communicable Diseases / Q000453:epidemiology*; D004196:Disease Outbreaks; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D011159:Population Surveillance / Q000379:methods*; D011634:Public Health; D014944:World Health Organization