title: Evaluation of the enterovirus laboratory surveillance system in Denmark, 2010 to 2013.
abstract: The primary aim of the Danish enterovirus (EV) surveillance system is to document absence of poliovirus infection. The conflict in Syria has left many children unvaccinated and movement from areas with polio cases to Europe calls for increased awareness to detect and respond to virus-transmission in a timely manner. We evaluate the national EV laboratory surveillance, to generate recommendations for system strengthening. The system was analysed for completeness of viral typing analysis and clinical information and timeliness of specimen collection, laboratory results and reporting of clinical information. Of 23,720 specimens screened, 2,202 (9.3%) were EV-positive. Submission of cerebrospinal fluid and faecal specimens from primary diagnostic laboratories was 79.5% complete (845/1,063), and varied by laboratory and patient age. EV genotypes were determined in 68.5% (979/1,430) of laboratory-confirmed cases, clinical information was available for 63.1% (903/1,430). Primary diagnostic results were available after a median of 1.4 days, typing results after 17 days, detailed clinical information after 33 days. The large number of samples typed demonstrated continued monitoring of EV-circulation in Denmark. The system could be strengthened by increasing the collection of supplementary faecal specimens, improving communication with primary diagnostic laboratories, adapting the laboratory typing methodology and collecting clinical information with electronic forms.
authors.affiliation: Department of Microbiological Diagnostics and Virology, Statens Serum Insitut, Copenhagen S, Denmark.
authors.forename: Orla
authors.initials: O
authors.lastname: Condell
authors.forename: Sofie
authors.initials: S
authors.lastname: Midgley
authors.forename: Claus Bohn
authors.initials: CB
authors.lastname: Christiansen
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Chen Nielsen
authors.forename: Svend
authors.initials: S
authors.lastname: Ellermann-Eriksen
authors.forename: Mette
authors.initials: M
authors.lastname: Mølvadgaard
authors.forename: Kristian
authors.initials: K
authors.lastname: Schønning
authors.forename: Silje
authors.initials: S
authors.lastname: Vermedal Hoegh
authors.forename: Peter Henrik
authors.initials: PH
authors.lastname: Andersen
authors.forename: Marianne
authors.initials: M
authors.lastname: Voldstedlund
authors.forename: Thea Kølsen
authors.initials: TK
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000592:standards* / Q000706:statistics & numerical data; D003718:Denmark / Q000453:epidemiology; D060740:Disease Eradication / Q000592:standards / Q000706:statistics & numerical data; D018563:Disease Notification / Q000592:standards* / Q000706:statistics & numerical data; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: completeness; enterovirus; evaluation; surveillance; timeliness