Volume 12, Number 7—July 2006
Global Public Health Surveillance under New International Health Regulations
|Attribute||Attribute details||Relevance to IHR 2005|
|Usefulness||Contribution to prevention and control of adverse health-related events||Design and scope imply improved usefulness compared with IHR 1969 but attribute must be evaluated after IHR 2005 has operated for a period|
|Sensitivity||Proportion of true events detected by system and ability to detect outbreaks||Specifies notification of all potential public health emergencies of international concern (PHEIC) and provides multiple pathways to increase sensitivity|
|Timeliness||Speed between steps particularly from event onset to response||Specifies assessment within 48 h and reporting within 24 h by state parties and prescribes immediate reporting of events at local and intermediate levels within state parties|
|Stability||Reliability and availability of surveillance system||All state parties must notify all potential PHEIC from June 2007 and establish capacity to detect, assess, and report events by 2012, with potential extensions to 2016|
|Simplicity||Simplicity of structure and ease of operation||Architecture of surveillance system is streamlined and transparent, especially at international level|
|Flexibility||Ability to adapt to changing information needs and operating conditions||Use of risk assessment criteria means that surveillance applies to new as well as established disease threats|
|Acceptability||Willingness of persons and organizations to participate||Establishment of surveillance in international law represents commitment by state parties to participate|
|Data quality||Completeness and validity of recorded data||Specifies information to be reported and includes provisions for validation and assessment of all reports to separate rumors from real events|
|Positive predictive value||Proportion of reported events that are true events||Oriented toward high sensitivity with correspondingly low specificity and positive predictive value, so WHO will not declare most notified events to be PHEIC|
|Representativeness||Ability to describe events over time and their distribution by place and person||Likely to be increased after validation and assessment, as for data quality|
- World Health Assembly. Revision of the International Health Regulations, WHA58.3. 2005 [cited 2006 May 2]. Available from http://www.who.int/gb/ebwha/pdf_files/WHA58-REC1/english/Resolutions.pdf
- United Nations. International Sanitary Regulations, 175 UN Treaty Series 214. 1951.
- World Health Organization. International Health Regulations (1969). 3rd ed. Geneva: The Organization; 1983.
- Fidler D. International law and infectious diseases. Oxford: Clarendon Press; 1999.
- World Health Organization. Global crises—global solutions: managing public health emergencies through the revised International Health Regulations. Geneva: The Organization; 2002.
- Fidler D. From international sanitary conventions to global health security: the new International Health Regulations. Chin J Int Law. 2005;4:325–92.
- Thacker SB. Historical development. In: Teutsch ST, Churchill RE, editors. Principles and practice of public health surveillance. New York: Oxford University Press; 2000. p. 1–16.
- Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. MMWR Morb Mortal Wkly Rep. 2001;50:1–36 Available from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5030a5.htm.
- Morse SS. Factors in the emergence of infectious diseases. Emerg Infect Dis. 1995;1:7–15.
- Heymann DL, Rodier G. Global surveillance, national surveillance, and SARS. Emerg Infect Dis. 2004;10:173–5.
- Morris J, Ward JD, Nicoll A. Proposed new International Health Regulations 2005—validation of a decision instrument (algorithm). Euro Surveill. 2004;9:66–7 Available from http://www.eurosurveillance.org/eq/2004/04-04/pdf/eq_12_2004_66-67.pdf.
- Jajosky RA, Groseclose SL. Evaluation of reporting timeliness of public health surveillance systems for infectious diseases. BMC Public Health. 2004;4:29.
- Grein TW, Kamara KB, Rodier G, Plant AJ, Bovier P, Ryan MJ, Rumors of disease in the global village: outbreak verification. Emerg Infect Dis. 2000;6:97–102.
- Reflections on SARS. Lancet Infect Dis. 2004;4:651.
- Ferguson NM, Cummings DA, Cauchemez S, Fraser C, Riley S, Meeyai A, Strategies for containing an emerging influenza pandemic in Southeast Asia. Nature. 2005;437:209–14.
- Longini IM Jr, Nizam A, Xu S, Ungchusak K, Hanshaoworakul W, Cummings DA, Containing pandemic influenza at the source. Science. 2005;309:1083–7.
- Samaan G, Patel M, Olowokure B, Roces MC, Oshitani H; World Health Organization Outbreak Response Team. Rumor surveillance and avian influenza H5N1. Emerg Infect Dis. 2005;11:463–6.
- Butler D. Disease surveillance needs a revolution. Nature. 2006;440:6–7.
- Fraser C, Riley S, Anderson RM, Ferguson NM. Factors that make an infectious disease outbreak controllable. Proc Natl Acad Sci U S A. 2004;101:6146–51.
- Mandl KD, Overhage JM, Wagner MM, Lober WB, Sebastiani P, Mostashari F. Implementing syndromic surveillance: a practical guide informed by the early experience. J Am Med Inform Assoc. 2004;11:141–50.
- Weber SG, Pitrak D. Accuracy of a local surveillance system for early detection of emerging infectious disease. JAMA. 2003;290:596–8.
- Revision of the International Health Regulations. Progress report. Wkly Epidemiol Rec. 2001;76:61–3.
- Cockerill FR, Smith T. Response of the clinical microbiology laboratory to emerging (new) and reemerging infectious diseases. J Clin Microbiol. 2004;42:2359–65.
- Silk BJ, Berkelman R. A review of strategies for enhancing the completeness of notifiable disease reporting. J Public Health Manag Pract. 2005;11:191–200.
- Secretary-General of the United Nations. In larger freedom: towards development, security and human rights for all: report of the secretary-general, A/59/2005. New York: United Nations; 2005.
- McNabb SJ, Chungong S, Ryan M, Wuhib T, Nsubuga P, Alemu W, Conceptual framework of public health surveillance and action and its application in health sector reform. BMC Public Health. 2002;2:2.
- Bravata DM, McDonald KM, Smith WM, Rydzak C, Szeto H, Buckeridge DL, Systematic review: surveillance systems for early detection of bioterrorism-related diseases. Ann Intern Med. 2004;140:910–22.
- Statement for the record by the Government of the United States of America concerning the World Health Organization's revised International Health Regulations. 2005 May 23 [cited 2006 May 2]. Available from http://usinfo.state.gov/usinfo/Archive/2005/May/23-321998.html
- Wilson K, McDougall C, Upshur R. The new International Health Regulations and the federalism dilemma. PLoS Med. 2006;3:e1.
- Hesketh T. China in the grip of SARS. BMJ. 2003;326:1095.
- Liu Y. China's public health-care system: facing the challenges. Bull World Health Organ. 2004;82:532–8.
- Fidler D. SARS, governance, and the globalization of disease. Basingstoke (UK): Palgrave Macmillan; 2004.
- World Health Assembly. Application of the International Health Regulations (2005). WHA59.3. 26 May 2006 [cited 2006 June 1]. Available from http://www.who.int/gb/ebwha/pdf_files/WHA59/WHA59_2-en.pdf
Page created: December 16, 2011
Page updated: December 16, 2011
Page reviewed: December 16, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.