Abstract:
Timely case notifications following the introduction of an uncommon pathogen, such as mpox, are critical for understanding disease transmission and for developing and implementing effective mitigation strategies. When Massachusetts public health officials notified the Centers for Disease Control and Prevention (CDC) about a confirmed orthopoxvirus case on May 17, 2023, which was later confirmed as mpox at CDC, mpox was not a nationally notifiable disease. Because existing processes for new data collections through the National Notifiable Disease Surveillance System were not well suited for implementation during emergency responses at the time of the mpox outbreak, several interim notification approaches were established to capture case data. These interim approaches were successful in generating daily case counts, monitoring disease transmission, and identifying high-risk populations. However, the approaches also required several data collection approvals by the federal government and the Council for State and Territorial Epidemiologists, the use of four different case report forms, and the establishment of complex data management and validation processes involving data element mapping and record-level de-duplication steps. We summarize lessons learned from these interim approaches to inform and improve case notifications during future outbreaks. These lessons reinforce CDC\'s Data Modernization Initiative to work in close collaboration with state, territorial, and local public health departments to strengthen case-based surveillance prior to the next public health emergency.
摘要:
在引入不常见病原体后及时通知病例,比如水痘,对于了解疾病传播以及制定和实施有效的缓解策略至关重要。当马萨诸塞州公共卫生官员于2023年5月17日将确诊的正痘病毒病例通知疾病控制与预防中心(CDC)时,该病例后来在CDC被确认为水痘,水痘不是一种国家法定报告的疾病。由于通过国家应报告疾病监测系统收集新数据的现有流程不太适合在水痘爆发时的应急响应期间实施,我们建立了几种临时通知方法来获取病例数据.这些临时方法成功地生成了每日病例数,监测疾病传播,识别高危人群。然而,这些方法还需要联邦政府和州和地区流行病学家委员会的多次数据收集批准,使用四种不同的病例报告表,以及建立涉及数据元素映射和记录级重复数据消除步骤的复杂数据管理和验证过程。我们总结了从这些临时方法中吸取的经验教训,以在未来爆发期间通知和改进病例通知。这些课程加强了CDC的数据现代化计划,与国家密切合作,领土,和地方公共卫生部门在下一次突发公共卫生事件之前加强基于病例的监测。