Overview of Public Health Surveillance

1
Overview of Public Health Surveillance

• Denise Koo, MD, MPH
• Epidemiology Program Office
• Centers for Disease Control and Prevention

2
Public Health Approach
Implementation How do you do it?
Intervention Evaluation What works?
Problem
Response
3
Public Health Surveillance

• Ongoing, systematic collection, analysis, and
  interpretation of health-related data essential
  to the planning, implementation, and evaluation
  of public health practice, closely integrated
  with the timely dissemination of these data to
  those responsible for prevention and control.

4
Public Health Surveillance

• Systematic, ongoing
• Collection
• Analysis
• Interpretation
• Dissemination
• Link to public health practice

5
Purposes of Public Health Surveillance

• Assess public health status
• Define public health priorities
• Evaluate programs
• Stimulate research

6
Core Public Health Functions

• Assessment
• Policy development
• Assurance

7
Surveillance

• Information for Action

8
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

9
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

10
ShigellosisUnited States, 1968-1998
Source CDC. Summary of notifiable diseases.
1998.
11
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

12
Rate of Hepatitis A United States, 1998
NYC
DC
PR
NA
VI
GUAM
AM SAMOA
NA
NA
CNMI
lt 5.0
5.09.9
10.019.9
gt20.0
Source CDC. Summary of notifiable diseases.
1998.
13
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

14

• TOXIC SHOCK SYNDROME (TSS)
• United States, 1983-1998

160
National Center for Infectious Diseases (NCID)
data
140
National Electronic Telecommunications System for
Surveillance (NETSS) data
120
Reported Cases
100
80
60
40
20
Year (Quarter)
1984
1997
0
1992
1986
1990
1988
1994
1998
1996
1983
1989
1995
1993
1991
1985
1987
15
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

16
Botulism (Foodborne) United States, 1978-1998
Laboratory-confirmed cases
Outbreak caused by sautéed onions, IL
NETSS data
Outbreak caused by potato salad, NM
Outbreak caused bybaked potatoes, TX
Outbreak caused by fermented fish/sea products, AK

Reported Cases
1983
1988
1993
1998
1978
Year
Source CDC. Summary of notifiable diseases.
1998.
17
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

18
MEASLES (Rubeola) United States, 1963-1998
Vaccine licensed
Reported Cases (Thousands)
20
10
Year
19
Pertussis (Whooping Cough)
United States, 1998
Reported Cases
Age Group (Years)
20
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

21
Poliomyelitis (Paralytic)
United States, 1968-1998
Inactivated Vaccine
Oral Vaccine
Rate/100,000 Population
Reported Cases
Year
Year
Source CDC. Summary of notifiable diseases.
1998.
22
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

23
Trends in Plasmid-Mediated Resistance to
Penicillin and Tetracycline United States,
1988-1997
Percent
Source Gonococcal Isolate Surveillance Project
(GISP)
Year
24
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

25
Breast Cancer Screening
26
Uses of Public Health Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning

27
Tuberculosis United States, 1986-1998 (U.S.-
and foreign-born persons)
Foreign-born
28
Obesity
United States, 1987-1998
Not available
lt 10
.
.

10-15
gt15
29
Physical Activity
Georgia 1998
PER CENT
Responses
NO
YES
Less than 15,000
15,000- 24,999
25,000- 34,999
35,000- 49,999
50,000gt
Source BRFSS 1998