Background and Rationale

Throughout human history, infectious diseases have caused human suffering, disrupted trade, restricted travel, and limited human settlement. Today the emergence of new pathogens and reemergence of new strains of old pathogens in different parts of the world illustrates the continuing threat of infectious diseases to the public’s health. A combination of globalization of the food supply and travel within countries and across international borders makes it easy for an outbreak in one location to spread rapidly within and beyond national borders. Endemic infectious diseases, including sexually transmitted diseases (STDs) like gonorrhea, foodborne illnesses like campylobacteriosis, and bloodborne pathogens such as hepatitis B and C remain problems in North America, Europe, and other regions of the world. Table 1.1 lists the ten most commonly reported communicable diseases in the United States, which include multiple types of STDs, infections transmitted by food and water, vaccine-preventable diseases, and a vectorborne disease transmitted by ticks. (The United States population was estimated at 314 million in 2013.) The cumulative morbidity from these 10 diseases, in a single wealthy country, is nearly 2 million cases a year or approximately 32 cases of a communicable disease per 10,000 persons. Given that underreporting occurs in many surveillance systems, the real human toll in terms of cases and attendant suffering and healthcare costs is undoubtedly higher.

Surveillance can provide timely information crucial to public health interventions in an evolving situation. For example, during the 2009–2010 H1N1 influenza pandemic, surveillance data were used to prioritize vaccination to specific high-risk groups such as pregnant women because the supply of vaccine was limited [1]. Surveillance data also form the bases for disease-specific treatment guidelines; in the United States, for example, public health authorities now recommend use of injectable third-generation cephalosporins for treatment of gonococcal infections because of increasing resistance to oral cephalosporins [2]. Information from carefully designed and implemented surveillance systems can also inform the allocation of resources to public health programs and reassure the public in face of public health crises resulting from natural disasters such as the Sichuan earthquake in China in 2008 [3]. Epidemiologic data generated through disease surveillance serve as the bases for research and development of drugs, vaccines, and other therapeutic and prophylactic interventions.

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5: Surveillance for Vaccine-Preventable Diseases and Immunization 2: The Legal Basis for Public Health Surveillance 14: Public Health Surveillance for Tuberculosis 3: National, State, and Local Public Health Surveillance Systems 19: Practical Considerations in Implementation of Electronic Laboratory Reporting for Infectious Disease Surveillance 15: Analysis and Interpretation of Surveillance Data

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