Author: Hugo Lopez Gatell

Did Advances in Global Surveillance Notification Systems Make a Difference in the 2009 H1N1 Pandemic? A Retrospective Analysis

CELIA MERCEDES ALPUCHE ARANDA Ying Zhang Hugo Lopez Gatell Michael Stoto (2013)

Background: The 2009 H1N1 outbreak provides an opportunity to identify strengths weaknesses of disease surveillance

notification systems that have been implemented in the past decade.

Methods: Drawing on a systematic review of the scientific literature, official documents, websites, news reports, we

constructed a timeline differentiating three kinds of events: (1) the emergence spread of the pH1N1 virus, (2) local

health officials’ awareness understanding of the outbreak, (3) notifications about the events their implications.

We then conducted a ‘‘critical event’’ analysis of the surveillance process to ascertain when health officials became aware of

the epidemiologic facts of the unfolding pandemic whether advances in surveillance notification systems hastened

detection.

Results: This analysis revealed three critical events. First, medical personnel identified pH1N1in California children because

of an experimental surveillance program, leading to a novel viral strain being identified by CDC. Second, Mexican officials

recognized that unconnected outbreaks represented a single phenomenon. Finally, the identification of a pH1N1 outbreak

in a New York City high school was hastened by awareness of the emerging pandemic. Analysis of the timeline suggests

that at best the global response could have been about one week earlier (which would not have stopped spread to other

countries), could have been much later.

Conclusions: This analysis shows that investments in global surveillance notification systems made an important

difference in the 2009 H1N1 pandemic. In particular, enhanced laboratory capacity in the U.S. Canada led to earlier

detection characterization of the 2009 H1N1. This includes enhanced capacity at the federal, state, local levels in

the U.S., as well as a trilateral agreement enabling collaboration among U.S., Canada, Mexico. In addition, improved

global notification systems contributed by helping health officials underst the relevance importance of their own

information.

Article

MEDICINA Y CIENCIAS DE LA SALUD

Centinelas de la influenza pandémica en México: perspectivas de la vigilancia epidemiológica y el control

ALETHSE DE LA TORRE ROSAS HUGO LOPEZ GATELL RAMIREZ CELIA MERCEDES ALPUCHE ARANDA ALEJANDRO ERNESTO MACIAS HERNANDEZ (2010)

Tema del mes

La respuesta adecuada ante una pandemia depende en gran medida de la detección oportuna, que puede lograrse mediante una vigilancia epidemiológica eficiente. En México, la vigilancia epidemiológica la realiza el Sistema Nacional de Vigilancia Epidemiológica (SINAVE), una red institucional que monitorea, analiza e informa sobre la situación epidemiológica nacional. El SINAVE tiene dos estrategias principales: la vigilancia general, que registra datos numéricos sobre casos nuevos de 114 padecimientos atendidos en más de 19,000 establecimientos de salud y la vigilancia especial, que documenta datos nominales detallados, incluyendo confirmación por laboratorio sobre un número seleccionado de padecimientos. Desde 2006, la vigilancia de la influenza sigue el modelo de vigilancia centinela, en la que la información no se recolecta en todas las unidades de salud, sino en un pequeño conjunto de centros de salud y hospitales denominados Unidades de Salud Monitoras de Influenza (USMI)

During a pandemic, a rapid response relies on the capacity for early warning and diagnosis based on effective epidemiological surveillance. Mexico conducts epidemiologic surveillance using two main strategies: general surveillance, which collects statistics on new cases of 114 diseases detected in over 19,000 health care facilities, and special surveillance, including laboratory case confirmation, which gathers detailed nominal information on a selected set of illnesses. Starting in 2006, influenza surveillance follows a sentinel model in Influenza Monitoring Units. This article reviews different surveillance approaches, the international health regulations, and some of the lessons learned in Mexico during the first influenza pandemic of the 21st century

Article

MEDICINA Y CIENCIAS DE LA SALUD Influenza H1N1 Epidemias