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Systematic Review of Surveillance Systems for Emerging Zoonotic Diseases

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Systematic Review of Surveillance Systems for Emerging Zoonotic Diseases 2009 Systematic Review of Surveillance Systems for Emerging Zoonotic Diseases LINDA VRBOVA, CRAIG STEPHEN, NAOMI KASMAN, RICHARD BOEHNKE, MIMI DOYLE- WATERS, ANDENYE CHABLITT-CLARK, BRIAN GIBSON, MICHAEL BRAUER, DAVID PATRICK 5/11/2009 ABSTRACT A systematic review of peer-reviewed articles that described and/or evaluated surveillance systems for emerging zoonotic diseases between 1992 and 2006 revealed that only 17 of 221 identified systems were evaluated. Only four of these used their evaluation results to examine the usefulness of their systems in identifying outbreaks or cases of disease. This lack of evidence makes it difficult for decision-makers to choose surveillance initiatives that have been shown to be effective. Many systems included in this review claim to be surveillance systems, but it remains unclear how many of them were just monitoring systems, highlighting confusion in the use of the term ‘surveillance’. LIST OF AUTHORS AND ROLES Authors Linda Vrbova (LV): School of Population and Public Health, University of British Columbia Craig Stephen (CS): Faculty of Veterinary Medicine, University of Calgary; Centre for Coastal Health; School of Population and Public Health, University of British Columbia Naomi Kasman (NK): Health Protection Division, York Region Health Services Department Richard Boehnke (RB): Infectious Diseases Branch, Ontario Ministry of Health and Long Term Care Mimi Doyle-Waters (MD-W): Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute Andenye Chablitt-Clark (AC-C): Environmental Health Branch, Ontario Ministry of Health and Long-Term Care Brian Gibson (BG): Environmental Health Branch, Public Health Division, Ontario Ministry of Health and Long- Term Care; Dalla Lana School of Public Health, University of Toronto Michael Brauer (MB): School of Environmental Health, University of British Columbia David Patrick (DP): Epidemiology Services, British Columbia Centre for Disease Control; School of Population and Public Health, University of British Columbia ii Roles LV and CS designed the study and determined the study questions, LV and MD-W developed and implemented the search strategy, with help from CS, RB, NK, AC-C, DP, BG, and MB at a mid-study meeting, LV and NK selected the articles for inclusion from article titles (round 1) and abstracts, LV obtained the articles and LV and NK completed the second round of inclusion/exclusion and extracted the data from the articles, LV cleaned and analyzed the database. The first draft report was prepared by LV, while editing and preparation of the final document was conducted by all authors (LV, CS, RB, NK, MD-W, AC-C, DP, BG, and MB). ACKNOWLEDGEMENTS The authors would like to thank Mark Fitzgerald for his input regarding the validity of broad search definitions and the pitfalls of using search terms that are misapplied in the literature, the Canadian Field Epidemiology Program and associated field epidemiologist placements across Canada for providing evaluation reports of health events under surveillance, Mark Pahulje for his help in editing the final reference and data tables, Eleni Galanis and André Ravel for their help in editing the non peer-reviewed literature result section of this report, and the National Collaborating Centre for Environmental Health peer reviewers, whose insightful comments and suggestions have greatly improved this report. FUNDING NOTE AND DISCLAIMER Production of this report has been made possible through a financial contribution from the Public Health Agency of Canada through the National Collaborating Centre for Environmental Health. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada or the National Collaborating Centre for Environmental Health. iii CONTENTS ABSTRACT ........................................................................................................................................ ii LIST OF AUTHORS AND ROLES .......................................................................................................... ii Authors ..................................................................................................................................................... ii Roles ........................................................................................................................................................ iii ACKNOWLEDGEMENTS .................................................................................................................... iii FUNDING NOTE AND DISCLAIMER .................................................................................................... iii CONTENTS........................................................................................................................................ iv CHAPTER 1. BACKGROUND AND INTRODUCTION ............................................................................. 1 Emerging Infectious Diseases and Zoonoses .............................................................................................. 1 Factors Leading to Emergence of Infectious Diseases ................................................................................. 1 Surveillance for Emerging Infectious Diseases ............................................................................................ 2 Surveillance in Human and Animal Public Health Sectors, and Integrated Surveillance ............................... 3 Objectives of this Review ........................................................................................................................... 4 CHAPTER 2. METHODS ..................................................................................................................... 5 Search Strategy.......................................................................................................................................... 5 Study Selection .......................................................................................................................................... 7 Data Extraction and Quality Assessment .................................................................................................... 8 Descriptive Analysis ................................................................................................................................... 9 CHAPTER 3. RESULTS ...................................................................................................................... 10 Results of all Surveillance Systems ........................................................................................................... 12 Results of Evaluated Surveillance Systems ............................................................................................... 13 Results of Select Non-Peer Reviewed Search ........................................................................................... 14 CHAPTER 4. DISCUSSION ................................................................................................................ 16 Evaluation of Surveillance Systems .......................................................................................................... 16 Definition of Surveillance ......................................................................................................................... 17 Definition of Emerging Zoonoses ............................................................................................................. 17 Case Definitions of Diseases or Syndromes under Surveillance ................................................................ 18 Integration of Human and Animal Data .................................................................................................... 18 Role of Public Health Inspectors .............................................................................................................. 19 Comparison of Peer-reviewed Literature and Non Peer-Reviewed Literature ........................................... 19 Limitations............................................................................................................................................... 19 CHAPTER 5. CONCLUSIONS AND RECOMMENDATIONS .................................................................. 21 Conclusions ............................................................................................................................................. 21 Recommendations ................................................................................................................................... 21 TABLE OF FIGURES ......................................................................................................................... 22 TABLE OF TABLES ........................................................................................................................... 22 TABLE OF APPENDICES ................................................................................................................... 23 REFERENCES ................................................................................................................................... 24 APPENDICES ................................................................................................................................... 26 Appendix 1: Emerging and re-emerging zoonoses listed by agent ............................................................ 26 Appendix 2: Emerging and re-emerging zoonoses listed by transmission route and disease ....................
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