Timeliness of Infectious Disease Notification & Response Systems

CM Swaan

Research output: Types of ThesisDoctoral ThesisInternal

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Timely infectious disease notification and response is necessary to achieve effective disease control. Capacities for preparedness and response have been defined internationally, however standardized timeframes and thresholds for timeliness do not exist.
This thesis presents a timeframe for notification from patients disease onset until notification by physicians or laboratories to municipal health services (GGD’en), subsequent reporting to the RIVM, and for response by these organizations. An outbreak control timeframe for the local reporting delay is developed including patient, doctor and laboratory delay.
Study results show that the administrative notifications and reporting in the Netherlands are timely according legal frameworks. However, outbreak control delays are longer and only achieved for two out of six investigated diseases: hepatitis A and hepatitis B. For real-time outbreak investigation, insight in causes of the patient identification delay, by collection dates of physician consultation and laboratory testing, is necessary to decide on interventions.
The thesis shows substantial response delay in provision of post-exposure prophylaxes to flight contacts exposed to pandemic influenza A/H1N1 in 2009 and in referral time of suspected Ebola patients to dedicated hospitals in the Netherlands in 2014-2015. The authors conclude that response timeframes are disease specific and need to be determined per event preferably with involved medical professionals. Delay in implementation can affect effectiveness, and should be taken into account when deciding on control measures. The authors recommend that WHO after action review methodology should include timeliness as quantitative performance indicator. This thesis provides thresholds for standardization of measuring timeliness of preparedness & response systems.
Original languageEnglish
Awarding Institution
  • Erasmus University Rotterdam
  • Richardus, Jan Hendrik, Supervisor
  • Kretzschmar, MEE, Supervisor, External person
Award date19 Dec 2019
Place of PublicationRotterdam
Publication statusPublished - 19 Dec 2019


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