Post-Event
Operational Issues
Active
Smallpox Surveillance
Active
smallpox surveillance would entail distributing the case definitions
to places that medically evaluate and treat patients. Other sources,
such as medical examiners or schools, may also be targeted for
active surveillance. It is also important to make sure that all
the public health and medical authorities involved in the response
have a standard set of data collection tools that have been developed
for use in surveillance, contact tracing and monitoring, and vaccination
record keeping. Distribution of case definitions and case classifications
should be provided to:
- Public health
staff involved in surveillance
- Hospitals
- Clinics
- Health care
providers
- Other reporting
sources
In active surveillance,
there is active solicitation of cases. The frequency of reporting
would be established by local public health authorities and may
be daily in the initial stages of the outbreak. Daily contact with
major reporting sources would be required in a post-outbreak scenario.
Some retrospective
surveillance will also be required at the recognition of the outbreak
to determine if cases occurred earlier than the first confirmed
case. This would entail reviewing deaths over the last month, especially
from all rash illnesses including hemorrhagic rashes.
In a post-event
situation, daily reporting of case counts to state and national
levels. Mechanisms for reporting identified contacts that have
left a health jurisdiction must also be in place (e.g. state to
state, providence to providence, or country to country). Report
out of jurisdiction contacts to the National coordinating authorities
or through identified jurisdiction to jurisdiction mechanisms.
Other important
surveillance activities would include the confirmation of non-smallpox
causes of rash illnesses with laboratory testing when possible
in order to provide the appropriate treatment for the illness and
more accurately reflect the number of true smallpox cases. Review
of reported varicella cases will also be important to make sure
they weren’t misdiagnosed smallpox cases.
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