Public Health Capacity
The mission of public health is to safeguard and improve the health of the community as a whole. Effectively responding to infectious disease threats therefore requires a robust public health system. In the United States, public health surveillance for infectious diseases is conducted through a variety of agencies.
Public health advocates have called for improved surveillance to better monitor infectious diseases across the country.
Health care providers and others report cases of notifiable infectious diseases (as defined by local and state health codes) to state health departments. State health department officials, in turn, verify disease reports, monitor disease incidence, identify possible outbreaks, and forward their findings to the Centers for Disease Control and Prevention (CDC). The CDC and other federal agencies, including the Food and Drug Administration, the U.S. Department of Agriculture, and the U.S. Department of Defense, independently gather and analyze information for disease surveillance.
Public health advocates have called for improved surveillance to better monitor infectious diseases across the country. Among their recommendations: a national electronic infectious diseases reporting system; innovative methods of disease surveillance (such as automated laboratory reporting of infectious disease or systematic gathering of informal reports of disease from the Internet); and a strengthening of the entire public health system, which historically has been underfunded compared to biomedical research.
Syndromic surveillance—the near- or real-time monitoring of nonspecific pre-diagnostic signs of disease outbreaks—is an innovative surveillance method that is being explored by some cities and states with assistance from the federal government as a means of providing early warning of infectious disease outbreaks. Syndromic surveillance rests on the idea that, following large-scale exposure to infectious disease in an epidemic or bioterrorist attack, people will first develop symptoms, stay away from work or school, and attempt to treat themselves before seeing a doctor. These systems therefore monitor school and work absenteeism, sales of over-the-counter medications, illness- related 9-1-1 calls, and other patterns that suggest an outbreak. However, most surveillance still focuses on tracking reported infections.
