A community-level Communicable Disease Surveillance System in a Metropolitan city

Objectives: The surveillance of infectious diseases, which is crucial in public health, may also suffer from poor community support. In South Korea, the government operates several national surveillance system for the National notifiable infectious diseases(NNID). Some programs work satisfactorily but other programs may not be fully accepted at the community level which result in low participation and delayed report. Methods: May 2003, to improve the blind side of the National Surveillance System, a district health agency initiated a community based surveillance system for infectious diseases called as Communicable Disease Information Sharing System (CDISS) to complement the national program. As the name suggests, it underscores the mutual benefit of surveillance for public and private health sectors through partnership. With collaboration of participating private clinics and hospitals around the district, the health agency collects data and provides the health practitioners more up-to-dated information on the trend of infectious diseases than National level information. Total population of study area, Dong-gu which locate in the center of Gwangju-metropolitan city, is about 120,000 in 2005. Reporting facilities consist of 6 daycare clinics, 3 hospitals, and 1 university hospital, 2 local public health organizations. Results: CDISS was introduced in May 2003, and full system has been successfully operated since March 2004 with 10 participating facilities. Each reporting facility regularly sends the weekly reporting form, filled with the number of patients in last week, to Dong-gu District Health Center in every Wednesday. All data were organized in tables and graphs by weekly summarizing the reporting data and interpreted information. Feedback is done to reporting facilities until Friday through faxes, email, website (http://kjdisweb.richis.org ) - at least a week earlier than National Surveillance System.If reported data exceeded epidemic alert level, the community warnings are issued through mass-media and other means of public communication.During the period of CDISS operation, some epidemic events and sporadic outbreak occurred in Dong-gu were detected well-earlier than the notification at national level, such as chickenpox, viral enteritis, and epidemic keratoconjunctivitis(EKC). Conclusions: The program has been functioning successfully with active community participation and revealed to be economic and effective way of disease surveillance in the community Several episodes of disease epidemic were reported by the program well before the recognition of the epidemic at the national level. We suggest that the community surveillance program may well complement national surveillance system.