Group A Diseases
Group B Diseases
Group C Diseases
Group D Pathogens
AIDS
Smallpox
Acute hemorrhagic fever syndrome
Campylobacter jejuni
Acute bloody diarrhea
Epidemic typhus
Creutzfeldt-Jakob disease
Chlamydia trachomatis(as a sexually transmitted infection)
Yellow fewer
Pertussis
Plague
Echinococcosis
Brucellosis
Haemophilus influenzae type B (HiB) meningitis
Diphtheria
Cryptosporidiumssp.
Gonorrhea
HIV
Influenza
Entamoeba histolytica
Mumps
Leishmaniasis (Kala Azar)
Rubella
Enterohemorrhagic E. coli
Measles
Congenital rubella syndrome
Cholera
Giardia intestinalis
Rabies
Legionnaires’ disease
Listeria monocytogenes
Meningococcal disease
Leprosy
Poliomyelitis
Leptospirosis
Salmonellosis (Non-typhoidal Salmonellosis)
Malaria
Subacute sclerosing panencephalitis (SSPE)
Syphilis
Anthrax
Shigellosis
Tetanus
Schistosomiasis
Typhoid fever
Toxoplasmosis
Tuberculosis
Trachoma
Acute viral hepatitis
Tularemia
Cutaneous leishmaniasis
Neonatal tetanus
Group C mostly consists of diseases that have been newly included in the notification system. A common feature of these, except for trachoma, is that notification from the first level is not necessary. Depending on the type of the disease, “sentinel surveillance” is an acceptable way to follow these diseases because:
1.
Starting from the second level, some of these diseases can only be identified by more specialized institutions or laboratories, which would then be responsible for notification.
2.
In the case of a pandemic influenza outbreak, the rules state that samples from not all cases but from an adequate number of cases should be taken into account, and the fact that this is done at a certain center to control pandemics means that there is an overlap of purpose in achieving the same goal.
3.
In some cases, such as Creutzfeldt-Jakob disease (CJD) or congenital rubella, the return of information to the first level and the notification of the information collected there do not in practice contribute to overall surveillance. As it can be seen, the surveillance of diseases included in Group C will be a significant experience for the health system of our country. With regard to the specific capacities in relation to these diseases and the provision of diagnostic and treatment services, each health facility at or above the second level will also be obliged to provide notification of these diseases.
Group D, unlike other groups, describes the notification of the “infection agents”. This is an important innovation that requires the laboratories to be involved in the direct notification system. The aim here is to obtain information on etiologic agents for those diseases that are still a threat to public health and to be able to carry out epidemiological research when necessary. What is important here is that the laboratory can be a part of the notification system if it has an acceptable diagnostic capacity. Therefore, the Group D surveillance method, together with the indirect role of laboratory on the notification of Groups A, B and C, will bring the dissemination of the work concept based on the standardization and quality assurance.
The Notification System does:
1.
Update the list of notifiable infectious diseases
2.
Introduce standard case definitions. For example, the case definition for Diphtheriae.
Clinical description: An illness characterized by laryngitis, pharyngitis and/or tonsillitis, and adherent membranes of tonsils, pharynx and/or nose (pseudo-membrane).
Laboratory criteria for diagnosis: Isolation of toxigenic Corynebacterium diphtheriaefrom a clinical specimen such as pseudomembrane, oropharyngeal or nasal smear.
Case classification: (1) Probable case: A case that meets the clinical description. (2) Confirmed case: (a) A probable case that is laboratory confirmed, or (b) A probable case linked epidemiologically to a confirmed case. Note: Persons with positive C. diphtheriaecultures who do not meet the clinical description (i.e. asymptomatic carriers) should not be reported as probable or confirmed diphtheria cases. They have to be given only prophylactic treatment and monitored [8].
3.
Establish group criteria in the declaration of diseases according to their characteristics. For example, Group A includes diseases which can be easily diagnosed at all levels of health services.
4.
Include some new infectious agents in the notification list.
5.
Involve direct (Group D, or infectious agents) and indirect participation (Groups A, B, C diseases) of the laboratories within the system.
17.4 Preparation for Medical Response
The intentional use of biological agents is very difficult to anticipate. The release and spread of a contagious agent, such as the smallpox virus, could prove catastrophic if measures for control were not promptly and effectively applied.
A biological crisis may involve many factors, such as location of the attack, population, characteristics of biological agent, treatment and prophylaxis capabilities, and environmental conditions. All these factors must be considered, and given that any such attack is a criminal act, a thorough investigation must also be performed, which may include local, regional, or national authorities. Forensic microbiology is a multidisciplinary field of science which aims to establish the pathogen involved in an outbreak and its source with the ultimate goal of securing the prosecution of the guilty party [3].
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