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Public health surveillance 

Public health surveillance
Chapter:
Public health surveillance
Author(s):

Ruth L. Berkelman

, Patrick S. Sullivan

, and James W. Buehler

DOI:
10.1093/med/9780199218707.003.0042
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date: 19 June 2019

Public health surveillance is the epidemiological foundation for modern public health. Surveillance data resulting from the continuous monitoring of the occurrence of a disease or condition underlie what public health actions are taken and reflect whether these actions are effective. Surveillance may also include monitoring of risk factors associated with adverse health events. A surveillance system should be designed to meet the needs of a prevention and control programme, which generally include a description of the temporal and geographical trends in the occurrence of a health event in a particular population. Most importantly, surveillance systems should identify changes in disease occurrence and in its characterization (for example, changes in antimicrobial resistance, changes in mortality). The data should be useful for substantiating patterns of both endemic and epidemic disease.

General principles that underlie the practice of surveillance are essentially the same for all countries, regardless of economic development. Defining the objectives of a surveillance system depends on what information is needed, who needs it, and how it will be used. Implementing a system will require a balance of competing interests, and a clear statement of objectives will provide a framework for subsequent decisions. Public health surveillance data are collected in many ways, depending on the nature of the health event under surveillance, potential methods for identifying the disease, the population involved, the resources available, and the goals of the programme. The widespread use of the Internet and electronic media has led to innovations in public health surveillance reaching far beyond traditional methods of disease monitoring on an individual patient basis. The performance of surveillance systems can be assessed by using a series of attributes, including sensitivity, timeliness, representativeness, positive predictive value, acceptability, flexibility, simplicity, and costs. Systems should be periodically or continually assessed as part of quality assurance. Surveillance provides a stimulus to keep prevention and control activities moving rapidly and in the right direction, guiding the response to individual cases as well as public policy. The term ‘surveillance’ is derived from the French word meaning ‘to watch over’ and, as applied to public health, means the close monitoring of the occurrence of selected health conditions in the population. Although surveillance methods were originally developed as part of efforts to control infectious diseases, basic concepts of surveillance have been applied to all areas of public health.

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