Finding Outbreaks Faster - Assessing Where We Are, Where We Have Been, and Where We Go Next

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Nov 16, 2018
by Oscar Tollast
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Finding Outbreaks Faster - Assessing Where We Are, Where We Have Been, and Where We Go Next

Participants reflect on metrics and definitions used by Ending Pandemics and learn more about existing pilot programs Participants of Finding Outbreaks Faster: How Do We Measure Progress? in Parker Hall

Each day of Finding Outbreaks Faster: How Do We Measure Progress? had a theme. On Monday, participants were asked to focus on “Prioritizing Challenges.” In aid of this, participants were given a refresher of the metrics and definitions currently used by Ending Pandemics.

These metrics include the date of outbreak start, the date of outbreak detection, the date of outbreak reporting, the date of laboratory confirmation, the date of public health response, and the date of first public communication. Working definitions are in place, but it is hoped participants will help improve and refine these definitions as the program progresses.

Pilot programs have taken place all over the world, from Albania and Serbia to Costa Rica and Pakistan. Participants heard from Zimbabwe and Taiwan, two of the first countries to receive investment from Ending Pandemics and provided greater detail as to what work had taken place so far.

In Zimbabwe, the detection of infectious disease outbreaks was monitored between 2003 and 2013. Data sources included official Ministry of Health reports, outbreak reports by the Zimbabwe FETP, and informal online reports collected using ProMED and HealthMap. Data points included total cases and dates for timeline milestones. Priority diseases included anthrax, cholera, malaria, rabies, H1N1, typhoid, and hepatitis.

In this period, there was an increase in the number of outbreaks reported. There was also a decrease in the overall time in outbreak discovery and response. Overall, there was an improvement in surveillance over time across a number of public health conditions. Moving forward, a need was identified to track the outbreak milestones prospectively and correct issues of missing data.

In Taiwan, meanwhile, the detection and notification of infectious disease outbreaks was monitored between 2006 and 2013. Data sources included total cases, geographical information, and dates for the timeline. Confirmed outbreaks included respiratory diseases, diarrheal diseases, and varicella.

In this period the timelines of outbreak reports and responses did improve over time except for outbreaks concerning respiratory diseases. Those behind the analyses also concluded different sources of outbreak reporting had a measurable influence on the timeliness of outbreak detection. Good coordination between local health departments and Taiwan’s Centers for Disease Control greatly assisted data collection.

The next steps for the project are to set up an operational definition of an “outbreak” and develop a standardized workflow for reporting, data collection, and database management.


The program Finding Outbreaks Faster: How Do We Measure Progress? is being held in partnership with Ending Pandemics and the University of Minnesota. To keep up to date with the conversations taking place during the program, please follow #SGShealth on Twitter and Instagram.