Communicable-disease surveillance in New Jersey.

The DHSS and federal agencies have expanded their surveillance efforts to improve existing methods of reporting notifiable communicable diseases and to include additional data sources that might provide a more comprehensive view of disease activity in New Jersey. Currently, the DHSS is evaluating these efforts and recognizes several issues that need to be addressed, including: assessment of the timeliness, completeness, and accuracy of surveillance data; validation of surveillance data through comparison with hospital uniform billing data; characterization of the sensitivity of alerts through examination of reasons for identified aberrations in disease activity; evaluation of DHSS staffs and LINCS epidemiologists' follow-up efforts in response to alerts; evaluation of cumulative data trends to determine patterns in baseline disease activity (e.g., variations in disease activity attributed to seasonality); development of methods to integrate data from all surveillance efforts to provide timely, comprehensive, and coordinated summaries of disease activity and to distribute these summaries regularly to all New Jersey public health partners to better inform public health and clinical management; and development of a coordinated multi-agency response plan in conjunction with adjacent states. Though the DHSS hopes that these surveillance efforts will contribute to the early detection of sentinel events that might represent possible bioterrorist or emerging infectious disease threats, the DHSS will also need to engage the medical community more fully in surveillance activities. In previous experiences, astute clinicians were responsible for the identification of the first cases of West Nile virus, anthrax, and SARS. Therefore, to further ensure the success of its surveillance efforts, the DHSS will also need to continue educating clinicians about its surveillance activities and the importance of timely reporting of patients with illness patterns that might suggest an unusual infectious disease outbreak associated with bioterrorism or emerging infectious diseases.