Jelinek Tomas, Mühlberger Nikolai
Berlin Institute of Tropical Medicine, Spandauer Damm 130, Berlin 14050, Germany.
Infect Dis Clin North Am. 2005 Mar;19(1):1-13. doi: 10.1016/j.idc.2004.10.005.
When using all its advantages of clinical vigilance, direct communication,and fast feedback, a clinical surveillance network can be remarkably effective in detecting sentinel events and in translating the new information into modifications of clinical practice. Travelers have great advantage when serving as surveillance tools for imported diseases. They travel widely and potentially expose themselves to all types of infectious diseases, they are very mobile, and they return during the incubation period of most diseases to a medical system that is capable of achieving fast and definitive diagnosis. Clustering of infections in returnees can be used immediately to warn outbound travelers of a particular risk and to increase their protection. In addition, travelers can also serve as "canary birds" for disease outbreaks in developing countries that might not be able to provide facilities for fast diagnosis. Information derived from returning travelers can be invaluable for the host country if channeled back to the medical authorities. TropNetEurop screening for increases in unexpected notifications has proved to be a sensitive early warning tool for the detection of increased transmission rates in endemic countries. For the future, it is hoped that traditional surveillance systems and recently introduced networks will be able to cooperate more fully. All systems have strengths and weaknesses and can gain from information provided by each other. Linkage of existing networks, which avoids duplication of work and fully exploits the information potential of all combined systems, should be targeted.
临床监测网络在充分发挥临床警觉性、直接沟通和快速反馈等优势时，在发现哨点事件以及将新信息转化为临床实践的改进方面会非常有效。旅行者作为输入性疾病的监测工具具有很大优势。他们广泛旅行，可能接触到各类传染病，行动非常灵活，而且在大多数疾病的潜伏期返回能够进行快速明确诊断的医疗系统。归国人员中感染的聚集情况可立即用于警示出境旅行者特定风险并增强其防护。此外，旅行者还可作为发展中国家疾病暴发的“金丝雀”，这些国家可能无法提供快速诊断设施。如果将归国旅行者的信息反馈给医疗当局，对东道国来说可能非常宝贵。事实证明，TropNetEurop对意外通报增加情况的筛查是检测流行国家传播率上升的灵敏预警工具。未来，希望传统监测系统和最近引入的网络能够更充分地合作。所有系统都有优缺点，可从彼此提供的信息中获益。应致力于现有网络的连接，这可避免工作重复并充分挖掘所有组合系统的信息潜力。
