Dreesman J, Benzler J
Niedersächsisches Landesgesundheitsamt, Hannover.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2005 Sep;48(9):979-89. doi: 10.1007/s00103-005-1125-3.
By the Protection against Infection Act new instruments were established for infectious disease surveillance in Germany. The main innovations were a shift of responsibility for notifications from clinicians to laboratories, the validation of cases by means of case definitions in local public health departments, and the electronic transmission of single case data via state health departments to the Robert Koch Institute. Four years after the Protection against Infection Act was enacted, its implementation was successful from the perspective of state and national health authorities. This was proven by the detection and successful investigation of several diffuse outbreaks. However, further improvements seem necessary and the following points should be considered in a revision of the act: reduction of time limits for data transmission, unambiguous regulation of responsibilities and for data exchange in non-localized outbreaks as well as for international exchange of case data, and introduction of an obligation for clinicians to supply local public health departments with complementary information regarding laboratory reports on demand. The public health sector can contribute to a further improvement of the surveillance system by working to better inform clinicians and laboratories and therewith motivate them to comply with their obligations for notifying diseases and by promoting the scientific evaluation of the system, in particular concerning potential underreporting.
根据《感染防护法》，德国建立了新的传染病监测手段。主要创新之处在于将报告责任从临床医生转移至实验室，通过地方公共卫生部门的病例定义对病例进行验证，并通过州卫生部门将单个病例数据电子传输至罗伯特·科赫研究所。《感染防护法》颁布四年后，从州和国家卫生当局的角度来看，其实施是成功的。这一点在几起散发性疫情的发现和成功调查中得到了证明。然而，似乎仍有必要进一步改进，在修订该法案时应考虑以下几点：缩短数据传输时限，明确规定非局部性疫情中责任和数据交换以及病例数据国际交换的规则，并规定临床医生有义务应要求向地方公共卫生部门提供有关实验室报告的补充信息。公共卫生部门可以通过努力更好地告知临床医生和实验室，从而激励他们履行疾病报告义务，并通过促进对该系统的科学评估，特别是关于潜在漏报情况的评估，来推动监测系统的进一步改进。
