Arima Yuzo, Matsui Tamano, Partridge Jeffrey, Kasai Takeshi
Emerging Disease Surveillance and Response, Division of Health Security and Emergencies, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
Western Pac Surveill Response J. 2011 Dec 23;2(4):3-6. doi: 10.5365/WPSAR.2011.2.4.007. Print 2011 Oct.
After a devastating earthquake and tsunami struck north-eastern Japan in March 2011, the public health system, including the infectious disease surveillance system, was severely compromised. While models for post-disaster surveillance exist, they focus predominantly on developing countries during the early recovery phase. Such models do not necessarily apply to developed countries, which differ considerably in their baseline surveillance systems. Furthermore, there is a need to consider the process by which a surveillance system recovers post-disaster. The event in Japan has highlighted a need to address these concerns surrounding post-disaster surveillance in developed countries. In May 2011, the World Health Organization convened a meeting where post-disaster surveillance was discussed by experts and public health practitioners. In this paper, we describe a post-disaster surveillance approach that was discussed at the meeting, based on what had actually occurred and what may have been, or would be, ideal. Briefly, we describe the evolution of a surveillance system as it returns to the pre-existing system, starting from an event-based approach during the emergency relief phase, a syndromic approach during the early recovery phase, an enhanced sentinel approach during the late recovery phase and a return to baseline during the development phase. Our aim is not to recommend a specific model but to encourage other developed countries to initiate their own discussions on post-disaster surveillance and develop plans according to their needs and capacities. As natural disasters will continue to occur, we hope that developing such plans during the "inter-disaster" period will help mitigate the surveillance challenges that will arise post-disaster.
2011年3月，日本东北部遭受了毁灭性的地震和海啸袭击，包括传染病监测系统在内的公共卫生系统受到严重损害。虽然存在灾后监测模型，但它们主要关注处于早期恢复阶段的发展中国家。此类模型不一定适用于发达国家，因为发达国家的基线监测系统差异很大。此外，有必要考虑监测系统灾后恢复的过程。日本发生的事件凸显了应对发达国家灾后监测相关问题的必要性。2011年5月，世界卫生组织召开了一次会议，专家和公共卫生从业者讨论了灾后监测问题。在本文中，我们根据实际发生的情况以及可能或将会是理想的情况，描述了会议上讨论的一种灾后监测方法。简而言之，我们描述了监测系统恢复到原有系统的演变过程，从紧急救援阶段基于事件的方法，到早期恢复阶段的症状监测方法，再到后期恢复阶段的强化哨点监测方法，最后在发展阶段恢复到基线水平。我们的目的不是推荐特定的模型，而是鼓励其他发达国家就灾后监测展开自己的讨论，并根据自身需求和能力制定计划。由于自然灾害将持续发生，我们希望在“灾害间期”制定此类计划将有助于减轻灾后出现的监测挑战。
