Case reports on dangerous infectious diseases: a review of patient consent.

Case reports are commonly used to describe new infectious diseases. In the past 20 years, there have been an increasing number of emerging infectious diseases that could constitute a major threat to global health security (through naturally occurring pandemics or deliberate release of infectious agents). It is vitally important that case reports related to infectious diseases are written up according to the highest possible standards and that guidelines regarding patient consent to publish are followed. So, do case reports that relate to dangerous infectious diseases follow guidance related to patient consent? To help find the answer to this question, I looked at a sample of case reports published on PubMed between 1 January 2014 and 31 December 2016. I searched for freely available full-text reports of infections that affected humans. The search was conducted for case reports on infectious diseases that pose the greatest risk to global health-infections that have been classified as Tier 1 agents by the Centers for Disease Control and Prevention. An assessment was carried out as to whether the identified case reports satisfied the criteria related to consent as outlined in the CARE guidelines. In total, 71 case reports were found. These were related to Ebola, Botulism, Yersinia and Tularaemia. The authors stated that they had obtained consent to publish in 17 of these case reports. Only a minority of published case reports on extremely dangerous pathogens contain documented evidence that consent was obtained from the patient in question. In this sample, 24% of case reports contained such evidence regarding consent.