System of Notifiable Infectious Disease Surveillance in Japan
In Japan, notifiable infectious diseases are classified into categories 1 to 5 according to their infectivity, severity, and high fatality rate.
For example,
Category 1: Ebola hemorrhagic fever, Crimean-Congo hemorrhagic fever, smallpox, South American hemorrhagic fever, plague, Marburg disease, Lassa fever
Category 2: Acute poliomyelitis, tuberculosis, diphtheria, SARS, avian influenza (H5N1, H7N9), Middle East respiratory syndrome (MERS)
Category 3: cholera, shigellosis, enterohemorrhagic E. coli infection, typhoid fever, paratyphoid fever
Category 4: Hepatitis A/E, avian influenza (other than H5N1 and H7N9), monkeypox, Nipah virus infection, botulism, yellow fever, rabies, dengue fever, malaria, Lyme disease, Legionellosis, etc.
Category 5: amoebic dysentery, syphilis, tetanus, whooping cough, measles, rubella, chickenpox, influenza, COVID-19...etc. (Ministry of Health, Labour and Welfare, n.d.)
If a doctor diagnoses a patient as a category 1-4 infectious disease, or among the category 5 infectious diseases, measles, rubella, invasive meningococcal infection, food poisoning, new influenza, or COVID-19, the doctor will Regardless, it is legally required to immediately (within 24 hours) report to the nearest public health center by telephone or document (Ministry of Health, Labour and Welfare, n.d.). For other Category 5 infectious diseases, the government is responsible for ascertaining and monitoring the total number of infected patients, and doctors are required by law to report to the public health center within seven days after diagnosing a patient (Ministry of Health, Labour and Welfare, n.d.).
Think about the country you live in, what do you think could be the limitations of notifiable disease surveillance?
In Japan, there is a disparity in medical care between urban and rural areas, and there may be some delays and restrictions in the collection, analysis, and distribution of data on notifiable diseases (Centers for Disease Control and Prevention, 2012). In regular times, rural areas may have weaker inspection regimes than urban areas. It is undeniable that it is disadvantageous to grasp the situation of infectious diseases. Additionally, "sometimes related to factors such as climate, or social and cultural habits," and "distribution of a disease may be limited by the localization of the cases, for example a contaminated water supply" (Barratt & Kirwan, 2009, para.7).
Conversely, during the recent COVID-19 pandemic, Tokyo, the fourth most densely populated city in the world, experienced an explosive increase in the number of infected people, and the infectious disease surveillance and control system was in danger of collapsing. Even though they could test people and clarify the test results, the functions of medical institutions and health institutions that monitor infected people were overwhelmed. A few lives were lost due to the collapse of those systems. At this time, the Japanese government has not changed its tracking system and monitoring all COVID-19 cases, but if the number of infected people increases again, the same thing may happen.
Discuss two recommendations for improvement?
Currently, notifiable diseases in Japan must be reported by the diagnosing physician. However, other health-skilled personnel, such as infection control personnel, nurses, and public health nurses, may be able to perform this task for them (Centers for Disease Control and Prevention, 2012). We can also delegate the task of collecting and aggregating data to other staff rather than relying on the provider. In order to deal with cases where the number of infected people has increased rapidly, it is necessary to establish a system in advance that can respond to emergencies through these 2 ways.
Questions
・List infectious diseases that are registered as notifiable diseases in your country.
・Who reports it to whom?
(579 words)
References
Barratt, H., & Kirwan, M. (2009). Use of routine vital and health statistics to describe the distribution of disease in time and place and by person. HealthKnowledge. Retrieved from http://www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-epidemiology/use-of-routine-vital-and-health-statistics
Centers for Disease Control and Prevention. (2012, May 18). Appendix E. Limitations of Notifiable Disease Surveillance and Recommendations for Improvement. Centers for Disease Control and Prevention. Retrieved December 29, 2022, from https://www.cdc.gov/csels/dsepd/ss1978/lesson5/appendixe.html
Ministry of Health, Labour and Welfare. (n.d.). Favor of doctor's notification based on a Health, Medical care infectious disease way. Ministry of Health, Labour and Welfare. Retrieved December 28, 2022, from https://translation.mhlw.go.jp/LUCMHLW/ns/tl.cgi/https:/www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000073432.html?SLANG=ja&TLANG=en&XMODE=0&XCHARSET=utf-8&XJSID=0
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