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<title xml:lang="en">Global capacity for emerging infectious disease detection</title>
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<name sortKey="Chan, Emily H" sort="Chan, Emily H" uniqKey="Chan E" first="Emily H." last="Chan">Emily H. Chan</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Brewer, Timothy F" sort="Brewer, Timothy F" uniqKey="Brewer T" first="Timothy F." last="Brewer">Timothy F. Brewer</name>
<affiliation>
<nlm:aff id="aff3">ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff4">Departments of Medicine and Epidemiology, Biostatistics and Occupational Health,
<institution>McGill University</institution>
, Montreal, QC,
<country>Canada</country>
H3A 1A2;</nlm:aff>
</affiliation>
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<name sortKey="Madoff, Lawrence C" sort="Madoff, Lawrence C" uniqKey="Madoff L" first="Lawrence C." last="Madoff">Lawrence C. Madoff</name>
<affiliation>
<nlm:aff id="aff3">ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff5">Department of Medicine,
<institution>University of Massachusetts Medical School</institution>
, Worcester, MA 01655;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pollack, Marjorie P" sort="Pollack, Marjorie P" uniqKey="Pollack M" first="Marjorie P." last="Pollack">Marjorie P. Pollack</name>
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</affiliation>
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<name sortKey="Sonricker, Amy L" sort="Sonricker, Amy L" uniqKey="Sonricker A" first="Amy L." last="Sonricker">Amy L. Sonricker</name>
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, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Keller, Mikaela" sort="Keller, Mikaela" uniqKey="Keller M" first="Mikaela" last="Keller">Mikaela Keller</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff6">Department of Pediatrics,
<institution>Harvard Medical School</institution>
, Boston, MA 02215</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Freifeld, Clark C" sort="Freifeld, Clark C" uniqKey="Freifeld C" first="Clark C." last="Freifeld">Clark C. Freifeld</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
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, Boston, MA 02215;</nlm:aff>
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<name sortKey="Blench, Michael" sort="Blench, Michael" uniqKey="Blench M" first="Michael" last="Blench">Michael Blench</name>
<affiliation>
<nlm:aff id="aff7">Global Public Health Intelligence Network, Health Portfolio Operations Centre, Centre for Emergency Preparedness and Response,
<institution>Public Health Agency of Canada</institution>
, Ottawa, ON,
<country>Canada</country>
K0A 0K9</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mawudeku, Abla" sort="Mawudeku, Abla" uniqKey="Mawudeku A" first="Abla" last="Mawudeku">Abla Mawudeku</name>
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<nlm:aff id="aff7">Global Public Health Intelligence Network, Health Portfolio Operations Centre, Centre for Emergency Preparedness and Response,
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, Ottawa, ON,
<country>Canada</country>
K0A 0K9</nlm:aff>
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</author>
<author>
<name sortKey="Brownstein, John S" sort="Brownstein, John S" uniqKey="Brownstein J" first="John S." last="Brownstein">John S. Brownstein</name>
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<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
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<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff4">Departments of Medicine and Epidemiology, Biostatistics and Occupational Health,
<institution>McGill University</institution>
, Montreal, QC,
<country>Canada</country>
H3A 1A2;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff6">Department of Pediatrics,
<institution>Harvard Medical School</institution>
, Boston, MA 02215</nlm:aff>
</affiliation>
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<title xml:lang="en" level="a" type="main">Global capacity for emerging infectious disease detection</title>
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<name sortKey="Chan, Emily H" sort="Chan, Emily H" uniqKey="Chan E" first="Emily H." last="Chan">Emily H. Chan</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Brewer, Timothy F" sort="Brewer, Timothy F" uniqKey="Brewer T" first="Timothy F." last="Brewer">Timothy F. Brewer</name>
<affiliation>
<nlm:aff id="aff3">ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff4">Departments of Medicine and Epidemiology, Biostatistics and Occupational Health,
<institution>McGill University</institution>
, Montreal, QC,
<country>Canada</country>
H3A 1A2;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Madoff, Lawrence C" sort="Madoff, Lawrence C" uniqKey="Madoff L" first="Lawrence C." last="Madoff">Lawrence C. Madoff</name>
<affiliation>
<nlm:aff id="aff3">ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff5">Department of Medicine,
<institution>University of Massachusetts Medical School</institution>
, Worcester, MA 01655;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pollack, Marjorie P" sort="Pollack, Marjorie P" uniqKey="Pollack M" first="Marjorie P." last="Pollack">Marjorie P. Pollack</name>
<affiliation>
<nlm:aff id="aff3">ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sonricker, Amy L" sort="Sonricker, Amy L" uniqKey="Sonricker A" first="Amy L." last="Sonricker">Amy L. Sonricker</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Keller, Mikaela" sort="Keller, Mikaela" uniqKey="Keller M" first="Mikaela" last="Keller">Mikaela Keller</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff6">Department of Pediatrics,
<institution>Harvard Medical School</institution>
, Boston, MA 02215</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Freifeld, Clark C" sort="Freifeld, Clark C" uniqKey="Freifeld C" first="Clark C." last="Freifeld">Clark C. Freifeld</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Blench, Michael" sort="Blench, Michael" uniqKey="Blench M" first="Michael" last="Blench">Michael Blench</name>
<affiliation>
<nlm:aff id="aff7">Global Public Health Intelligence Network, Health Portfolio Operations Centre, Centre for Emergency Preparedness and Response,
<institution>Public Health Agency of Canada</institution>
, Ottawa, ON,
<country>Canada</country>
K0A 0K9</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mawudeku, Abla" sort="Mawudeku, Abla" uniqKey="Mawudeku A" first="Abla" last="Mawudeku">Abla Mawudeku</name>
<affiliation>
<nlm:aff id="aff7">Global Public Health Intelligence Network, Health Portfolio Operations Centre, Centre for Emergency Preparedness and Response,
<institution>Public Health Agency of Canada</institution>
, Ottawa, ON,
<country>Canada</country>
K0A 0K9</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Brownstein, John S" sort="Brownstein, John S" uniqKey="Brownstein J" first="John S." last="Brownstein">John S. Brownstein</name>
<affiliation>
<nlm:aff id="aff1">HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff2">Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="aff4">Departments of Medicine and Epidemiology, Biostatistics and Occupational Health,
<institution>McGill University</institution>
, Montreal, QC,
<country>Canada</country>
H3A 1A2;</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff6">Department of Pediatrics,
<institution>Harvard Medical School</institution>
, Boston, MA 02215</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Proceedings of the National Academy of Sciences of the United States of America</title>
<idno type="ISSN">0027-8424</idno>
<idno type="eISSN">1091-6490</idno>
<imprint>
<date when="2010">2010</date>
</imprint>
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<front>
<div type="abstract" xml:lang="en">
<p>The increasing number of emerging infectious disease events that have spread internationally, such as severe acute respiratory syndrome (SARS) and the 2009 pandemic A/H1N1, highlight the need for improvements in global outbreak surveillance. It is expected that the proliferation of Internet-based reports has resulted in greater communication and improved surveillance and reporting frameworks, especially with the revision of the World Health Organization's (WHO) International Health Regulations (IHR 2005), which went into force in 2007. However, there has been no global quantitative assessment of whether and how outbreak detection and communication processes have actually changed over time. In this study, we analyzed the entire WHO public record of
<italic>Disease Outbreak News</italic>
reports from 1996 to 2009 to characterize spatial-temporal trends in the timeliness of outbreak discovery and public communication about the outbreak relative to the estimated outbreak start date. Cox proportional hazards regression analyses show that overall, the timeliness of outbreak discovery improved by 7.3% [hazard ratio (HR) = 1.073, 95% CI (1.038; 1.110)] per year, and public communication improved by 6.2% [HR = 1.062, 95% CI (1.028; 1.096)] per year. However, the degree of improvement varied by geographic region; the only WHO region with statistically significant (α = 0.05) improvement in outbreak discovery was the Western Pacific region [HR = 1.102 per year, 95% CI (1.008; 1.205)], whereas the Eastern Mediterranean [HR = 1.201 per year, 95% CI (1.066; 1.353)] and Western Pacific regions [HR = 1.119 per year, 95% CI (1.025; 1.221)] showed improvement in public communication. These findings provide quantitative historical assessment of timeliness in infectious disease detection and public reporting of outbreaks.</p>
</div>
</front>
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<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Proc Natl Acad Sci U S A</journal-id>
<journal-id journal-id-type="hwp">pnas</journal-id>
<journal-id journal-id-type="pmc">pnas</journal-id>
<journal-id journal-id-type="publisher-id">PNAS</journal-id>
<journal-title-group>
<journal-title>Proceedings of the National Academy of Sciences of the United States of America</journal-title>
</journal-title-group>
<issn pub-type="ppub">0027-8424</issn>
<issn pub-type="epub">1091-6490</issn>
<publisher>
<publisher-name>National Academy of Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">21115835</article-id>
<article-id pub-id-type="pmc">3003006</article-id>
<article-id pub-id-type="publisher-id">201006219</article-id>
<article-id pub-id-type="doi">10.1073/pnas.1006219107</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Biological Sciences</subject>
<subj-group>
<subject>Medical Sciences</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Global capacity for emerging infectious disease detection</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Chan</surname>
<given-names>Emily H.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brewer</surname>
<given-names>Timothy F.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>c</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>d</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Madoff</surname>
<given-names>Lawrence C.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>c</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>e</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pollack</surname>
<given-names>Marjorie P.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>c</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sonricker</surname>
<given-names>Amy L.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Keller</surname>
<given-names>Mikaela</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
<xref ref-type="aff" rid="aff6">
<sup>f</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Freifeld</surname>
<given-names>Clark C.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Blench</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>g</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mawudeku</surname>
<given-names>Abla</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>g</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brownstein</surname>
<given-names>John S.</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>a</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>b</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>d</sup>
</xref>
<xref ref-type="aff" rid="aff6">
<sup>f</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>1</sup>
</xref>
</contrib>
<aff id="aff1">
<sup>a</sup>
HealthMap, Children's Hospital Informatics Program,
<institution>Harvard–Massachusetts Institute of Technology Division of Health Sciences and Technology</institution>
, Boston, MA 02215;</aff>
<aff id="aff2">
<sup>b</sup>
Division of Emergency Medicine,
<institution>Children's Hospital Boston</institution>
, Boston, MA 02215;</aff>
<aff id="aff3">
<sup>c</sup>
ProMED-mail,
<institution>International Society for Infectious Diseases</institution>
, Brookline, MA 02446;</aff>
<aff id="aff4">
<sup>d</sup>
Departments of Medicine and Epidemiology, Biostatistics and Occupational Health,
<institution>McGill University</institution>
, Montreal, QC,
<country>Canada</country>
H3A 1A2;</aff>
<aff id="aff5">
<sup>e</sup>
Department of Medicine,
<institution>University of Massachusetts Medical School</institution>
, Worcester, MA 01655;</aff>
<aff id="aff6">
<sup>f</sup>
Department of Pediatrics,
<institution>Harvard Medical School</institution>
, Boston, MA 02215; and</aff>
<aff id="aff7">
<sup>g</sup>
Global Public Health Intelligence Network, Health Portfolio Operations Centre, Centre for Emergency Preparedness and Response,
<institution>Public Health Agency of Canada</institution>
, Ottawa, ON,
<country>Canada</country>
K0A 0K9</aff>
</contrib-group>
<author-notes>
<corresp id="cor1">
<sup>1</sup>
To whom correspondence should be addressed. E-mail:
<email>john_brownstein@harvard.edu</email>
.</corresp>
<fn fn-type="con">
<p>Author contributions: E.H.C., T.F.B., L.C.M., M.P.P., M.B., A.M., and J.S.B. designed research; E.H.C., A.L.S., C.C.F., and J.S.B. performed research; E.H.C., T.F.B., M.K., and J.S.B. analyzed data; and E.H.C., T.F.B., and J.S.B. wrote the paper.</p>
</fn>
<fn fn-type="edited-by">
<p>Edited by Burton H. Singer, University of Florida, Gainesville, FL, and approved October 29, 2010 (received for review May 10, 2010)</p>
</fn>
<fn fn-type="conflict">
<p>The authors declare no conflict of interest.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>14</day>
<month>12</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub">
<day>29</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>29</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<volume>107</volume>
<issue>50</issue>
<fpage>21701</fpage>
<lpage>21706</lpage>
<permissions>
<license license-type="open-access">
<license-p>Freely available online through the PNAS open access option.</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="pnas.201006219.pdf"></self-uri>
<abstract>
<p>The increasing number of emerging infectious disease events that have spread internationally, such as severe acute respiratory syndrome (SARS) and the 2009 pandemic A/H1N1, highlight the need for improvements in global outbreak surveillance. It is expected that the proliferation of Internet-based reports has resulted in greater communication and improved surveillance and reporting frameworks, especially with the revision of the World Health Organization's (WHO) International Health Regulations (IHR 2005), which went into force in 2007. However, there has been no global quantitative assessment of whether and how outbreak detection and communication processes have actually changed over time. In this study, we analyzed the entire WHO public record of
<italic>Disease Outbreak News</italic>
reports from 1996 to 2009 to characterize spatial-temporal trends in the timeliness of outbreak discovery and public communication about the outbreak relative to the estimated outbreak start date. Cox proportional hazards regression analyses show that overall, the timeliness of outbreak discovery improved by 7.3% [hazard ratio (HR) = 1.073, 95% CI (1.038; 1.110)] per year, and public communication improved by 6.2% [HR = 1.062, 95% CI (1.028; 1.096)] per year. However, the degree of improvement varied by geographic region; the only WHO region with statistically significant (α = 0.05) improvement in outbreak discovery was the Western Pacific region [HR = 1.102 per year, 95% CI (1.008; 1.205)], whereas the Eastern Mediterranean [HR = 1.201 per year, 95% CI (1.066; 1.353)] and Western Pacific regions [HR = 1.119 per year, 95% CI (1.025; 1.221)] showed improvement in public communication. These findings provide quantitative historical assessment of timeliness in infectious disease detection and public reporting of outbreaks.</p>
</abstract>
<kwd-group>
<kwd>disease reporting</kwd>
<kwd>disease surveillance</kwd>
<kwd>epidemiology</kwd>
<kwd>disease outbreaks</kwd>
<kwd>public health</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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This area was generated with Dilib version V0.6.33.
Data generation: Tue Apr 28 14:49:16 2020. Site generation: Sat Mar 27 22:06:49 2021