Public health implications of using various case definitions in The Netherlands during the worldwide SARS outbreak
Identifieur interne : 000F07 ( Pmc/Curation ); précédent : 000F06; suivant : 000F08Public health implications of using various case definitions in The Netherlands during the worldwide SARS outbreak
Auteurs : A. Timen ; G. J. J. Van Doornum ; M. Schutten ; M. A. E. Conyn-Van Spaendonck ; J. W. M. Van Der Meer ; A. D. M. E. Osterhaus ; J. E. Van SteenbergenSource :
- Clinical Microbiology and Infection [ 1198-743X ] ; 2006.
Abstract
This study analysed the consequences of deviation from the WHO case definition for the assessment of patients with suspected severe acute respiratory syndrome (SARS) in The Netherlands during 2003. Between 17 March and 7 July 2003, as a result of dilemmas in balancing sensitivity and specificity, five different case definitions were used. The patients referred for SARS assessment were analysed from a public health perspective. None of the patients referred had SARS, based on serological and virological criteria. Nevertheless, all 72 patients required thorough assessment and, depending on the results of the assessment, institution of appropriate prevention and control measures. Changing case definitions caused confusion in classifying cases. A centralised assessment of the reported cases by a team with clinical and public health expertise (epidemiological and geographical risk assessment) is a practical solution for addressing differences in applying case definitions. The burden of managing non‐cases is an important issue when allocating public health resources, and should be taken into account during the preparation phase, rather than during an outbreak. This applies not only to SARS, but also to other public health threats, such as pandemic influenza or a bioterrorist episode.
Url:
DOI: 10.1111/j.1469-0691.2006.01552.x
PubMed: 17121628
PubMed Central: 7129494
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<p>This study analysed the consequences of deviation from the WHO case definition for the assessment of patients with suspected severe acute respiratory syndrome (SARS) in The Netherlands during 2003. Between 17 March and 7 July 2003, as a result of dilemmas in balancing sensitivity and specificity, five different case definitions were used. The patients referred for SARS assessment were analysed from a public health perspective. None of the patients referred had SARS, based on serological and virological criteria. Nevertheless, all 72 patients required thorough assessment and, depending on the results of the assessment, institution of appropriate prevention and control measures. Changing case definitions caused confusion in classifying cases. A centralised assessment of the reported cases by a team with clinical and public health expertise (epidemiological and geographical risk assessment) is a practical solution for addressing differences in applying case definitions. The burden of managing non‐cases is an important issue when allocating public health resources, and should be taken into account during the preparation phase, rather than during an outbreak. This applies not only to SARS, but also to other public health threats, such as pandemic influenza or a bioterrorist episode.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Microbiol Infect</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin. Microbiol. Infect</journal-id>
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<title-group><article-title>Public health implications of using various case definitions in The Netherlands during the worldwide SARS outbreak</article-title>
<alt-title alt-title-type="left-running-head"><bold>Timen <italic>et al.</italic>
</bold>
</alt-title>
<alt-title alt-title-type="right-running-head">Implications of SARS case definitions</alt-title>
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<contrib-group><contrib id="cr1" contrib-type="author"><name><surname>Timen</surname>
<given-names>A.</given-names>
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<xref ref-type="aff" rid="a1"><sup>1</sup>
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<xref ref-type="aff" rid="a2"><sup>2</sup>
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<xref ref-type="aff" rid="a1"><sup>1</sup>
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<aff id="a1"><label><sup>1</sup>
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Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven</aff>
<aff id="a2"><label><sup>2</sup>
</label>
Virology Department, Erasmus Medical Centre, Rotterdam and</aff>
<aff id="a3"><label><sup>3</sup>
</label>
Internal Medicine Department, University Medical Centre St Radboud, Nijmegen, The Netherlands</aff>
<author-notes><corresp id="correspondenceTo">Corresponding author and reprint requests: A. Timen, LCI, RIVM (Postbak 13), PO Box 1, 3720 BA Bilthoven, The Netherlands
E‐mail: <email>Aura.Timen@rivm.nl</email>
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<pub-date pub-type="epub"><day>07</day>
<month>8</month>
<year>2006</year>
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<pub-date pub-type="ppub"><month>12</month>
<year>2006</year>
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<volume>12</volume>
<issue>12</issue>
<issue-id pub-id-type="doi">10.1111/clm.2006.12.issue-12</issue-id>
<fpage>1214</fpage>
<lpage>1220</lpage>
<history><bold>Original Submission:</bold>
19 August 2005; <bold>Revised Submission:</bold>
13 May 2006; <bold>Accepted:</bold>
8 June 2006</history>
<permissions><license><license-p>This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.</license-p>
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<abstract><title>Abstract</title>
<p>This study analysed the consequences of deviation from the WHO case definition for the assessment of patients with suspected severe acute respiratory syndrome (SARS) in The Netherlands during 2003. Between 17 March and 7 July 2003, as a result of dilemmas in balancing sensitivity and specificity, five different case definitions were used. The patients referred for SARS assessment were analysed from a public health perspective. None of the patients referred had SARS, based on serological and virological criteria. Nevertheless, all 72 patients required thorough assessment and, depending on the results of the assessment, institution of appropriate prevention and control measures. Changing case definitions caused confusion in classifying cases. A centralised assessment of the reported cases by a team with clinical and public health expertise (epidemiological and geographical risk assessment) is a practical solution for addressing differences in applying case definitions. The burden of managing non‐cases is an important issue when allocating public health resources, and should be taken into account during the preparation phase, rather than during an outbreak. This applies not only to SARS, but also to other public health threats, such as pandemic influenza or a bioterrorist episode.</p>
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