What is Surveillance, Anyway?
One term that comes up a lot when we are talking about epidemics and pandemics is surveillance. The official definition of surveillance is "Disease surveillance is the detection, rapid verification and response to epidemic-prone and emerging disease threats." In its simplest form, surveillance is keeping track of where and when infectious diseases break out. That lets us know what infections are on the rise, and how they are travelling.
We can't, obviously, keep track of every infection that happens everywhere. For one thing, there are plenty of infections you don't go to the doctor for. The common cold, stomach flu, yeast infections. So we can only track infections that lead to contact with the health care system. That being said, we don't track every infection that requires a doctor visit, either. The time and effort of reporting and analyzing all that data wouldn't be worth what we learned from it. There would just be too much to process.
Instead, certain serious diseases are selected for reporting. In the US, these are the Nationally Notifiable Infectious Diseases. They include AIDS, anthrax, rabies, and smallpox. Health care providers in the United States are legally obligates to report any infections on the NNID list. The resulting data is then published in the Morbidity and Mortality Weekly Report. Nearly every country has a similar system of disease reporting, but not all publish the results. The US, like most other countries, then reports its infectious disease data to the World Health Organization in accordance with the International Health Regulations published by the WHO.
There are several places this system runs into trouble. As discussed, people don't always go to the doctor when they are sick. Health care providers may be sloppy about their reporting of infectious diseases, or they may misdiagnose illnesses. This is especially likely when the disease is fatal, and an autopsy is not performed. National governments are often reluctant to share information with WHO that might make them look bad, or they may lack the capacity to collect and report accurate data on an ongoing basis.
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