Real-Time Surveillance of Infectious Diseases: Taiwan's Experience

Abstract

Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability. We describe Taiwan's disease surveillance system and use surveillance efforts for influenza and Zika virus as examples of surveillance capability. Timely and integrated influenza information showed a higher level and extended pattern of influenza activity during the 2015-16 season, which ensured prompt information dissemination and the coordination of response operations. Taiwan also has well-developed disease detection systems and was the first country to report imported cases of Zika virus from Miami Beach and Singapore. This illustrates a high level of awareness and willingness among health workers to report emerging infectious diseases, and highlights the robust and sensitive nature of Taiwan's surveillance system. These 2 examples demonstrate the flexibility of the surveillance systems in Taiwan to adapt to emerging infectious diseases and major communicable diseases. Through participation in the GHSA, Taiwan can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in the Asia Pacific and in Southeast Asia, in order to advance a world safe and secure from infectious disease.

Keywords: Infectious diseases; Surveillance.

Figure 1.

Schematic diagram of Taiwan's hospital information system (HIS) and laboratory information management system (LIMS), used to report infectious diseases and release data

Figure 2.

The influenza laboratory surveillance in Taiwan: laboratory automated reporting system (LARS) (A) and the laboratory surveillance network (B), week 40, 2015 to week 40, 2016.

Figure 3.

Percentage of visits for influenzalike illness (ILI) in emergency rooms (monitored through RODS) and outpatient departments (OPD, monitored through NHI), week 26, 2013, to week 25 in Taiwan, 2016.

Figure 4.

Number of severe complicated influenza cases and influenza-associated hospitalizations from week 26, 2013, to week 25, 2016, in Taiwan

Figure 5.

The incidence of severe complicated influenza by age group during 2013 to 2016 influenza seasons

Figure 6.

Pneumonia and influenza mortality from week 27, 2013, to week 26, 2016, in Taiwan

Figure 7.

The incidence and number of Guillain-Barré Syndrome (GBS) cases in Taiwan, 2004-2013