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In countries where a mandatory surveillance system was already established, legally no informed consent was needed.
However, the data of this mandatory surveillance system are still confidential.
NOIS was established in 2005 and is a national, mandatory surveillance system for health-care institutions [ 2].
To our knowledge, however, no studies have so far quantified the influence of veterinarians on the implementation of a mandatory surveillance system.
Improving the coordination of veterinarians by official bodies providing technical support, training and information on the results of the differential diagnosis protocol (in addition to the results from the mandatory surveillance system) is also expected to increase participation in the surveillance system [ 12].
The transition from a voluntary to a mandatory surveillance system did not lead to lower quality of reference data and also did not influence the use of surveillance data for reducing nosocomial infections, at least in the field of neonatal intensive care medicine [ 4].
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Coordination of veterinarians, including technical support and information on the results of the mandatory surveillance systems, depends greatly on local veterinary services.
The analysis was based on data from the case-based, mandatory German surveillance system for infectious diseases.
In conclusion, the step from a voluntary to a mandatory HCAI surveillance system alone may lead to substantial improvements.
By definition, there is much overlap of cases between the Robert Koch Institute's mandatory reporting surveillance system, and the voluntary sentinel system.
Thirdly, our outcome measures for gonorrhea and chlamydia are from the CDC's mandatory passive surveillance system and are limited to the available data.
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