Although these studies focused on the best described clusters of human Q fever cases observed during the outbreaks, information about the number of C. burnetii genotypes circulating in patients, the environment, and potential veterinary sources in the Netherlands was not available at that time.
In this outbreak, information from the surveillance systems was as important for health providers as for policymakers; this information had to lead to immediate recognition of a public health threat and direct action.
Despite the lack of clarity in these relationships, public health agencies will likely play a critical role in the provision of information, medications, and vaccine dissemination as they will be supplied by the federal strategic national stockpile and may have the most accurate outbreak information as the pandemic unfolds.
Related sites More information about the outbreak WHO information about SARS.
The optimal surveillance network maximizes outbreak information, or equivalently minimizes the uncertainty related to the average distance between real and predicted outbreak sources.
Surveillance network topologies are selected by considering their integrated network resilience expressing the rewiring probability that is related to the ability to report outbreak information even in case of network destruction or missing information.
However, given that ProMED-mail, the non-official global surveillance system, can freely receive outbreak information from the media at any time, it is understandable that the reporting timeliness gap between ProMED-mail and the WHO was larger in countries with better civil liberties.
In countries with inadequate surveillance systems or with insufficient civil liberties to release outbreak information, the shortened timeliness gap might be meaningless for public health concerns.
Because in the early phase of an outbreak information is often limited to confirmed cases, we concentrate on confirmed cases only, and refer to the CFR as the confirmed CFR (cCFR) for clarity.
