1.How can surveillance help to detect and control the disease?
With a disease surveillance which including systematic data collection, data analysis, data sharing and action taken of ongoing event or disease, in case of Monkeypox, it can help us describe the current burden and epidemiology of the disease, monitor trends (number, etiology of cases) and the control of disease, also formulate the national policy. Early detection of suspected and probable cases needed further intervention either to confirm or to discard and proper treatment including isolation will eventually prevent the outbreak in clean area and timely control the disease globally.
2.Should we conduct active or passive surveillance or both for the disease, why?
In my opinion, for Monkeypox, we have to use combine approach. There are at least three groups involved; those who have symptoms of rash or fever with other symptoms as suspected cases, and some come out with positive laboratory as confirmed case, these two groups are collected from hospital-based (passive). Another group is as probable case, who had contacted the suspected and confirm case, which might be initially asymptomatic but might need further investigation, so we should set up an active approach for collect more data.
3.Which method should be best to identify cases, why?
1)Cases in medical facilities VS community
My answer is both. We can identify suspected and confirmed cases in medical facilities and contact tracing for those who contact the confirmed case via community-based method.
2)Sentinel VS population-based surveillance
Sentinel surveillance is appropriate. For Monkeypox, we collect data on cases enrolled with the case definition under global network surveillance so we could get high quality of data.
3)Case-based VS aggregated surveillance
For Monkeypox surveillance, which still small number of cases, it has a case investigation form and collect data from individual case or their contact members, their medical records including laboratory. So it is case-based surveillance. However it might transition to aggregated system if number of cases become larger.
4)Syndromic VS laboratory-confirmed surveillance
Both syndromic and laboratory-confirmed surveillance. For Monkeypox, one confirmed case is an outbreak (by WHO), so it will need both sensitivity and specificity for case definition. Syndromic surveillance allows rapid identification of cluster of case that need further investigation and monitor. However, symptoms especially rash can be mimic with those who has Herpes Simplex infection, serology testing like real-time PCR or Rapid test kits for Monkeypox will provide more specific data on the circulation strains.
4.What dissemination tools will you choose to disseminate monkeypox surveillance information? Why do you choose this/these tools?
Of course, Ongoing, Real-time Dissemination tools, like Health Alert Network (HAN) at CDC that provide information for medical and public health professionals. Also, there is data dashboard online that provide number of cases, global map for public actually. (https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html)