1. How can surveillance help to detect and control the disease?
The surveillance can help:
_The early detection of outbreaks: Continuous monitoring can help to identify unusual case cluster or new geographic spread that allow the rapid containment and vaccination or isolation measures.
_For understanding epidemiology: It can provide data on incidence, risk groups, transmission routes and reservoir patterns that are essential for targeted interventions and public health messaging.
_The monitoring trend and impact: It can assess the effectiveness of control measures and detect the re-emergence.
_The detection of mutation and resistance: Laboratory-based surveillance can identify new viral strains or changes in virulence.
2. Should we conduct active or passive surveillance or both? Why?
We should conduct both. The passive surveillance can provide ongoing monitoring at low cost and can identify background incidence trend. The active surveillance is essential during outbreak to detect every case and interrupt transmission that is especially for an emerging or re-emerging disease.
3. Which method should be best to identify cases, why?
a. The medical facility vs community:
We should practice both but priority should depend on outbreak context. The severe cases often present to medical facilities and so hospital-based reporting can efficiently detect serious infections. However, mild cases may stay in the community especially in resource-limited or rural and hard to reach area.
b. The sentinel vs population-based surveillance
The sentinel surveillance is efficient for early outbreak detection and monitoring trend and population-based surveillance can give more generalize incidence data of the population although it is costly.
c. The case-based vs aggregated surveillance
The case-based surveillance should be prioritized while it can collect detailed information on each case. The aggregate system can only count the number of case and cannot support detailed outbreak investigation.
Monkeypox requires case-based surveillance to understand transmission, contact and vaccination status.
d. The syndromic vs laboratory-confirmed surveillance
The syndromic surveillance allows rapid alerts in the field. Laboratory confirmation can ensure diagnostic accuracy and monitoring of viral strains. The combined use of syndromic surveillance for early detection and lab confirmation for verification should be done for outbreak-prone disease.
4. What dissemination tools will you choose to disseminate monkeypox surveillance information? Why do you choose this/these tools?
a. The periodic tool: The weekly or monthly surveillance reports to inform health authority, partner and clinician.
b. The real-time tool: Event-based and online platform such as health map to share rapid alerts and outbreak locations. The mobile dashboard and map for real-time visualization and data sharing between local stakeholder enable faster dissemination, public awareness and coordinated response.