Communicable Disease Surveillance: Strengthening the National Perspective

T HE MASS VAC CI NA TION CAM PAIGNS IN CANADA, IN re sponse to an in crease in group C men in go coc cal men in gi tis in 199193 and the world re ac tion to plague in In dia in 1994, were sa lu tory re mind ers of the abil ity of in fec tious dis eases to pro voke wide spread pub lic and po liti cal con cern. Com mu ni ca ble dis eases re main the ma jor cause of mor bid ity in the world and are a lead ing cause of mor tal ity in de vel op ing na tions. How ever, the de clin ing in ci dence of many of these dis eases in Can ada and other de vel oped na tions, al lied to im prove ments in so cial con di tions, popu la tion health status and child hood im mu ni za tion prac tices, and the ad vent of an ti bi ot ics, has cre ated high pub lic and po liti cal ex pec ta tions con cern ing our abil ity to con trol com mu ni ca ble dis ease. Suc cess has been achieved in sub stan tially re duc ing mor bid ity and mor tal ity due to such child hood dis eases as mea sles, diph the ria, po lio, per tus sis and mumps. Such suc cess sto ries are, how ever, coun tered by the per sis tence of sexu ally trans mit ted dis eases, as the most com mon re port able dis eases in Can ada (1), and res pi ra tory vi rus and en teric in fec tions, as ma jor causes of mor bid ity, in ad di tion to the emer gence of ‘new’ in fec tions such as AIDS and mul ti ple antibioticresistant mi cro or gan isms in clud ing, for ex am ple, mul ti ple drugresistant tu ber cu lo sis.