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Establishing communicable disease surveillance systems
  1. Thomas Falconer Hall1 and
  2. D A Ross2
  1. 1 AMS Support Unit, Army Medical Services, Camberley, UK
  2. 2 Worshipful Society of Apothecaries, London, UK
  1. Correspondence to Thomas Falconer Hall, AMS Support Unit, Army Medical Services, Camberley, UK; tomfalconerhall{at}


Humanitarian emergencies can result in an increase of communicable diseases, leading to a rise in mortality and/or morbidity in vulnerable populations. This requires a public health approach to re-establish control of communicable disease. Communicable disease surveillance systems play a key role, providing the information required for disease control measures, through systematic data collection, analysis, interpretation and dissemination. In humanitarian emergencies, they use the principles, practices and processes of wider surveillance systems, while being more focused on urgent priorities. However, communicable disease surveillance systems in humanitarian emergencies are constrained by multiple environmental, epidemiological and sociopolitical factors. Basic data collection, the bedrock of surveillance systems, can be extremely challenging and may require additional methods to estimate population size and prioritise diseases. Surveillance systems may be operating in conditions of weak state capacity with little physical or institutional infrastructure to support their operation. However, there are examples of successful self-sustaining disease surveillance systems in these circumstances, such as the deployment of WHO’s Early Warning Alert and Response System in a Box. Individuals and organisations charged with establishing communicable disease surveillance systems in emergencies would be well advised to learn from recent examples of success, use the sources of planning guidance outlined in this article and seek advice from organisations with recent experience. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.

  • public health
  • preventive medicine
  • epidemiology
  • infection control
  • public health

Data availability statement

No data are available. This review article does not have original data.

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Data availability statement

No data are available. This review article does not have original data.

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  • Contributors TFH wrote the initial draft of the paper, with revisions and additions made by DR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.