Integrated Serologic Surveillance of Population Immunity and Disease Transmission

Benjamin F. Arnold; Heather M. Scobie; Jeffrey W. Priest; Patrick J. Lammie

Disclosures

Emerging Infectious Diseases. 2018;24(7):1188-1194. 

In This Article

Abstract and Introduction

Abstract

Antibodies are unique among biomarkers in their ability to identify persons with protective immunity to vaccine-preventable diseases and to measure past exposure to diverse pathogens. Most infectious disease surveillance maintains a single-disease focus, but broader testing of existing serologic surveys with multiplex antibody assays would create new opportunities for integrated surveillance. In this perspective, we highlight multiple areas for potential synergy where integrated surveillance could add more value to public health efforts than the current trend of independent disease monitoring through vertical programs. We describe innovations in laboratory and data science that should accelerate integration and identify remaining challenges with respect to specimen collection, testing, and analysis. Throughout, we illustrate how information generated through integrated surveillance platforms can create new opportunities to more quickly and precisely identify global health program gaps that range from undervaccination to emerging pathogens to multilayered health disparities that span diverse communicable diseases.

Introduction

The potential to combine public health and environmental surveillance data with innovations in machine learning, statistical modeling, and data visualization has contributed to an emerging vision of precision public health, the idea that global health programs should use high-resolution data to guide interventions and direct scarce resources to those who would benefit most.[1] Robust disease surveillance is a cornerstone of global health efforts that range from detecting emerging pathogens and epidemics to the control or elimination of vaccine-preventable diseases, HIV, malaria, and neglected tropical diseases (NTDs) (http://www.who.int/neglected_diseases/9789241564540/en/).[2–4] Most infectious disease surveillance maintains a single-disease focus. In this perspective, we encourage an integrated approach to surveillance of population immunity and infectious disease transmission. First, we argue that antibody-based methods provide a unique opportunity to augment and integrate surveillance across diverse global health initiatives. Second, we highlight multiple areas for synergy through integration, where the combined result will add more value to public health efforts than independent disease monitoring through vertical programs. Finally, we draw on innovations in laboratory and data science to suggest key ingredients for an integrated serologic surveillance (serosurveillance) platform. Throughout, we show how information generated through an integrated platform can create new opportunities to more quickly and precisely identify public health program gaps, and we draw on examples from many global health programs that use serosurveillance to target and monitor their efforts.

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