Utility of sentinel surveillance as an early warning system for emerging pathogens in a low-resource setting: correlations of dengue, chikungunya, Zika, and COVID-19 trends between sentinel and passive surveillance systems in Puerto Rico, 2012-2023
Hernandez-Romieu, A. C.; Madewell, Z. J.; Delorey, M.; Volkman, H. R.; Sanchez-Gonzalez, L.; Rivera-Amill, V.; Sainz, D.; Bertran-Pasarell, J.; Frasqueri-Quintana, V. M.; Aponte, J. T.; Marzan-Rodriguez, M.; Rivera, A.; Lorenzi, O.; Espinet-Crespo, C. P.; Maldonado, Y.; Lugo-Robles, R.; Santiago, G. A.; Perez-Padilla, J.; Munoz-Jordan, J. L.; Paz-Bailey, G.; Adams, L. E.
Show abstract
The representativeness and timeliness of sentinel surveillance for endemic and emerging arboviral and respiratory diseases in low-resource settings are understudied. We compared laboratory-confirmed epidemic dengue, non-epidemic dengue, Zika, chikungunya, and COVID-19 (pre-Omicron and Omicron periods) cases reported in Puerto Ricos Sentinel Enhanced Dengue Surveillance System (SEDSS) with island-wide trends reported by the Department of Healths passive disease surveillance system (PADSS). We plotted trends over time to assess representativeness and used lagged cross-correlations to determine whether SEDSS reporting preceded PADSS. SEDSS trends were representative of island-wide trends for all pathogens. SEDSS preceded reporting in PADSS by up to three, eight, and two weeks for epidemic dengue, Zika, and pre-Omicron COVID-19, respectively. Increasing case trends for non- epidemic dengue and chikungunya occurred simultaneously in both systems. In Puerto Rico, sentinel surveillance was representative of island-wide trends and could provide early warning for dengue epidemics and emerging diseases, such as Zika, and COVID-19.
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