It is somewhat easier to recognize the different requirements for effective zoonotic disease surveillance than to actually integrate them and manage the outbreak. In other words, it's a puzzle where you have all the pieces but it's difficult to fit them all together. Some pieces of the zoonotic puzzle include:
- Public health laboratory surveillance
- Vectors and vector-borne disease surveillance
- Veterinary surveillance at all levels–local, state, federal, and international
- Systems for identification and containment of unknown and rare pathogens
- Oversight of food-borne pathogens
- Monitoring informal data sources and rumor-based disease reporting
- Statistical analysis and disease modeling
- Enacting standards for laboratory practices and network operations
- Input from social science experts
And the list goes on and on. This is not a small task, especially because all of these pieces need to be eventually integrated at the global level.
The image below indicates a very theoretical, non-specific "cycle of surveillance" put forth in 2009, the year that Dr. Chan made her famous statement.
18. National Research Council (US) Committee on Achieving Sustainable Global Capacity for Surveillance and Response to Emerging Diseases of Zoonotic Origin; Keusch GT, Pappaioanou M, Gonzalez MC, et al., editors. "Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases: Achieving an Effective Zoonotic Disease Surveillance System." National Academies Press (US); 2009. Available from: https://www.ncbi.nlm.nih.gov/books/NBK215315/.
