3. Introduction

Updated 15 October 2025

Objectives of the Guidelines

  • To guide the systematic collection, analysis and dissemination of epidemiological data on the magnitude and trends, distribution and determinants of communicable diseases, non- communicable diseases, and risk factors for action.
  • To define roles and responsibilities for those involved in public health surveillance.
  • To provide orientation on the tools used for the reporting and verification of health-related events.
  • To provide health practitioners with guidance on the management of public health related events.

 

To Whom do the Guidelines Apply?

These guidelines apply to healthcare professionals working in public and private health facilities, laboratories (labs), outreach programs that have a component of patient interaction, and special clinics including those for HIV, family planning, environmental health and other health services. It also applies to public health interventions headed by the Ministry of Health, Wellness and Elderly Affairs (MOH) in collaboration with other ministries and organizations accordingly with International Health Regulations (2005) (IHR) and St. Lucia (SL) health-related legislation.

What is Health Surveillance?

The International Health Regulations (2005) define surveillance as “the systematic on-going collection, collation and analysis of data for public health purposes and the timely dissemination of public health information for assessment and public health response as necessary”. Surveillance is action based, including prevention and control of any public health problem. It is an essential function of the Public Health System, inextricably linked to the public health services, including other key Sectors, and it is frequently associated with research & development (COVID-19 lessons learned have reinforced this interconnection) (Annex Graph surveillance cycle).

Integrated Disease Surveillance 
Integrated Disease Surveillance and Response (IDSR) is a strategy which incorporates both Indicator-based surveillance (IBS) and Event-based surveillance (EBS) to facilitate early warning, alert and response (EWARS) to potential public health threat.
While IBS uses standard case definitions to identify diseases, conditions, and events, EBS relies on alerts from various sources to detect, triage and verify events.

The IDSR strategy promotes the rational use of resources by integrating and streamlining common surveillance activities, as opposed to the use of multiple surveillance systems with separate vertical activities.

One Health Approach
This is a framework which promotes collaboration across surveillance systems to achieve optimal health outcomes. Using an integrated disease surveillance approach, the One Health approach collects, analyzes and shares data from the human, animal and environmental sources to coordinate and respond to outbreaks and safeguard public health.

Types of Surveillance

Surveillance systems can be passive, active or a combination of both.   
Passive surveillance is the most common form of surveillance and occurs when laboratories, physicians, or other healthcare providers regularly report cases, diseases, or any other public health information to the local health department or MOH EpiU. These reports are based on standard case definitions for a particular disease or condition. Passive surveillance means that the healthcare provider or laboratory initiates the forwarding of the data to the MOH or Health District.
Active surveillance occurs when the collection of data from the lab, physician, community, or other healthcare provider is initiated by the Health District or EpiU. Active surveillance is often used during the practice of field epidemiology, case, or outbreak investigations, contact tracing or research studies. Active surveillance has an advantage over passive surveillance because it achieves more complete and accurate reporting. However, the draw-back is that it’s more resource intensive for the public health agency that is conducting the active surveillance. It costs more, it takes more personnel, and more time to do active surveillance.

Surveillance systems can also use syndromic or etiologic information, or a combination of both. 
Syndromic surveillance is particularly useful as an early alert system and is based on the reporting of different categories of clinical presentations (signs and symptoms). Syndromic surveillance better suits frequent reporting mechanisms allowing for a timely response.
Etiologic surveillance is based on the identification and characterization of disease-specific agent(s) by the laboratory and is more useful for monitoring specific disease trends.

Since clinical diagnosis is the basis of syndromic surveillance and laboratory diagnosis is the basis of etiologic surveillance, they should not be considered mutually exclusive but rather complementary. They should be combined according to circumstances and resources available.
 

Legal Framework

  • The Public Health Act, No. 8 of 1975 (revised).
  • The Public Health (Communicable and Notifiable Diseases) Regulations, Statutory Rules, and Orders, 1978, No. 12: This includes the surveillance of: (a) Communicable diseases under International Health Regulations, and (b) Communicable diseases and syndrome s as stipulated by the Chief Medical Officer and Chief Veterinary Officer, including those required by IHR through Caribbean Public Health Agency (CARPHA) and Pan-American Health Organization / World Health Organization (PAHO/WHO).
  • The Quarantine Bill
  • Public Health Food Act, No. 70 of 1960 Animal (Disease and Importation) Ordinance (Amendment 1994) Act replaced by Animal Health Act 2006.
  • The Saint Lucia MOH Communicable Disease Manual (2006).
  • Other Sectors also work in collaboration with the Health Sector, Health Care workers (HCW) and Public Health workers (PHW), applying these legislations and their own, and make important contributions in surveillance and response.