Surveillance gaps analysis and impact of the late detection of the first Middle East respiratory syndrome case in South Batinah, Oman: a teaching case-study

Timeliness is one of the most important components of any successful surveillance system, besides the sensitivity, stability and positive predictive value. The impact of significantly delayed detection of a serious threatening disease could be so severe. Therefore, filling the gaps or defects is of high priority to prevent undesirable consequences to the public health. This teaching case study provides gaps analysis through a systematic approach to the existing surveillance system which detected Middle East Respiratory Syndrome (MERS-CoV) case significantly late, thus improving the ability to mitigate those gaps. It simulates an outbreak investigation including laboratory confirmation, finding epidemiological links, and implementation of control measures. The analysis of surveillance gaps for this single case of MERS-CoV would help the learner realize the role of surveillance major components; case definition, the implementation step, laboratory samples, training and follow up. This case study was developed based on a report submitted to the General Directorate of Disease Surveillance and Control in the Omani Ministry of Health in September 2017. It was designed for the training of field epidemiology trainees or any other health care workers working in public health-related fields. It can be administered in 4-5 hours as two sessions. Used as adjunct training material, the case study provides the trainees with the practical aspects and challenges of any surveillance system which might not be fully understood through theoretical lectures solely. It also builds competencies in identifying the major gaps and recommending the right root solutions.