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Contact tracing
In public health, contact tracing is the process of identifying people who may have been exposed to an infected person ("contacts") and subsequent collection of further data to assess transmission. By tracing the contacts of infected individuals, testing them for infection, and isolating or treating the infected, this public health tool aims to reduce infections in the population. In addition to infection control, contact tracing serves as a means to identify high-risk and medically vulnerable populations who might be exposed to infection and facilitate appropriate medical care. In doing so, public health officials utilize contact tracing to conduct disease surveillance and prevent outbreaks. In cases of diseases of uncertain infectious potential, contact tracing is also sometimes performed to learn about disease characteristics, including infectiousness. Contact tracing is not always the most efficient method of addressing infectious disease. In areas of high disease prevalence, screening or focused testing may be more cost-effective.
The goals of contact tracing include:
Contact tracing programs were first implemented to track syphilis cases in the 1930s. Initial efforts proved to be difficult given the stigmatization associated with sexually transmitted infections (STIs). Individuals were reluctant to report infections because they were concerned for their privacy. Revealing partner history and details about sexual activity was challenging as it affected relationships among individuals and community members. In addition, public health officials targeted certain populations such as sex workers, minorities, and at-risk populations further eliciting feeling of fear, shame, and guilt in society. With these negative implications of contact tracing, particularly in the space of sexually transmitted infections, public health officials found it difficult to elicit information from exposed individuals. During the HIV epidemic, many affected person were hesitant to report information, which hindered the efforts to understand HIV and curb the spread. To combat some of the negative stigma associated with contact tracing and STIs, health departments sometimes referred to contact tracing as partner notification in the 1980s. Partner notification, also called partner care, is a subset of contact tracing aimed specifically at informing sexual partners of an infected person and addressing their health needs. This definition evolved from identifying infected individuals to including a comprehensive program that encompasses counseling and medical care to treat the infection.
The official title, contract tracers, was first implemented in the United Kingdom during the smallpox outbreaks. Dedicated individuals served on a surveillance-based team to curb the spread of disease. This process served as a blueprint for other public health agencies to have a formalized program. The United States soon followed and enacted a contact tracing program for the prevention of infectious diseases which included TB, HIV, SARS, and now SARS-CoV-2.
Contact tracing generally involves the following steps as provided by CDC:
The types of contacts that are relevant for public health management vary because of differing modes of transmission. For sexually transmitted infections, sexual contacts of the index case are relevant, as well as any babies born to the index case. This information is crucial for investigating congenital syphilis cases for example. For blood-borne infections, blood transfusion recipients, contacts who shared a needle, and anyone else who could have been exposed to the blood of the index case are relevant. This information becomes relevant for health systems to keep track of high risk populations and medical errors, unavoidable and preventable. For pulmonary tuberculosis, people living in the same household or spending a significant amount of time in the same room as the index case are relevant. Understanding the pathology and transmissibility of the disease guides the approach to contact tracing strategy.
Although contact tracing is most commonly used for control of diseases, it is also a critical tool for investigating new diseases or unusual outbreaks. For example, as was the case with SARS, contact tracing can be used to determine if probable cases are linked to known cases of the disease, and to determine if secondary transmission is taking place in a particular community.
Contact tracing has also been initiated among flight passengers during the containment phase of larger pandemics, such as the 2009 pandemic H1NI influenza. Contact tracing played a major role in investigating Ebola virus in the UK in 2014 and monkeypox in the UK in 2018. The eradication of smallpox, for example, was achieved by exhaustive contact tracing to find all infected persons. This was followed by isolation of infected individuals and immunization of the surrounding community and contacts at-risk of contracting smallpox. Contact tracing can help identify the etiology of a disease outbreak. In 1984, contact tracing provided the first direct evidence that AIDS may be spread by an infectious agent during sexual contacts. The infective agent has since been identified as HIV.
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Contact tracing
In public health, contact tracing is the process of identifying people who may have been exposed to an infected person ("contacts") and subsequent collection of further data to assess transmission. By tracing the contacts of infected individuals, testing them for infection, and isolating or treating the infected, this public health tool aims to reduce infections in the population. In addition to infection control, contact tracing serves as a means to identify high-risk and medically vulnerable populations who might be exposed to infection and facilitate appropriate medical care. In doing so, public health officials utilize contact tracing to conduct disease surveillance and prevent outbreaks. In cases of diseases of uncertain infectious potential, contact tracing is also sometimes performed to learn about disease characteristics, including infectiousness. Contact tracing is not always the most efficient method of addressing infectious disease. In areas of high disease prevalence, screening or focused testing may be more cost-effective.
The goals of contact tracing include:
Contact tracing programs were first implemented to track syphilis cases in the 1930s. Initial efforts proved to be difficult given the stigmatization associated with sexually transmitted infections (STIs). Individuals were reluctant to report infections because they were concerned for their privacy. Revealing partner history and details about sexual activity was challenging as it affected relationships among individuals and community members. In addition, public health officials targeted certain populations such as sex workers, minorities, and at-risk populations further eliciting feeling of fear, shame, and guilt in society. With these negative implications of contact tracing, particularly in the space of sexually transmitted infections, public health officials found it difficult to elicit information from exposed individuals. During the HIV epidemic, many affected person were hesitant to report information, which hindered the efforts to understand HIV and curb the spread. To combat some of the negative stigma associated with contact tracing and STIs, health departments sometimes referred to contact tracing as partner notification in the 1980s. Partner notification, also called partner care, is a subset of contact tracing aimed specifically at informing sexual partners of an infected person and addressing their health needs. This definition evolved from identifying infected individuals to including a comprehensive program that encompasses counseling and medical care to treat the infection.
The official title, contract tracers, was first implemented in the United Kingdom during the smallpox outbreaks. Dedicated individuals served on a surveillance-based team to curb the spread of disease. This process served as a blueprint for other public health agencies to have a formalized program. The United States soon followed and enacted a contact tracing program for the prevention of infectious diseases which included TB, HIV, SARS, and now SARS-CoV-2.
Contact tracing generally involves the following steps as provided by CDC:
The types of contacts that are relevant for public health management vary because of differing modes of transmission. For sexually transmitted infections, sexual contacts of the index case are relevant, as well as any babies born to the index case. This information is crucial for investigating congenital syphilis cases for example. For blood-borne infections, blood transfusion recipients, contacts who shared a needle, and anyone else who could have been exposed to the blood of the index case are relevant. This information becomes relevant for health systems to keep track of high risk populations and medical errors, unavoidable and preventable. For pulmonary tuberculosis, people living in the same household or spending a significant amount of time in the same room as the index case are relevant. Understanding the pathology and transmissibility of the disease guides the approach to contact tracing strategy.
Although contact tracing is most commonly used for control of diseases, it is also a critical tool for investigating new diseases or unusual outbreaks. For example, as was the case with SARS, contact tracing can be used to determine if probable cases are linked to known cases of the disease, and to determine if secondary transmission is taking place in a particular community.
Contact tracing has also been initiated among flight passengers during the containment phase of larger pandemics, such as the 2009 pandemic H1NI influenza. Contact tracing played a major role in investigating Ebola virus in the UK in 2014 and monkeypox in the UK in 2018. The eradication of smallpox, for example, was achieved by exhaustive contact tracing to find all infected persons. This was followed by isolation of infected individuals and immunization of the surrounding community and contacts at-risk of contracting smallpox. Contact tracing can help identify the etiology of a disease outbreak. In 1984, contact tracing provided the first direct evidence that AIDS may be spread by an infectious agent during sexual contacts. The infective agent has since been identified as HIV.