Improving disease reporting in Los Angeles County: trial and results

A telephone survey of physicians in Los Angeles County revealed that 50 percent of 405 contacted were unaware of the legal mechanism for reporting communicable diseases--the Confidential Morbidity Report (CMR) card. After that survey, three measures were taken in an effort to improve reporting and surveillance: (a) use of a stamped self-addressed CMR postcard, (b) publication of the monthly newsletter "Public Health Letter," which was distributed to 23,000 health professionals in Los Angeles County free of charge, and (c) initiation of an active disease surveillance system that included 171 reporting sites contacted weekly (76 physicians, 36 schools, 33 preschools, 22 hospitals, and 4 university student health centers). No increase in the levels of disease reporting was observed, based on 4 years' experience with the revised CMR card and the Public Health Letter. The active disease surveillance system, however, has provided anecdotal reports of disease occurrence and notification of outbreaks of both reportable and nonreportable diseases. Moreover, the authors believe it has improved rapport between the county health department and the medical community.