[Present situation and future prospects for epidemiological surveillance within the framework of Quebec new health...

Epidemiological surveillance in Quebec is part of the integral system of this activity throughout the whole of Canada and the United States. Since surveillance is aimed mainly at the ecosystem of the disease rather than just the cases, the activities are insured from the horizontal point of view by several organisations, aided by various Ministeries (health, agriculture, industry and commerce). The vertical structure (besides the Center for Disease Control in Atlanta as coordinator) includes the federal Laboratory Centre for Disease Control, its epidemiology and surveillance bureaus, as well as its territorial epidemiologists, provincial epidemiologists and their teams. Quebec has recently been given a new health structure, introduced in conjunction with the traditional organisations by the new Departments of Community Health, and the Social Centres of Community Services. This structure which is new to North America is characterised mostly by its close integration with community health. Moreover, it represents an excellent opportunity for developing an epidemiological surveillance complementary to local problems and for heightening their responsibility.