Public Health Surveillance — Notifiable Diseases in Saudi Arabia
Over one week, a family physician at a primary health care centre in a small town sees a 22-year-old man with urethral discharge and a positive Chlamydia trachomatis NAAT, a 25-year-old woman with bacterial vaginosis, an 18-year-old man with infectious mononucleosis, and a 70-year-old man with community-acquired pneumonia without an identified organism. Which condition must be notified to the Ministry of Health?
- A.Infectious mononucleosis
- B.Community-acquired pneumonia
- C.Chlamydia trachomatis infectionCorrect
- D.Bacterial vaginosis
Explanation
Chlamydia trachomatis infection appears on the Saudi Ministry of Health list of notifiable diseases and must be reported through the HESN electronic system within 72 hours, with the laboratory confirming the result also responsible for notification. Reporting sexually transmitted infections allows partner notification, contact treatment and surveillance of transmission in the community, which matters because most infections in women and many in men are asymptomatic yet cause pelvic inflammatory disease, ectopic pregnancy and infertility. Gonorrhoea, syphilis, chancroid and HIV are reportable for the same reason. Bacterial vaginosis is an overgrowth of anaerobes rather than a sexually transmitted infection in the conventional sense, partners are not treated, and it is not notifiable. Infectious mononucleosis is a self-limited Epstein-Barr virus illness with no public health action. Community-acquired pneumonia as a syndrome is not reportable, but the pathogen may be: laboratory-confirmed influenza requiring hospitalisation or causing death, legionellosis, invasive pneumococcal disease, tuberculosis and MERS coronavirus must all be notified. For chlamydia the MOH list makes the laboratory confirming the result responsible for notification, and clinicians must notify any condition they diagnose that the list assigns to the attending physician; confidentiality is preserved within the surveillance system.
Why each option
- A.
- Infectious mononucleosis is a self-limited Epstein-Barr virus infection requiring no contact tracing or public health intervention, so it is not notifiable.
- B.
- Pneumonia as a clinical syndrome is not reportable, although specific causes such as legionellosis, influenza or MERS coronavirus are.
- C.
- Correct. Chlamydia trachomatis infection is on the Saudi notifiable list and must be reported through HESN within 72 hours.
- D.
- Bacterial vaginosis reflects an imbalance of vaginal flora, partners are not treated, and it does not appear on the notifiable list.
Reference: Saudi Ministry of Health. List of Notifiable Diseases, KSA 2023 (HESN); CDC Sexually Transmitted Infections Treatment Guidelines 2021
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