Policy responses for Montenegro - HSRM


Policy responses for Montenegro

1.4 Monitoring and surveillance

Definition of COVID-19
For the purpose of monitoring and surveillance, the WHO case definition is used.

Definition of probable cases and contacts

The Montenegrin Institute for Public Health defines probable and confirmed cases as follows:
• Suspected case: A patient with any acute respiratory illness with no other aetiology that fully explains the clinical presentation
• Probable case: A suspected case for whom testing for the virus causing COVID-19 is inconclusive (according to the test results reported by the laboratory).
• Confirmed case: A person with laboratory confirmation of the virus causing COVID-19 infection, irrespective of clinical signs and symptoms

Contact : a person that is involved in any of the following within a 14‐day period after the onset of symptoms in the case under consideration: Providing direct care without proper personal protective equipment (PPE)2 for COVID-19 patients OR Staying in the same close environment of a COVID-19 patient (including workplace, classroom, household, gatherings) OR Traveling together in close proximity (1 m) with a COVID-19 patient in any kind of conveyance.

Contact tracing
Contact tracing is implemented on all levels of health care and consists of the Identification of all social, familial, work, and health care worker contacts who had contact with a confirmed case from 2 days before symptom onset of the case and up to 14 days after their symptom onset. If the case had no symptoms, contact tracing is covering all contacts as described 2-5 days before the laboratory confirmation.

Contact tracing is performed by skilled epidemiologists on all levels of healthcare,  depending on the institution or setting in which a case has been detected. Contact racing is performed usually by phone.

Systems used for surveillance of COVID-19:
Surveillance is being conducted on several levels:
• primary health care centres are conducting municipal surveillance in accordance with case definition
• all suspected cases are reported to the national Institute for Public Health
• A national call centre (1616) has been established in order to timely identify, investigate and sample suspected cases
• at primary care level: if the primary care physician suspects a COVID-19 infection, the patient is referred to one of the designated ambulances specifically set up for the physical examination of Covid-19 patients
• sampling is performed in the primary health care institutions, homes or as drive-through
• surveillance at the secondary and tertiary health care level has been based on SARIO sentinel surveillance, respiratory disease surveillance systems, and general hospital-based surveillance – if the clinician suspects a COVID-19 infection at the hospital, they will take samples and send them to the Institute for Public Health. Until the arrival of results, the patient is treated as positive (isolated with all other IPC measures implemented).