Infectious Disease Surveillance

Public health surveillance ‘Public health surveillance is the ongoing, systematic collection, analysis, interpretation and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health’

Ongoing

Systematic

Interpretation and Communication

• Sustainable, not a 1-2 year study

• Consistent case definitions and reporting methods

• Results should be regularly reported in the public domain (even if not all the details are available)

CDC. MMWR 2001; 50(RR13): 1-35. Available at http://www.cdc.gov/mmwr/PDF/rr/rr5013.pdf. Last accessed: 20 February 2013

ABCs, Active Bacterial Core surveillance; IPD, invasive pneumococcal disease ; WHO, World Health Organization. WHO 2012. Measuring impact of Streptococcus pneumonia and Haemophilus influenzae type b conjugate vaccination. Available at http://apps.who.int/iris/bitstream/10665/75835/1/WHO_IVB_12.08_eng.pdf Last accessed 27 February 2013; Schuchat A, et al. Emerg Infect Dis 2001; 7: 92–9; Saha, et al. Clin Infect Dis 2009; 48: S75–81.

• Routine reporting (e.g. notifiable conditions, WHO reports)ü Simple, many countries have

adopted lists of legally mandated notifiable diseases

Potential for under-reporting and underestimating disease burden

• Routine reporting AND proactive follow-up to ensure all cases are reported (e.g. CDC’s ABCs)ü M o s t a c c u r a t e m e t h o d f o r

capturing cases Resource intensive (e.g. training,

standardisation) and associated cost

Passive Active

Types of surveillance (1)

Key challenges: Stability of surveillance over time

•CDC, Centre for disease control; HPA, health protection agency; NVP, national vaccine programme; PCV, pneumococcal conjugate vaccine•HPA Enhanced Surveillance of Invasive Pneumococcal Disease (IPD). Available at http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Pneumococcal/EnhancedSurveillancePneumococcal/pneumoEnhancedSurveillanceofIPD/ Last accessed 14 March 2013. CDC Updated Guidelines for Evaluating Public Health Surveillance Systems. Available at http://www.cdc.gov/mmwr/PDF/rr/rr5013.pdf. Last accessed 14 March 2013.

Surveillance artefacts may correspond to:• Increased availability of BACTEC systems• New laboratory tests • More laboratories involved in surveillance

Improvements in case detection

May bring improved awareness of disease, leading to improved reporting e.g. enhanced surveillance by the HPA following the introduction of PCV to the NVP

Introduction of vaccine

Surveillance data must be interpreted with caution

• Quality of the surveillance system can be evaluated using the CDC guidelines

Surveillance artefacts: improvement in case detection or awareness of disease may increase reporting. However, this does not necessarily

correlate with an increased disease burden

Uses of Surveillance

• To provide a scientific database for recognition, evaluation of the disease problem, rational prevention and control.

• To recognize and understand the recent trends in the spread of disease.

• To facilitate epidemiological forecasts of disease incidence, trend and outbreak.

•To help in periodic evaluation of control measures.

•To assess the cost-effectiveness of control measures.

•To determine strategies, establish priorities, and suggest areas for further research in health planning and management

• IDSP (Integrated Disease Surveillance Project)

– Nationwide outbreak surveillance system. – Including Measles, Diphtheria, Pertussis, AFP, Hepatitis and AES.– Sustainable but variable State ownership– Data not capture Age & Immunization Status– Lab Component Weak– In Transition

Surveillance systems in India

• CBHI/SBHI (Central and State Bureaus of Health Intelligence)

– Nation-wide passive reporting system of suspected cases– All VPDs & Traditional EPI– Extremely Variable Completeness, Data Quality and reliability– Annual Updates

Surveillance systems in India

• AFP and lab surveillance for Poliovirus– Global eradication program

• Fever and rash for Measles/Rubella– National mortality reduction target

– May be scaled up to a regional elimination goal

• Acute Encephalitis Syndrome (AES) for JE– Control program for endemic districts

All supported by laboratory investigations in WHO accredited labs

WHO-NPSP supported surveillance systems:

• T h e I n d i a n Ro t av i r u s S t ra i n Surveillance Network: 4 labs and 10 hospitals in 7 regions.

• Children <5 yrs admitted with acute gastroenteritis and given re hyd ra t i o n fo r a t l e a s t 6 h enrolled.

• A fecal specimen is tested for rotavirus using a commercial enzyme immunoassay, and strains characterized using rtPCR.

The Journal of Infectious Diseases : 200:S147–53

Rotavirus Surveillance Network- India

• Sentinel hospital based surveillance sites for bacterial meningitis (Hib, pneumococcal and meningococcal meningitis).

• 11 sites in 6 different states of India– Kerala: Trivandrum and Alapuzha– Tamil Nadu: Chennai (3 places), Madurai & Vellore – Karnataka: Manipal– Orissa: Bhubaneswar– HP: Shimla – Delhi: Chacha Nehru Bal Chikitsalaya, Delhi

Bacterial Meningitis Surveillance

III. IDSurv-an innovative ID & AEFI surveillance system from IAP

IDSurv

• URL: www.IDSurv.org • A passive web-based,

fully interactive reporting system by pediatricians

• Few important Infectious Diseases & serious AEFIs are reported

• 10 IDs are reported:

• ABM• Diphtheria• Pertussis• Pneumonia• Enteric fever • Hepatitis• Varicella• Measles • Mumps • Dengue

How to report a new Infectious Disease case?

1. Through website idsurv.org, after logging into your account.

2. By sending a SMS to 57333 through your registered mobile number.

3. Through mobile website m.idsurv.org

4. By calling IVR system on 02653090533

Why should I join IDsurv network?

Cases reported by you would help in generating data regarding disease burden in India. Cases reported by you can be viewed and edited by you. It can serve as your personal Infectious Disease records system. These can be viewed & analyzed by you anytime anywhere by logging into your account.

Reporting a case through SMS:

• You can report a case by using SMS (Short Messaging Service) by sending and SMS to 57333 from your registered mobile number in the following format:

• “ IT space IDS space 4 letter code of the disease space Age in months space Sex space Severity of Disease space Microbial Diagnosis Established space Immunization status space Outcome ”

How to get registered? Click on the ‘Sign up/ Log in’ button as shown below

Then the following panel will open……

Click on “Register” button

Then the following form will appear……..

How to report a case?

Click on this Tab

Surveillance data in different Formats

Click FAQ for getting answers of your Queries

Click FAQ’s for getting answers of your Queries

Thank you!!!