Surveillance Systems

Each year, influenza affects approximately 5-20% of the United States population causing over 200,000 hospitalizations and 3,000 – 49,000 death. As a key point of entry to the health care system, EDs are responsible for the initial management and treatment of a substantial proportion of these influenza patients, thus directly impacting overall public health. As the front line of influenza diagnosis and treatment, ED providers may benefit from real-time easily shared influenza surveillance information.

Objective

To evaluate the utility and acceptability of a real-time cloud based influenza surveillance tool amongst emergency department (ED) providers.

The vulnerability of mankind to disasters of various types has increased considerably all over the world. The situation in India is not better since 55 per cent of India’s landmass is prone to earthquakes; 68 per cent is vulnerable to drought; 12 per cent to floods; and 8 per cent to cyclones apart from the heat waves, and severe storms. Odisha, one of the developing coastal states of India, with a coastline of around 495 km and a population of about 43 million, is most prone to natural disasters like super cyclones and major floods every year. It has witnessed and suffered a number of super cyclones and floods in the last ten years. Such conditions give rise to various health hazards and diseases. Such an environment demands for a nodal agency which is dedicated towards public health surveillance during disasters in the state of Odisha, India. This paper tries to put forth the goals, requirement and role in setting up a centre for disaster preparedness for preparedness and surveillance during disaster. The paper also discusses various challenges and roadblocks in establishing such an institute.

Objective

To setup a nodal agency called the Centre for Public Health Preparedness (CPHP) dedicated towards public health surveillance during disasters in the state of Odisha, India. For better public health preparedness in disaster management the objectives of CPHP will be to: 1. To strengthen public health surveillance and preparedness for disaster management, through research, capacity building and action. 2. To act as a comprehensive technical support unit and resource centre for State Government of Odisha, India on public health preparedness for disaster management and to eventually provide similar support to other states of India. 3. To collaborate with National Disaster Management Authority to provide support in surveillance, preparedness and capacity building during public health emergencies. 4. To become a national centre of excellence in the area, in due course of time.

Disease surveillance particularly surveillance for communicable diseases is essential in identifying cases and preventing the occurrence of an outbreak. Surveillance can also contribute to reducing the size of an outbreak. In order to achieve these, surveillance activities must include all possible sites for case detection. The lack of established mechanisms to provide feedback to the surveillance system at all such points can cause a failure of the surveillance system. These are extremely relevant particularly in the current outbreak of Ebola in some parts of the West African Sub Region. Ghana, like many countries has established surveillance systems for specific diseases. Currently, 44 diseases/public health events including Ebola are under surveillance as part of an Integrated Disease Surveillance and Response (IDSR) system. Although the Ministry of Health (MOH) exercises authority over issues of health, the operation of policies and practices on disease surveillance is by the Ghana Health Service (GHS), an agency of the MOH despite the existence of other agencies such as the teaching hospitals.

Objective

To describe Ghana’s disease surveillance system operation and the potential challenges in the light of the Ebola outbreak in West Africa

A simplified syndromic surveillance system, based on early detection and reporting of four core syndromes and immediate reporting of unusual events, was established across PICTs in 2010. An early evaluation of the system was undertaken to make recommendations on improvements. The evaluation examined whether the system was meeting its objective of serving as an early warning system and its capacity to investigate and respond to outbreaks. Metrics included system acceptability, data quality, timeliness and level of compliance. The evaluation identified a critical need to better equip local public health officials with the knowledge and skills to rapidly and appropriately respond to suspected infectious disease outbreaks across the Pacific.

In response to the evaluation findings, the RAPID (Response and Analysis for Pacific Infectious Diseases) project was implemented to strengthen capacity in surveillance, epidemiology and outbreak response across the PICTs. Principally funded by Australian aid and developed in partnership with the World Health Organization (WHO), the Secretariat of the Pacific Community (SPC) and the Pacific Public Health Surveillance Network (PPHSN), RAPID is an example of a multi-organisational approach to swiftly address identified surveillance issues and strengthen regional surveillance capacity.

Objective

Surveillance evaluations should not only describe surveillance systems but provide evidence to improve public health practice. This presentation documents how knowledge gathered through a syndromic surveillance evaluation in Pacific Island Countries and Territories (PICTs) with local health personnel was translated into action, in collaboration with global health partners.

National studies estimate that respiratory syncytial virus (RSV) is responsible for one in 38 emergency department (ED) visits for children < 5 years old. The Council for State and Territorial Epidemiologists position statement (13-ID-07): “RSV-Associated Pediatric Mortality” advocates for improved RSV surveillance including monitoring of RSV-associated pediatric mortality and hospitalizations. The goal of that data collection is to establish prevaccine baselines to evaluate vaccine effectiveness should one become available. As RSV is not reportable in Florida, RSV surveillance relies on a small subset of all Florida hospital laboratories to report data in aggregate and calculation of percent positive of all tests for RSV performed. These data assess virus activity, and do not allow for assessment of morbidity or age-specific analysis. Moreover, this data is not complete or timely, most often becoming available a minimum of a week after the testing was conducted. Florida’s RSV surveillance efforts guide clinical decision making and insurance reimbursements. Florida’s RSV seasonality not only differs from the nation but there is strong variation among five distinct regions, as exemplified by southeast Florida where the RSV season is year round. In Florida, pre-approval of prophylactic treatment by insurance companies is tied to seasonality.

Objective

In Florida, pre-approval of prophylactic treatment by insurance companies is tied to seasonality. Previous analyses determined that Florida’s syndromic surveillance system (Electronic Surveillance System for the Early Notification of Community-based Epidemics [ESSENCE-FL]) was capable of monitoring Florida’s statewide RSV seasonality. This analysis aims to determine if ESSENCE-FL can also be used to describe RSV and RSV-associated hospitalizations in children < 5 years by region and season.

Surveillance for STD in the United States (US) relies primarily on case reports from clinicians and laboratories and sentinel surveillance; however, nationwide reporting is not required for viral STD and clinical sequelae of STD.

Objective

To evaluate the potential usefulness of 3 sources of administrative health care data for sexually transmitted disease (STD) surveillance.

Stillbirth is an unfortunate event in a woman life which remains uncounted in developing countries, thus, seldom caught attention until recently. Among 3.2 million stillbirths globally, 98% occurs in LMICs with majority in South Asia, and 75% of those are preventable. Globally, it counts as equal to neonatal deaths and is not mentioned in MGDs, global charters and programs priority. Besides immense information gap, it is mostly not part of vital registration system. Mostly, the data for stillbirths is mostly collected in demographic surveys, clinical studies or retrospective records, underestimating the counts. Besides, lack of optimal national vital registration system, Pakistan has highest rate of stillbirth. Hence, to collect prospective data, efforts are made by Department of Paediatrics of Aga Khan University to maintain a Demographic & Health Surveillance System (DHSS) at Karachi to provide more robust data over years.

Objective

To describe characteristic of stillbirth in a diverse population in Karachi health and demographic surveillance system.

In order to transition the forecasting, estimation and management of epidemic risks to individual administrative areas, the Agency for Consumer Rights Protection of Kazakhstan has developed a concept for modernizing the existing national system of the epidemiological surveillance (SES).

It is proposed that the data from the SES (epidemiology, sanitary and epidemiological background, external environmental objects and database) will be consolidated to generate a new epidemic risk control and management tool called the Regional Sanitary-Epidemiological Passport (RSEP) for each of Kazakhstan’s districts. The RSEP will contain infectious incidence rate dynamics according to the primary (marker) infections (7 nosologies) including a forecast for 2-3 years, and natural and soil foci GIS maps for especially dangerous pathogens (EDP) with a 3-5 year forecast of their activity.

The RSEP is planned as a new working tool for epidemiologists to aid in making objective estimates, forecasting epidemic risks in particular areas of Kazakhstan, and taking preventive steps to lower epidemic risks.

Objective

Development and approbation of the epidemic risk estimation and management methodology based on multivariate analysis per administrative clusters of Kazakhstan using the Electronic Integrated Disease Surveillance System (EIDSS) technical capabilities.

Since April 2012, an integrated syndromic surveillance system in rural China (ISSC) has been established in health facilities in two rural counties of Jiangxi Province, China [1]. The objective of ISSC is to integrate syndromic surveillance with conventional case report system for the early detection of infectious disease outbreak in rural China.

Objective

To evaluate the validity of a syndromic surveillance system in health facilities of rural China, signals generated by Shewhart charts from the reported febrile patients in children were compared with that from the common infectious disease patients reported to the conventional case report system (CISDCP, China Information System for Disease Control and Prevention).