Download Epidemiological Surveillance

Epidemiological Surveillance
Kumnuan Ungchusak
Bureau of Epidemiology
Department of Disease Control
Ministry of Public Health
<[email protected]>
Key points
• its significant
• surveillance system: How it works
• Source of information
• common weakness
• how to improve
• evaluation of surveillance system
Question
: What are the role of these gods ?
Hakone’s Check point
I. The main purpose of Surveillance
Surveillance for
•
•
•
Knowledge of the distribution of health events
Rapid detection of outbreak
Public health planning and evaluation
II. Surveillance System: How it work?
1. Collection
•Record and report
2. Collation:
• data analysis
3. Information
synthesis
4. Dissemination
• timely
• action oriented
III. Source of information
1.
2.
3.
4.
5.
6.
7.
8.
8.
Morbidity
Mortality
Laboratory
Vaccines and drug
Outbreak news/ rumor
Vector
Behavior
Environmental
Demographic
Organization of Surveillance System
Ministry of Public Health
Dep of Disease Control
Regional Disease
Control Center
International Organization
Bureau of Epidemiology
Provincial Epidemiological Unit
ข้ อมูลรายงานโรค
ข่าวสาร/ข่าวกรอง
District Surveillance information
center
Private hospitals and clinics
Hospitals
Under MOH
And universal
coverage schemes
Hospitals and clinic under
universal coverage scheme
Important CD Diseases
Notification within 24 hours
1 SARS and Avian Flu
2.Cholera
3. Acute severely ill or death of unknown etiology
4. Cluster of diseases with unknown etiology
5. Anthrax
6. Meningococcal meningitis
7. Food poisoning outbreak
8. Encephalitis
9. Acute flaccid paralysis (AFP)
10. Severe Adverse Events Following Immunization
๑๑ Diptheria
๑๒ Rabies
Important CD Diseases
1 Measles
2. Pertussis
3. Hand Foot and Mouth Diseases
4. Influenza
5. Leptospirosis
6. Dysentery
7. Severe pneumonia of unknown etiology
8. Cluster of infectious cases
9. Dengue/DHF
Weakness
•
•
•
•
No action (surveillance for statistics)
No mandate (no receptor)
No funtional epidemiologist (CD4 <200)
No motivation
How to improve Surveillance
Surveillance and Rapid Response Team (SRRT)
• Tsunami
• Avian influenza
• Cholera outbreak
• Dengue
Surveillance and Rapid Response Team
Control action
ส่ วนกลำง
Intelligence
เขต
Information
จังหวัด
อำเภอ
หมู่บ้ำนตำบล
D-SRRT
อสม ๑๐๐,๐๐๐
P-SRRT
C-SRRT
R-SRRT
Influenza Pandemic
6 multi-countries
5. multiple outbreak
4. Confine easy H2H transmission
3. Human infection or inefficient H2H
2. Human at risk
1. New virus found
AI provincial Team (Human and Animal)
MoPH assigned “Mr.
Bird Flu”
Governor
Health
services
SRRTs
“SRRT ” 1030
Surveillance and
Rapid Response
Team
(800,000 village health volunteers
& community leaders)
Lay report
Network
Hospital
Laboratory
Pathologists
(SRRT)
Veterinarian
• History screening at all hospital
• Testing of respiratory specimen
• Survey of village and identify exposure
• Active case finding and monitor
household member for 10 days
• Antiviral prophylaxis for family member
of confirm H5 cases
• Culling of affected poultry
• Educated villagers to avoid risk
Early pandemic
Alert phase 4
Operational criteria for action:
“5 or more cases within 10 days”
• Epidemiological linkage
• Human-to-human
• Evidence of viral change
• Isolation & treat
• Antiviral prophylaxis
for all contacts
• Stop work /class
in affected area
Ro = 1.5 - 2
Influenza A (H1) outbreak at Samutsakorn
• 1700 workers
• ILI 180
• stop work
• Isolated dormitory
• Daily temperature
Unknown pneumonia dead
SRRT: Prae
• 13 yrs old boy, fever 3 day
• dead on arrival at district hospital , 6 April
• 3 out of 7 chicken died ??
Evaluation of surveillance system
Mandate
• clear
• unclear
Impact
Structure
• institution
• functional
• staff
Input
• skill
• equipment
• funding
Output
• public health
practice
• morbidity
• mortality
• policy
• information ( timely & action oriented)
• investigation
• implementation
Conclusion
1.
2.
3.
4.
5.
Surveillance to safeguard the people
Start with priority disease reporting
Timeliness is most crucial
Detection of outbreak
Investigation to know the cause