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Epidemiological Surveillance. Kumnuan Ungchusak Bureau of Epidemiology Department of Disease Control Ministry of Public Health . Key points. its significant surveillance system: How it works Source of information common weakness how to improve - PowerPoint PPT Presentation
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Epidemiological Surveillance Epidemiological Surveillance
Kumnuan UngchusakBureau of Epidemiology
Department of Disease ControlMinistry of Public Health
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
Surveillance for• Knowledge of the distribution of health events• Rapid detection of outbreak • Public health planning and evaluation
I. The main purpose of Surveillance
II. Surveillance System: How it work?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. Morbidity2. Mortality3. Laboratory4. Vaccines and drug5. Outbreak news/ rumor6. Vector7. Behavior8. Environmental8. Demographic
Organization of Surveillance SystemOrganization of Surveillance System
Ministry of Public Health
Dep of Disease Control
International Organization
Bureau of Epidemiolog
yProvincial
Epidemiological Unit
Private hospitals and
clinics
Hospitals and clinic under universal coverage scheme
District Surveillance information
centerHospitals
Under MOH
And universal coverage schemes
ข้�อมู�ลรายงานโรคข้�าวสาร/ข้�าวกรอง
Regional Disease Control Center
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)Surveillance and Rapid Response Team (SRRT)
• Tsunami• Avian influenza• Cholera outbreak• Dengue
ตำ��บล
จังหวัด
อำ��เภอำ
ส่�วันกล�ง
D-SRRT
P-SRRT
R-SRRT
C-SRRT
เขตำ
Surveillance and Rapid Response Team
อำส่ม ๑๐๐,๐๐๐หม��บ��น
Intelligence
Control action
Information
1. New virus found
2. Human at risk
3. Human infection or inefficient H2H
4. Confine easy H2H transmissionConfine easy H2H transmission
5. multiple outbreak
6 multi-countriesInfluenza Pandemic
“SRRT ” 1030
Surveillance and
Rapid Response
Team
Health services
SRRTs
AI provincial Team (Human and Animal)
MoPH assigned “Mr. Bird Flu”
(800,000 village health volunteers & community leaders)
Lay report
Governor
NetworkNetwork
• 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
(SRRT)Hospital
Laboratory
Veterinarian
Pathologists
Early pandemicAlert phase 4
Ro = 1.5 - 2
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
Influenza A (H1) outbreak at Samutsakorn
• 1700 workers• ILI 180• stop work• Isolated dormitory• Daily temperature
SRRT: Prae• 13 yrs old boy, fever 3 day• dead on arrival at district hospital , 6 April• 3 out of 7 chicken died ??
Unknown pneumonia dead
Evaluation of surveillance systemEvaluation of surveillance system
• clear• unclear
• institution• functional
• staff• skill• equipment• funding
• information ( timely & action oriented)• investigation• implementation
• public health practice• morbidity• mortality• policy
MandateMandate StructureStructure
InputInput
OutputOutputImpactImpact
ConclusionConclusion
1. Surveillance to safeguard the people2. Start with priority disease reporting3. Timeliness is most crucial4. Detection of outbreak5. Investigation to know the cause