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Introduction
• IDSP is a Decentralized District-based System ofweekly
surveillance for communicable Diseases so that timelyand effective Public Health actions can be initiated inresponse to the incidence of Disease Outbreaks in theurban and rural Areas.
• Started in Jammu & Kashmir during FY 2006-2007 underNSPCD (National Surveillance Programme forcommunicable Diseases).
Objectives
To Detect early warning signals of impending outbreaks.
To Integrate, Co-ordinate and Decentralize surveillance activities
To establish system for quality Data collection, Reporting, Analysis and Feedback using IT.
To improve Laboratory Support for disease surveillance
Responsibilities
Strengthening of Epidemiological capabilities at State and
District level by training of District RRT and Health
personnel at the periphery.
Modernization and Computerization of State & District Epidemiology cell.
Strengthening of State / District Laboratories.
Improving Sub-District Mobility and Communication.
IEC Activities.
Expected Outcome
Early Detection of Outbreaks.
Early Institution of Containment Measures.
Reduction in Morbidity & Mortality.
Minimize Economic loss.
ADMINISTRATIVE STRUCTURE
CENTRAL SURVEILLANCE UNIT (CSU) New Delhi
STATE SURVEILLANCE UNIT (SSU) Barzulla, Srinagar
Kashmir Division has one State Surveillance Unit.
Two Sentinel Surveillance units one each at GMC Srinagar and SKIMS.
DISTRICT SURVEILLANCE UNIT (DSU)
• One DSU in each of the Twelve districts
Establishment of Rapid Response Team at Districts** Twelve Districts have established Rapid Response Team
DistrictSub Centres PHC/SDH/DH Laboratories
Anantnag 121 43 41
Budgam 116 58 36
Bandipora 71 36 42
Baramulla 115 54 25
Ganderbal 55 31 17
Pulwama 96 53 24
Kulgam 104 32 23
Srinagar 80 40 24
Kargil 131 22 12
Leh 114 18 1
Kupwara 198 47 44
Shopian 46 13 9
TOTAL 1247 447 298
Reporting units on IDSP Portal
Indicators 20152016
(Ending May)
Number of Outbreaks Managed45 22
Reporting on Web Portal91.6 % 97 %
Laboratory tested performed3124 1290
Laboratory confirmed outbreaks in 2016 Measles = 2
Performance at a Glance
Performance Indicators 2012 2013 2014 2015
Outbreaks Managed 54 57 45 45
Laboratory tests conducted 1643 3345 2930 3124
Reporting on IDSP National WebPortal
63% 78% 84 % 91.6%
COMPARATIVE DETAILS
Salient features of activities since its inception in 2004• The percentage of reporting from Reporting units (RUs) from all the districts of Kashmirdivision(12 districts) has increased for past three years from 78 per cent in 2013 to 91.6 per cent in2015• The number of outbreaks have declined 57 in the year 2013 to 45 in the year 2015 because ofhealth education to the community at district level and control of outbreaks in timely manner as aresult of early intervention.• Awareness regarding communicable disease was given to the community both in print (Posters ,pamphlets ) and electronic media and as well on Social media• Awareness about emerging various viral disease like Influenza A H1N1 , MERS COv , Ebola Viraldisease (EVD) , Zika virus disease (ZIKV) was given to Health care workers and to the community .
Number of Outbreaks and Cases
Disease2016
Number Cases
Acute Respiratory Infection 1 15
Influenza A (H1N1) 0 0
Acute Diarrheal Disease 1 62
Measles 3 42
Hepatitis 3 88
Food Poisoning 0 0
Mumps 0 0
Chicken Pox 10 189
Enteric Fever 1 11
Dermatitis 0 0
Acute Viral Conjunctivitis 1 47
Hand Foot Mouth Disease 1 414
Pertusis 1 94
Total 22 outbreaks
S. No. District Percentage of Reporting (%)
1 Anantnag 1002 Budgam 993 Bandipora 1004 Baramulla 97.75 Ganderbal 95.56 Pulwama 1007 Kulgam 98.58 Srinagar 959 Kargil 90
10 Leh 92.511 Kupwara 10012 Shopian 100
Total Percentage 97%
District-wise Reporting status of SPL Forms on National PortalMay -2016
Diseases Covered
Air Borne Disease (ABD)
• Inf. A, B, Inf. A H1N1
• Measles
• Diphtheria
• Chicken pox
• Acute Respiratory Infection(ARI)
• Influenza like illness (ILI)
• Pneumonia
• Meningococcal Meningitis
Water Borne Disease (WBD)
• Enteric Fever
• Hepatitis A,E
• Acute Diarrheal Disease
• Bacillary Dysentery
• Viral Hepatitis
• Enteric Fever
• Typhoid Fever
• Cholera
• Fever of Unknown origin (PUO)
Vector Borne Disease (VBD)
• Dengue/DHF/DSS
• Malaria
• Chikungunya
• JE
• Zika Virus
Other (Specify) ANTI-HCV Other (Specify)HBSAG
Monthly- Comparative list of tests done at District Priority Lab IDSP
Name of test May - 2015 May - 2016
Total Water samples Tested 15 30
Blood Samples for Serology ( Typhi Dot / Measles)
10 11
Cultures to check sterility of OT’s 3 15
Stool culture 11 10
Rotavirus Ag from Stool 5 0
Blood Culture 15 20
Wound culture 9 15
Urine Culture 60 40
IgM to HAV & HEV by ELISA 63 52
Total 191 201
Laboratory confirmed outbreaks in 2016 Measles=2
Epidemic Action plan on Shri Amarnath ji Yatra 2016Preparedness for control of outbreaks
Surveillance strategicSurveillance of Epidemic prone diseases (Water Borne Diseases) by District Surveillance units Ganderbal and Anantnag.
Rapid Response Teams assigned in Ganderbal and Anantnag
Action Plan Regular random sampling of water at main base camps will be collected by DSUs of respective districts which will be tested in Public
health laboratory (PHL) at Barzulla and test results will be communicated to the concerned DSUs. Regular Health education to be given by CHOs and Health Educators to the pilgrims regarding safe drinking water and sanitation
through infographics.
Water collection bottles to be kept available at DSUs of each Districts.
Chlorine tablets to made available at the respective DSUs.
Posters and infographics to be displayed in Health camps and distributed to the pilgrims.
District Anantnag District Ganderbal State Surveillance Office
District Health Officer District Health Officer Epidemiologist
Epidemiologist Data Manager Microbiologist
Data Manager
RAPID RESPONSE TEAMS (RRTs) FOR ZIKA VIRUS DISEASE (ZIKV)KASHMIR DIVISION
District Designation
At Divisional
Level
State Surveillance Officer IDSP
State Epidemiologist IDSP
State Microbiologist IDSP
Anantnag Physician
Pediatrician
Epidemiologist
Budgam Physician
Pediatrician
District Health Officer
Bandipora Physician
Pediatrician
Epidemiologist
Baramulla Physician
Pediatrician
Epidemiologist
Ganderbal Physician
Pediatrician
District Health Officer
District Designation
Kulgam Physician
Pediatrician
Epidemiologist
Kupwara Physician
Consultant Medicine
Epidemiologist
Pulwama Physician
Pediatrician
District Health Officer
Srinagar Physician
Pediatrician
Epidemiologist
Microbiologist
Shopian Physician
Pediatrician
Epidemiologist
Leh Physician
Pediatrician
District Health Officer
Kargil Physician
Pediatrician
Epidemiologist
Passive surveillance of Hajj Piligrims at Srinagar International Airport for
MERS CoV and H1N1
Issuing Public Health Advisories to all districts on H1N1, Floods, Hepatitis, Measles, Gastroenteritis, ARI, Cholera,
Chicken Pox, Ebola, MERS-CoV from time to time.
Advisories & Surveillance
•As per the directions received from EMR , the Information in terms of IEC material with helpline numbers were given to Hajj pilgrims.
30th Sept - 14th October 2015
HELP-DESK for MERS COv Hajj Pilgrims at Srinagar International Airport
All private Hospitals of Kashmir province are informed to submit P and L
forms on regular and timely manner ( Letter with Hard copies of P and L ) form already submitted to concerned institutes
Issuing Public Health Advisories to all districts on Zika Virus (ZIKV)
Posters and infographics to be displayed in Health camps and distributed to the pilgrims during Shri Amarnathji Yatra 2016.
Innovations by the State IDSP Unit• Epidemic Action plan on Shri Amarnath ji Yatra 2016 Surveillance of Epidemic prone diseases (Water Borne Diseases) by District Surveillance units Ganderbal andAnantnag. Rapid Response Teams assigned in Ganderbal and Anantnag
• Passive surveillance of Hajj Pillgrims at Srinagar International Airport for MERS CoV and H1N1
• Issuing Public Health Advisories to all districts on H1N1, Floods, Hepatitis, Measles, Gastroenteritis, ARI, Cholera, Chicken Pox, Ebola, MERS-CoV from time to time
• Issuing Public Health Advisories to all districts on Zika Virus (ZIKV)
• Posters and infographics to be displayed in Health camps and distributed to the pilgrims during ShriAmarnathji Yatra 2016.
• Initiative taken to validate and verify S,P and L surveillance data in districts. Direction to DSU to conduct surprise visits for verification of S,P and L forms.
• Visits by a team from the state surveillance office to Districts for monitoring activities at District surveillance units.
• Inclusion of Private Hospitals and Nursing Homes in IDSP Surveillance system.
Media ScapeRegarding alerts, activities and information of Outbreaks, some articles and advisories are published in print media like newspapers etc to aware general public about the possible prevention and containment procedures.
Issued ‘Advisories’ as Infographics"Started implementing on infograhics in IDSP Kashmir, as we have frequent outbreaks of ADD, ARI , VPD,WBD in our valley. These infographics can be printed and displayed at your Health institutions and at the time of outbreaks distributed among the community. The first of this series is on the topic of Measles which is attached here"CMOs of the districts are asked to all the BMOs of their districts and as such the information will finally reach to the community at large.
New Approved Labs under IDSP
District Approved Status
Anantnag and Baramulla 2013-14 Not established (no funds received from GoI for the establishment of Labs)
Pulwama, Kupwara & Budgam 2014-15 Not established (no funds received from GoI for the establishment of Labs)
Establishment of IDSP Public Health Laboratory at three Districts viz. Anantnag, Baramulla and Budgam. Laboratory Items (Media & Serology Kits for investigation of Outbreaks like Dysentery ,Cholera Hepatitis A & E, Measles, Dengue, &) Repairing of Laboratory Equipments.
Expected Laboratory Targets for coming quarters.
Category Sanctioned Vacant In position Name of District with vacancy
Epidemiologist 13 4 9 Budgam, Leh, Ganderbal, Pulwama
Microbiologist 2 0 2 -
Entomologist 1 1 0 SSU
State Training Consultant 1 1 0 SSU
Consultant Finance &
Procurement Officer1 0 1
_
State Veterinary
Consultant1 1 0 SSU
Data Manager 13 1 12 Baramulla
Data Entry Operator 15 5 10 Srinagar(3), Leh(1), Anantnag(1)
Grand Total 46 12 34 -
CATEGORIZED MANPOWER STATUS (as on May - 2016)
* Due to lack of Funds during 2014-15 and 2015-16, the vacancies could not be filled.
Year Doctors /Paramedics Trained
2010-11 220
2011-12 185
2012-13 -
2013-14 130
2014-15 -
2015-16 -
Trainings Conducted under IDSP(2010-11 to 2015-16)
Year 2012 2013 2014 2015
Manpower Filled 66% 75% 75 % 76 %
Manpower trained nil 130 nil nil
Strategic Health Operations Centre (SHOC)
• Establishment of Crisis Management Center at State Surveillance
unit Barzulla Srinagar during Sept Floods 2014.
• Establishment of Control Room at State Surveillance unit Barzulla Srinagar for
MERS CoV, Zika Virus and influenza H1N1
RRT IDSP during floods 2014 Ex-Union Minister for Health on visit to Control room – during
Floods2014
• House to House Survey of Community need Health Assessment during Floods 2014
RRT IDSP during Surveillance for Inf H1N1
H1N1 Screening Status
Period Samples collected Positive
Oct 2014 to April 2015 71 24
Oct 2015 to April 2016 54 0
DSU Pulwama to Block Tral, Pulwama and Pampore, Pulwama(Dated: 12-19 May 2016)
DSU Srinagar to Zone Batmaloo, Srinagar
(Dated: 03 May 2016)
Visits by District Surveillance Units for validation of S,P and L surveillance data
DSU Bandipora
DSU Shopian
Acute Respiratory Infection (ARI) - Inf. A, B, Inf. A H1N1,Measles,Chicken pox, Acute Respiratory,Diphtheria,Pneumonia,Meningococcal Meningitis
Water Borne Disease- Enteric Fever,Hepatitis A,E, Diarrhea, Dysentery,Typhoid Fever,Cholera,Feverof Unknown origin
Vector Borne Disease- Dengue,Malaria,Zika Virus,Chikungunya,JE
Surveillance during Disasters- Floods, Earthquakes
Hospital Infection Control- for control of Nosocominal infection
Water Quality Monitoring- To check the contamination of drinking water
Laboratory Surveillance of Communicable Disease
Testing Facility 1 : District Priority Laboratory DPL, JLNM Hospital, SrinagarTesting Facility 2: Provincial Public Health Laboratory PHL, State Surveillance Unit, Srinagar
Hand Foot and Mouth Disease in District Leh(HFMD)
Number of cases 414Villages affected: Choglamsar, Saboo,Leh, Solar colony, Hemis, Igoo, Taru, Meru, Bogdang, Augling, Meru, Bema
Population of affected area: 28853
Age group affected: < 10 years.
Date of Outbreak : 02/05/2016
47 cases detectedAffected Population= 168
ACUTE VIRAL CONJUNCTIVITIS
Affected District LehAffected Village TarukAffected school Residential school taruk
Outbreak of Chicken Pox in District KulgamDate of Outbreak : 06/05/2016
Number of cases: 50 Village affected: Block D H Pora, Village Nagam
Population of affected area: 2789
Age group affected: 4 – 11 years.
Outbreak of ADD in BaramullaAcute Diarrheal Disease
Number of cases: 60
Villages affected: Boniyar Sub center Hundi Village Hundi
Population of affected area: 736
Age group affected: 2 to 60 years
Date of Outbreak : 13/05/2016
District and village affected: Natipora, Madrasa Babul Aloom, SrinagarNumber of students enrolled in a school : 120
Number of cases: 22 Age group affected: 06- 18 years Control measures performed: Health education to madrasa authorities was imparted regarding the disease and its preventive measures. Isolation of patients and systematic treatment with medicines was advised in case of fever.
Outbreak of Chicken Pox in SrinagarDate of outbreak: 13-05-2016