public health surveillance systems. goals review purpose of surveillance describe types of state and...
Post on 19-Dec-2015
215 views
TRANSCRIPT
![Page 1: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/1.jpg)
Public Health Surveillance Systems
![Page 2: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/2.jpg)
Goals Review purpose of surveillance Describe types of state and local
surveillance systems: Vital records Disease reporting
(morbidity data) Surveys Sentinel surveillance Zoonotic disease
surveillance Provide example of public health actions
resulting from surveillance data
Adverse events surveillance
Syndromic surveillance
Registries Laboratory data
![Page 3: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/3.jpg)
Purpose of Surveillance Collecting surveillance data has many
purposes Monitoring disease trends Detecting outbreaks Providing information to plan public health
interventions Stimulating research
![Page 4: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/4.jpg)
Purpose of Surveillance Specific uses of surveillance data vary
depending on organization or agency National agencies
Monitoring disease trends over time to inform policy
State and local agencies Assuring accurate diagnosis and treatment
of infected persons Managing people exposed to disease Detecting outbreaks Guiding public health prevention and
control programs
![Page 5: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/5.jpg)
Types of State and Local Surveillance Systems Surveillance systems used to monitor
disease trends and plan public health programs Vital statistics, disease reporting, surveys
More specialized systems Sentinel surveillance, zoonotic disease
surveillance, adverse events surveillance, syndromic surveillance, disease registries, laboratory surveillance
Some types more useful for certain diseases than others; each fills a specific need
![Page 6: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/6.jpg)
Vital Statistics Records of births and deaths: a basic but critical
cornerstone of public health surveillance Mortality data over past century show decrease in
rate of deaths due to infectious diseases; rate of death from non-infectious causes remain steady
Infant mortality rate (number of deaths among infants per 1,000 births) long used as indicator of overall population health
Birth data used to monitor incidence of preterm birth, risk factor for variety of adverse health outcomes
![Page 7: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/7.jpg)
Vital Statistics In United States, vital statistics available
from National Center for Health Statistics State vital records offices CDC WONDER – online system containing
data on births, deaths, many diseases from Centers for Disease Control and Prevention (CDC)
![Page 8: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/8.jpg)
Disease Reporting (Morbidity Data) Disease reporting required internationally
by World Health Organization through International Health Regulations Smallpox Wild-type poliomyelitis Severe acute respiratory syndrome (SARS) Human influenza caused by new subtypes Any public health emergency of international
concern Broad definition used to capture any disease,
condition, event that could represent international risk
![Page 9: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/9.jpg)
Disease Reporting (Morbidity Data) In the United States, disease reporting
mandated by state law List of reportable diseases varies by state
States report nationally notifiable diseases to CDC on voluntary basis List of notifiable diseases updated regularly
by Council of State and Territorial Epidemiologists and CDC
![Page 10: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/10.jpg)
Surveys Especially useful for monitoring chronic
diseases and health-related behaviors Youth Risk Behavior Survey (YRBS) asks
high school students about substance use, sexual behavior, physical activity, nutrition
Results used to monitor trends in health behaviors, plan public health programs, evaluate public health policies at national and state levels
![Page 11: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/11.jpg)
Surveys YRBS
shows decline in youth smoking from 36% in 1997 to 20% in 2007
20%23%22%
29%
35%36%
0
10
20
30
40
50
1997 1999 2001 2003 2005 2007Year
Perc
en
t
Percent of high school students who reported smoking in the 30 days prior to the survey,
United States, 1997-2007
![Page 12: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/12.jpg)
Surveys Other national surveys conducted by
CDC: Behavioral Risk Factor Surveillance System
(BRFSS) National Health Interview Survey (NHIS) Pregnancy Risk Assessment Monitoring
System (PRAMS) National Health and Nutrition Examination
Survey (NHANES)
![Page 13: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/13.jpg)
Sentinel Surveillance Alternative to population-based
surveillance, Involves collecting data from sample of
reporting sites (sentinel sites) Example: Selected health care providers
report number of cases of influenza-like illness to state health department on weekly basis
Allows states to monitor trends using relatively small amount of information
![Page 14: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/14.jpg)
Sentinel Surveillance Graph
indicates peak of influenza activity during 2007- 2008 season in late February and early March (Weeks 7-9)
Percentage of visits for influenza-like illness reported by US sentinel provider network,
2006-2007, 2007-2008
![Page 15: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/15.jpg)
Sentinel Surveillance Sentinel providers also used to gather
more specific information Example: sentinel provider network in
British Columbia, Canada, used in a study of vaccine effectiveness during 2005-2006 influenza season
![Page 16: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/16.jpg)
Zoonotic Disease Surveillance Surveillance of zoonotic diseases (diseases
found in animals that can be transmitted to humans) often involves system for detecting infected animals
Example: 2001 Florida surveillance for West Nile Virus (WNV):
Web site and telephone hotline to report dead birds, some collected and tested for WNV
Mosquitoes collected and tested for WNV in 10 counties Blood collected from 3-12 sentinel chickens in each of
212 flocks up to 4 times per month, tested for antibodies to WNV
Veterinarians asked to test horses with neurologic symptoms consistent with WNV
Health care providers reminded of reporting and diagnostic criteria for possible human cases of WNV
![Page 17: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/17.jpg)
Zoonotic Disease Surveillance Surveillance systems allowed public
health authorities to determine intensity of WNV by geographic area
Detection of WNV led to public health control measures: Advising public to protect against mosquito
bites Intensifying mosquito abatement efforts
![Page 18: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/18.jpg)
Adverse Events Surveillance Surveillance system focusing on patient
safety: Adverse Events Reporting System (AERS), operated by Food and Drug Administration (FDA)
Negative effects experienced by people who received approved drugs, therapeutic agents
Voluntary reports from health care providers (physicians, pharmacists, nurses) and public (patients, lawyers)
Health care providers/patients may report events directly to product manufacturer; manufacturer required to report event to AERS
FDA uses AERS to identify possible safety concerns associated with approved products
![Page 19: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/19.jpg)
Adverse Events Surveillance Vaccine Adverse Events Reporting
System (VAERS) also focused on patient safety; operated by CDC with FDA Like AERS, but for negative effects
experienced by people who have received licensed vaccines
Used in 2003 for smallpox vaccines to health care and public health professionals in preparation for bioterrorist attack
>100 adverse events reported after smallpox vaccination, 16 suspect and 5 probable cases of myocarditis or pericarditis
Advisory Committee on Immunization Practices recommended ending vaccination after health care and public health response teams
![Page 20: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/20.jpg)
Adverse Events Surveillance Passive surveillance systems may be
limited by underreporting or biased reporting, cannot be used to determine whether a drug or vaccine caused a specific adverse health event (See FOCUS Volume 5, Issue 5 for definitions
of active and passive surveillance) Used as early warning signals Possible associations between drugs or
vaccines and adverse events examined using well designed epidemiologic study, appropriate action based on results
![Page 21: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/21.jpg)
Syndromic Surveillance Relatively new surveillance method, uses
clinical information about disease signs and symptoms, before diagnosis is made
Often use electronic data from hospital emergency rooms
![Page 22: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/22.jpg)
Syndromic Surveillance Example: New York City operates
syndromic surveillance system using emergency department chief-complaint data from approximately 44 hospitals Data monitored electronically for beginning
of disease outbreak In 2002, system detected higher than usual
number of diarrheal and vomiting symptoms Health department notified hospital
emergency departments of possible outbreak and collected stool specimens, several tested positive for norovirus
![Page 23: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/23.jpg)
Syndromic Surveillance Example: New York City (continued)
Similar outbreak later that year not detected by the system
Failure to detect attributed to incorrect coding of chief complaint by emergency departments
Illustrates potential benefits of syndromic surveillance, areas where changes needed to increase usefulness of system
![Page 24: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/24.jpg)
Registries Surveillance system used for particular
conditions Often established at state level to collect
information about persons diagnosed with condition Example: cancer registries collect
information about type of cancer, anatomic location, stage of disease at diagnosis, treatment, outcomes
Used to improve prevention programs Example: women in rural areas diagnosed
with breast cancer later than women in urban areas; choose to promote mammography screening in rural areas using mobile van
![Page 25: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/25.jpg)
Laboratory Data Public health laboratories routinely conduct
tests for viruses, bacteria, other pathogens In US, labs participate in National Salmonella
Surveillance System through electronic reporting of Salmonella isolates
2006: >40,000 isolates reported Lab serotyping provides information about
cases likely to be linked to common source Serotypes are useful for detecting local,
state, or national outbreaks
![Page 26: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/26.jpg)
Laboratory Data Another lab system: PulseNet by CDC and
Association of Public Health Laboratories to monitor foodborne illness outbreaks Enables labs across US to compare pulsed-
field gel electrophoresis (PFGE) patterns of bacteria from ill persons and determine similarity
Allows scientists to determine whether outbreak is occurring, even at geographically distant locations
Can decrease time required to identify outbreaks of foodborne illness and causes
![Page 27: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/27.jpg)
Public Health Actions Resulting From Surveillance: Poliomyelitis
Global example: monitoring progress toward eradication of poliomyelitis
Number of cases of paralytic poliomyelitis by year, United States,
1967-1997
Dramatic decrease in paralytic poliomyelitis in US following licensure of inactivated polio vaccine (1955), oral polio vaccine (1961)
![Page 28: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/28.jpg)
Public Health Actions Resulting From Surveillance: Poliomyelitis
Global example: monitoring progress toward eradication of poliomyelitis (continued) Using data from countries around world, World
Health Organization implemented intensive vaccination programs where decline not as significant
![Page 29: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/29.jpg)
Public Health Actions Resulting From Surveillance: HIV/AIDS Example: surveillance for HIV/AIDS ongoing
since detection of disease in the US in 1981 Data on incidence and prevalence among
population subgroups, geographic areas important to guide prevention, control efforts 2003-2006: estimated number of cases increased
among men who have sex with men, remained steady among heterosexuals, decreased among injection drug users
Suggests that prevention programs working more effectively in some groups than others
![Page 30: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/30.jpg)
Public Health Actions Resulting From Surveillance: HIV/AIDS Mapping rates
shows clear pattern of higher risk in southeastern states than in rest of nation
Suggests need for more prevention measures in southeast
Rates of diagnosed HIV/AIDS, by area of residence, United States, 2006
![Page 31: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/31.jpg)
Conclusion Many sources of public health surveillance
data at local, state, national levels Knowing where to look for different types
of data can save time and resources Data used for variety of purposes:
Guiding prevention strategies and targeting resources
Detecting disease outbreaks of local, national, international significance
Evaluating control measures
![Page 32: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/32.jpg)
Resources National Vital Statistics System
Data on births, deaths, marriages, divorces, fetal deaths from all 50 states, 2 cities (Washington, DC, and New York City), 5 territories (Puerto Rico, Virgin Islands, Guam, American Samoa, Commonwealth of the Northern Mariana Islands); much of information available online
http://www.cdc.gov/nchs/nvss.htm CDC WONDER
User-friendly query system providing public health information on births, deaths, cancer incidence, HIV and AIDS, tuberculosis, vaccinations, census data
http://wonder.cdc.gov/ Nationally Notifiable Infectious Diseases
List of diseases recommended for states to report to CDC
http://www.cdc.gov/ncphi/disss/nndss/phs/infdis.htm
![Page 33: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/33.jpg)
References1. Birkhead GS, Maylahn CM. State and local public health
surveillance. In: Teutsch SM, Churchill RE, eds. Principles and Practice of Public Health Surveillance. 2nd ed. New York, NY: Oxford University Press; 2000:253-286.
2. Armstrong GL, Conn LA, Pinner RW. Trends in infectious disease mortality in the United States during the 20th century. JAMA. 1999;281(1):61-66.
3. World Health Organization. International health regulations (2005). 2nd ed. http://www.who.int/csr/ihr/en/. Published 2008. Accessed October 3, 2008.
4. Centers for Disease Control and Prevention. Summary of notifiable diseases – United States, 2006. Morb Mortal Wkly Rep. 2008;55(53):1-84.
5. Centers for Disease Control and Prevention. Cigarette use among high school students – United States, 1991-2007. Morb Mortal Wkly Rep. 2008;57(25):689-691.
![Page 34: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/34.jpg)
References6. FluView. Outpatient illness surveillance. Centers for
Disease Control and Prevention Web site. http://www.cdc.gov/flu/weekly/. Updated October 10, 2008. Accessed October 14, 2008.
7. Skowronski DM, Masaro C, Kwindt TL, et al. Estimating vaccine effectiveness against laboratory-confirmed influenza using a sentinel physician network: results from the 2005-2006 season of dual A and B mismatch in Canada. Vaccine. 2007;25(15):2842-2851.
8. Blackmore CGM, Stark LM, Jeter WC, Oliveri RL, Brooks RG, Conti LA, Wiersma ST. Surveillance results from the first west nile virus transmission season in Florida, 2001. Am J Trop Med Hyg. 2003;69(2):141-150.
9. Food and Drug Administration, Center for Drug Evaluation and Research. Adverse Event Reporting System (AERS) Web site. http://www.fda.gov/cder/aers/default.htm. Published August 7, 2002. Updated September 5, 2008. Accessed November 21, 2008.
![Page 35: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/35.jpg)
References10. Zhou W, Pool V, Iskander JK, et al. Surveillance for
safety after immunization: vaccine adverse events reporting system (VAERS) – United States, 1991-2001. MMWR CDC Surveill Summ. 2003;52(SS-1):1-11.
11. Centers for Disease Control and Prevention. Update: adverse events following civilian smallpox vaccination – United States, 2003. Morb Mortal Wkly Rep. 2004;53(5):106-107.
12. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) statement on smallpox preparedness and vaccination. http://www.bt.cdc.gov/agent/smallpox/vaccination/acipjun2003.asp. Published June 18, 2003. Accessed October 23, 2008.
13. Steiner-Sichel L, Greenko J, Heffernan R, Layton M, Weiss D. Field investigations of emergency department syndromic surveillance signals – New York City. Morb Mortal Wkly Rep. 2004;53(suppl):190-195.
![Page 36: Public Health Surveillance Systems. Goals Review purpose of surveillance Describe types of state and local surveillance systems: Vital records Disease](https://reader031.vdocuments.mx/reader031/viewer/2022013011/56649d375503460f94a107eb/html5/thumbnails/36.jpg)
References14. Centers for Disease Control and Prevention. Salmonella
surveillance: annual summary, 2006. http://www.cdc.gov/ncidod/dbmd/phlisdata/salmonella.htm. Published 2008. Accessed October 14, 2008.
15. Swaminathan B, Barrett TJ, Fields P. Surveillance for human salmonella infections in the United States. J AOAC Int. 2006;89(2):553-559.
16. Centers for Disease Control and Prevention. What is PulseNet? PulseNet Web site. http://www.cdc.gov/pulsenet/whatis.htm. Published July 24, 2006. Accessed December 3, 2008.
17. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1997. Morb Mortal Wkly Rep. 1998;46(54):1-87.
18. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2006. Vol. 18. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published 2008. Accessed October 14, 2008.