Vpd & IDsurv

One type of surveillance system done for the vaccine prevantble infectious disease and serious AEFI reporting systems.

1. Vaccine Preventable Disease &
An innovative Infectious Disease and
Serious AEFI surveillance system

2. Acknowledgement
Indian Academic of Pediatrics website
IDSurv.org website
Dr. MohuaMoitra

3. Background
Diseasesurveillanceisanimportantcomponentofpublic
healthprogrammes.
Surveillanceofvaccinepreventablediseases(VPDs)isa
veryimportantcomponentindiseasepreventionasmany
infectiousdiseasesarenowbeingpreventedbyhighly
effectivevaccines.
Thenumberofeffectivevaccinesisgoingtobe
increasingincomingtimeconsideringtherapid
advancementinthefieldofvaccinologytoday

4. Surveillancemethods
1)Activesurveillance:Doneactivelybydesignated
personsatanyhealthinstitutionsorcommunity.Foreg.
AFPsurveillancedonebyNPSP.
2)Passivesurveillance:wheresuspectedorconfirmed
casesofadiseasearereportedroutinelyandpassively
fromidentifiedhealthfacilitiessuchasIDSP,IDSurv,
etc.
3)Sentinelsurveillance:whereclinicalcasesarereported
afterlabconfirmationfromselectedhealthinstitutions
inrelationtoHIV,Rotavirus(IRSN),Hib-surveillance
etc.
IRSN : Indian Rotavirus Surveillance Network

5. 4)Populationbasedsurveillance:Conductedforselected
groupswithactivediseasesinawell-defined
area/populations,suchasLeprosysurveillancedoneby
healthworkerinthevillage
5)Outbreaksurveillance:wherenotificationisdoneonly
wheneverthereisclusterofcasesasperpredefined
norms,suchasmeaslessurveillance,diseasesreported
throughIDSPandFeversurveillancedonebyPSM
Dept.inNewCivilHospitalcampusin2014.
Surveillance methods cont…

6. 6)Case-basedsurveillance:whereanysuspectedcase
isimmediatelynotifiedforfurtherinvestigationslike
AFPandAESsurveillance.
7)Zeroreporting:meansreportingevenwhenthereis
nocasefoundlikeAFPsurveillance.
Surveillance methods cont…

7. VPD SURVEILLANCE
(Vaccine Preventable Diseases)

8. Why VPD surveillance is necessary?
Thegoalsofaneffectivediseasesurveillancesystemshouldservethe
followingfunctions:
Todefineepidemiologyofadisease
Toidentifyhigh-riskpopulationsandregionshavinghigh
transmissionofthedisease
Tomonitorprogressofadiseasecontrolprogram
Tospecifyandmonitormolecularepidemiologyofaninfectious
diseaseincludingidentificationofcirculatingstrainsofthe
pathogenresponsiblefortheinfectiousdisease
Tomonitorimpactofthevaccinationprogramonoveralldisease
(VPD)epidemiology.

9. Current status of VPD surveillance in India
Vaccinepreventablediseases(VPDs)arestillresponsiblefor
over500,000deathsannuallyinIndia
1
.
ThereislackofdiseaseburdendataonmanyimportantVPDs
inIndiathatresultsintheperceptionthatthediseaseisnot
importantpublichealthproblem.
Lackofbaselinesurveillancedataalsoisabottleneckin
introductionofmanynewvaccinesinthenational
immunizationprogram(NIP)andalsoinmonitoringthe
impactofvaccinationprovidedthroughUIP
Source 1: World Health Organization (Regional Office for South-East Asia). Available online:
http://www.searo.who.int/en/Section1226/Section2715.htm.

10. VPD Surveillance systems in India
FollowingarethekeysurveillancesystemsinIndia:
1)IDSP:(IntegratedDiseaseSurveillanceSystem)Nationwideoutbreak
surveillancesystem.Includingmeasles,diphtheria,pertussis,AFP,
hepatitisandAES.
2)CBHI/SBHI:(CentralandStateBureausofHealthIntelligence)
Nation-widepassivereportingsystemofsuspectedcases.
3)MEASLES:ICMRSelectedpractitionersandinstitutionsprovide
clinicalsamplestoNIV-Puneformeaslesvirusisolationand
genotyping.Atypeofcase-basedsurveillancesystem.
4)AES/JE:NVBDCPandICMRFacilitybasedsurveillanceforacute
encephalitissyndromeinendemicareas.ItisrunbyGovernmentof
IndiaunderNationalvector-bornediseasescontrolprogram.
AES: Acute Encephalitis syndrome, NIV Pune: National Institute of Virology, Pune

11. 5)MulticentrePNEUMONIA andMENINGITISsurveillance:
EstablishedinpreparationforHibvaccineprobestudy.Atypeof
case-basedsurveillance.
6)WHO-NPSPsupportedsurveillancesystems:Threedifferentmodelsfor
threedifferentVPDs.
a)AFPandlabsurveillanceforpoliovirus:Globaleradication
program.
b)Feverandrashformeasles/rubella:Nationalmortalityreduction
target;maybescaleduptoaregionaleliminationgoal.
c)AcuteEncephalitisSyndrome(AES)forJE:Controlprogramfor
endemicdistricts.
7)IDSurv―AnInnovativeProjecttoReportInfectiousDiseases:IAPin
collaborationwithitsKutchbranch,hasstartedanInfectiousDisease
SurveillanceandAEFIreportingsystemforreportingseriousAEFI,
knownasIDSurv.org.
VPD Surveillance systems in India

13. History
InitiallyIDsurv.orgwasdesignedonlyforKutchdistrict
IndianAcademyofPediatricsincollaborationwithits
KutchbranchhasstartedreportingsystemfortheInfectious
DiseaseSurveillanceandseriousAEFI
Thestandardcasedefinitionsforallthediseasescovered
underthisprojectareprovidedonthewebsite.
Allthecasesreportedthroughvariousmethodsarecollected
inasingledatabaseinrealtimeandreportsaresenttoall
usersonweeklybasis.
AEFI: Adverse Event Following Immunization

14. Incaseadiseaseoutbreakisrecordedonthesystem,email
andSMSalertaresenttoallusersinstantaneously.
AfterinterestshowninthisprojectbyIAPCOIandCIAP.
MOUwassignedbetweenIAPKutchBranchandCIAPto
makethisprojectavailablenationwideforallIAP
members.
Initiallyonly9diseaseswhereundersurveillance.
Hepatitisandacuteencephalitissurveillancewasadded
lateron
History
IAP COI: IAP Committee on Immunization, CIAP: Clinical Information Access Portal

15. To develop an early warning system for pediatric vaccine
preventable diseases in India
To generate data on burden of vaccine preventable diseases
in India
To generate data on Severe AEFI in India
Objectives of IDsurv

16. 1.Acute Bacterial Meningitis
2.Acute Encephalitis Syndrome
3.Chicken pox
4.Pertussis
5.Dengue
6.Diphtheria
RecentlytheyhavestartedsurveillanceforAEFIontheIDsurvplatform
withsupportGovernmentofIndia.OnlyseriousAEFIreportedthat
include:
Death
Hospitalization
Clusteringofcases
Disabilities
7.Typhoid
8.Pneumonia
9.Hepatitis
10.Measles
11.Mumps
At present only eleven key infectious diseasesare targeted
for surveillance under this project and they include:

17. How to Report a case on Idsurv?
There are 4 modes to report a case:
1.Laptop or computer
2.Mobile
3.By sending appropriate codes through SMS to 57333
4.By calling the IVR system on 02653090533 from your registered
mobile number and follow the instructions to report a case.

18. 1.Reportingacasethroughwebsite:First,oneshouldgotothesitewww.idsurv.org
andclickonloginandapanelwillopen.EnteryourUsernameandPassword.You
willberedirectedtoyouraccount.ClickonReportaCase’.Selectthediagnosis.
Enterpatient'sdetailsincludingallotherdetailsandclickonsubmit.Areference
numberwillbegeneratedforthepatientandgiventoyou.

19. 2.Reportingcasethroughmobile:
Inmobiletherearetwomethods
i.Logintoyouraccounton
m.idsurv.org.Clickonreporta
caseandfilluptheformand
clickonsubmit.
ii.DownloadmobileApplication
named“IDsurve’’

20. 3.Reportingacasethroughsms:Type'IT'space'IDS'space4-
letter'codeofthedisease'space'age'inmonthsspace'sex'space
'severityofdisease'space‘microbialdiagnosisestablished’space
‘immunizationstatus’space‘outcome’andsenditto57333.The
detailsaboutSMScodesareprovidedonthewebsite.
4.ReportingacasethroughIVRToreportacaseusingIVR
system,call02653090533usingyourregisteredmobilenumber
andfollowtheinstructions.Itusuallytakeslessthan2minutesto
registerthecase.Youcanenterthedetailslater.

22. How to report an Adverse Event Following Immunization
(AEFI)?
AnAEFIisdefinedas“amedicalincidentthattakesplaceafteran
immunization
OnlyseriousAEFIthatincludesdeaths,hospitalization,clusteringof
cases,anddisabilityisreportedtothesystem.
ToreportseriousAEFIcasesclickon“reportanAEFI”andfillinall
thefieldsregardingpatient,AEFIandthevaccine,andthenclickon
“save”.
OnecanviewtheAEFIcasesreportedbyclickingon'View/Update
AEFIcasesreportedbyme'.
OnceaseriousAEFIreportedthroughthissystem,automatede-mail
intimationissenttothedesignatedgovernmentauthorityforfurther
necessaryactions.

24. Whocanseethecasesreportedbyme?
Anybodywhoopensidsurv.orgcanseethecases
Buttheidentityofthedoctorandpatientiskeptconfidentialand
providedonlytoGovernmentauthoritiesifrequestedbythem.
HowtoviewsurveillancedataavailableatIDSurv?
Thedatacanbeviewedeitheronamap,tableorcharts.
Googlemapshowingtotalnumberofcasesalongwithbreak-upof
thecasesreportedfromaparticulardistrict.
ThechartsdisplaythetotalnumberofalltheelevenIDcases
reportedsofaralongwithdata

33. Anearlywarningsystem(IDsurvalerts)isbeing
introducedonthesite
Whenthesystemdetectsunusuallyhighnumberof
casesbeingreportedofaparticulardiseaseina
geographicalareainashortperiodoftime,anautomatic
(SMSandEmail)alertissenttoalltheregisteredusers
andgovernmentauthoritiesinthatareaandsameisalso
reflectedonthewebsite.
Early warning system/ IDsurvalerts

35. TheIDSurvhasagreatpotentialinfulfillingtheneedofinfectious
diseasesurveillanceofthecountry.ItcanprovideVPDreportingin
thecountryespeciallyamongstthepracticingpediatricians.
Theuser-friendlysystemandeasydisplayofthedatashould
providemotivationtopediatriciansinprivatesector.
Sofar,10,146casesofalltheelevenIDsarereportedthroughthis
projectfromalloverthecountry
2
.
Thetotalnumberofregisteredusersisonly602thatrepresent
around3%oftotalmembershipofIAPinthecountry
2
.
Themajorityofcasesregistereitherhadnoimmunizationorwere
onlypartiallyimmunized.
Current status of IDSurv
Source 2: IAP Guidebook on Immunization 2013–14 available online:
http://iapindia.org/files/IAP%20Guidelines/IAP%20Guidebook%20on%20Immunization%202013-14.pdf

36. Limitation
AllVPDs(VaccinePreventableDiseases)arenotcoveredunder
IDsurv.
MostofthePediatricdoctorsarenotawareaboutthissurveillance
system.OnlyfewPediatricdoctorsareawareaboutthisproject
anddoingregularreporting.
Registeringofthecasesonthiswebsiterequirethemotivationand
supportformtheprivatePediatricdoctors.
RegisteringofcasesnotdonefromtheGovernmenthospitals.