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Epidemiological Surveillance

Epidemiological Surveillance. Kumnuan Ungchusak Bureau of Epidemiology Department of Disease Control Ministry of Public Health <kum@health.moph.go.th>. Key points. its significant surveillance system: How it works Source of information common weakness how to improve

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Epidemiological Surveillance

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  1. Epidemiological Surveillance Kumnuan Ungchusak Bureau of Epidemiology Department of Disease Control Ministry of Public Health <kum@health.moph.go.th>

  2. Key points • its significant • surveillance system: How it works • Source of information • common weakness • how to improve • evaluation of surveillance system

  3. Question : What are the role of these gods ?

  4. Hakone’s Check point

  5. I. The main purpose of Surveillance • Surveillance for • Knowledge of the distribution of health events • Rapid detection of outbreak • Public health planningand evaluation

  6. II. Surveillance System: How it work? • 1. Collection • Record and report • Collation: • data analysis 3. Information synthesis • 4. Dissemination • timely • action oriented

  7. III. Source of information • Morbidity • Mortality • Laboratory • Vaccines and drug • Outbreak news/ rumor • Vector • Behavior • Environmental • Demographic

  8. Organization of Surveillance System Ministry of Public Health Dep of Disease Control International Organization Bureau of Epidemiology Regional Disease Control Center ข้อมูลรายงานโรค Provincial Epidemiological Unit ข่าวสาร/ข่าวกรอง District Surveillance information center Hospitals and clinic under universal coverage scheme Hospitals Under MOH And universal coverage schemes Private hospitals and clinics

  9. Important CD Diseases Notification within 24 hours 1SARS 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

  10. Important CD Diseases 1Measles 2. Pertussis 3. Hand Foot and Mouth Diseases 4. Influenza 5. Leptospirosis 6. Dysentery 7. Severe pneumonia of unknown etiology 8. Cluster of infectious cases9. Dengue/DHF

  11. Weakness • No action(surveillance for statistics) • No mandate(no receptor) • No funtional epidemiologist (CD4 <200) • No motivation

  12. How to improve Surveillance

  13. Surveillance and Rapid Response Team (SRRT) • Tsunami • Avian influenza • Cholera outbreak • Dengue

  14. Surveillance and Rapid Response Team Control action ส่วนกลาง C-SRRT Intelligence R-SRRT เขต Information จังหวัด P-SRRT อำเภอ D-SRRT หมู่บ้าน ตำบล อสม ๑๐๐,๐๐๐

  15. 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

  16. AI provincial Team (Human and Animal) MoPH assigned “Mr. Bird Flu” Health services Governor “SRRT ” 1030 Surveillance and Rapid Response Team SRRTs (800,000 village health volunteers & community leaders) Lay report

  17. Network Hospital (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 Laboratory Pathologists

  18. 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

  19. Influenza A (H1) outbreak at Samutsakorn • 1700 workers • ILI 180 • stop work • Isolated dormitory • Daily temperature

  20. 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 ??

  21. Evaluation of surveillance system Mandate Structure • clear • unclear • staff • skill • equipment • funding • institution • functional Input Impact Output • public health practice • morbidity • mortality • policy • information ( timely & action oriented) • investigation • implementation

  22. Conclusion • Surveillance to safeguard the people • Start with priority disease reporting • Timeliness is most crucial • Detection of outbreak • Investigation to know the cause

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