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Event-based surveillance and Risk assessment

Event-based surveillance and Risk assessment. Tomoe Shimada MD, MPH ESR/DSE/WPRO. Meeting on Strengthening INFOSAN and National Food Control Systems in Asia. 10-12 December 2013, Manila, Philippines. O utline. IHR and APSED Surveillance Event-based surveillance (EBS) and risk assessment

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Event-based surveillance and Risk assessment

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  1. Event-based surveillance and Risk assessment Tomoe Shimada MD, MPH ESR/DSE/WPRO Meeting on Strengthening INFOSAN and National Food Control Systems in Asia 10-12 December 2013, Manila, Philippines

  2. Outline • IHR and APSED • Surveillance • Event-based surveillance (EBS) and risk assessment • Event detected by EBS at WPRO • Information sharing/collaboration between INFOSAN and IHR • Summary

  3. IHR and APSED

  4. How to detect a potential threat? Surveillance: “Systematic ongoing collection, collation, and analysis of data and the timely dissemination of information to those who need to know so that action can be taken” analysis Data collection Timely dissemination Response

  5. Objectives of surveillance • To detect unusual/unexpected number of case(s) = outbreak • To monitor trend • To evaluate current intervention • To provide evidence for policy making • To provide research question

  6. IHR regional core capacity scores based on responses from the same 26 countries Progress 2012-2013

  7. Surveillance and Response

  8. Surveillance and Response Organized and rapid capture of information about events Risk assessment

  9. What is “event”?

  10. How do you catch the event?

  11. What is “event”? • Potential risk to public health • Rare or undefined condition • Disease that may raise concern, fear and alarm in a community • Disease known/suspected to have possible impact on human health • Potential exposure for humans: Contaminated food products or water, and environmental hazards including chemical and radio-nuclear events.

  12. EBS/IBS: complementary

  13. EBS/IBS: pros and cons

  14. EBSand risk assessment at WPRO Capture “event” Unofficial information: Media, ProMed, GPHIN, pers comm. Official information: IHR notification, MOH, WHO CO/HQ, FAO etc. Initial screening (i.e. initial risk assessment) discard discard Verification (“true event”?) discard Collect additional information Rapid risk assessment for “true event” • Response • Action • Information sharing • Monitoring archiving

  15. Criteria for initial screening (i.e. initial risk assessment) • Unusual/unexpected • Higher than expected mortality/morbidity • Cluster of cases/deaths with similar syndromes • High potential for spread • Related to commercial product • Potential for international travel/trade impact

  16. Algorithm for rapid risk assessment

  17. Regional event-based surveillance Event Management System and ESR Outbreak Monitoring and Alert News

  18. Food related eventsJuly 2011- Nov 2013 Syndrome / Mode of transmission 2 have been notified thru INFOSAN/IHR Pathogen Supplement/medicine and other commercial products • *Reporting year for Technical Advisory Group for APSED: July – June

  19. Example 1: Collaboration betweenEBS and IBS • On 4 Sep 2013, an increase in number of cases w/ paratyphoid travelled back from Cambodia was reported from ECDC. • Member States reported: • EBS in Cambodia did not show any unusual trend • JPN IBS indicated increased number of cases w/ PT • Researchers in Cambodia also reported increased number of cases w/ PT

  20. Decision instrument for IHR(2005) and INFOSAN “Annex 2” INFOSAN International Health Regulations 2005, Guidance for national policy-makers and partners （http://www.wpro.who.int/internet/resources.ashx/CSR/Publications/IHR_booklet.pdf）

  21. IHR and INFOSAN Serious health impact International spread Immediate action needs to be taken

  22. Information sharing/collaboration:INFOSAN(FOS) and IHR(ESR/WHO)

  23. Collaboration b/w INFOSAN and IHRExample 1 • On 3 Aug 2013, INFOSANECP in New Zealand(NZ) provided preliminary information about contaminated dairy products and ingredients exported from New Zealand. • On 7 Aug, NZ IHR NFP notified WHO on the event. • On 12 Aug, WHO posted this event on EIS.

  24. Collaboration b/w INFOSAN and IHRExample 2 • INFOSAN Secretariat released an INFOSAN alert on 1 Nov 2013 concerning an outbreak of acute hepatitis. • US notified the outbreak on 1 Nov through IHR. • WHO posted this event on EIS on 5 Nov with recommendation to strengthen surveillance of acute hepatitis of unknown aetiology and advice to consumers.

  25. Summary • EBS covers food related events, which have been reported through various types of source of information. • Food related diseases are sometime intersectional between INFOSAN and IHR. • Cross sectional information sharing is important for timely risk assessment and response.

  26. Thank you

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