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Surveillance Activities during Pandemic Phases. Anne-Luise Winter APHEO-COMOH Workshop Toronto February 1, 2007. Objectives of Pandemic surveillance. To detect early the entry of the Pandemic strain in Ontario To rapidly determine circulating strains in Ontario
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Surveillance Activities during Pandemic Phases Anne-Luise Winter APHEO-COMOH Workshop Toronto February 1, 2007
Objectives of Pandemic surveillance • To detect early the entry of the Pandemic strain in Ontario • To rapidly determine circulating strains in Ontario • To provide data on circulating influenza strains • To monitor activity and patterns of distribution of ILI • To estimate the impact of the Pandemic • To describe affected population/s, mode/s of transmission, risk factors • To detect unusual events • To track occurrence, severity, and progression by WHO/PHAC phase
Interpandemic Phases • No new influenza virus subtypes detected in humans A circulating animal influenza virus subtype poses a substantial risk of human disease Surveillance: • Routine influenza surveillance • Communication of phase progression
Pandemic alert phases • Human infection/s with a new subtype. Rare limited larger cluster/s of human to human spread Surveillance • Layered progression of activities • Detection of the novel strain, heightened surveillance for detection of any unusual cases/clusters (e.g. FRI/SRI surveillance) done through strain characterization of ~ 10% of all isolates plus atypical cases, their close contacts with ILI and unusual outbreaks • Continue with heightened surveillance until no longer sustainable aggregate reporting • Ongoing review of case definition • Ongoing evaluation of epidemiology of novel strain
Pandemic • Increased and sustained transmission in general population Surveillance: • Utilization of pandemic reporting tools, various data collection systems (portal for aggregate data + secure platform for case level data) • Case-level information collected on a small proportion of cases • Assessment centres/hospitals/LTCHs for aggregate and case level data • Monitor uptake, efficacy, adverse events associated with vaccines and antivirals • Ongoing evaluation of epidemiology, to direct priorities to high-risk group/s • Diagnosis by clinical, not lab, criteria • Prioritization of laboratory testing
Postpandemic Period • Recovery/Resolution Surveillance: • Estimate burden of disease • Evaluate surveillance systems • Eventual resumption of interpandemic activities, scaling down pandemic surveillance as appropriate
Questions? Anne-Luise Winter: anne-luise.winter@moh.gov.on.ca (416) 327-7301