3. Background
Disease surveillance is an important component of public
health programmes.
Surveillance of vaccine preventable diseases (VPDs) is a
very important component in disease prevention as many
infectious diseases are now being prevented by highly
effective vaccines.
The number of effective vaccines is going to be
increasing in coming time considering the rapid
advancement in the field of vaccinology today
4. Surveillance methods
1) Active surveillance: Done actively by designated
persons at any health institutions or community. For eg.
AFP surveillance done by NPSP.
2) Passive surveillance: where suspected or confirmed
cases of a disease are reported routinely and passively
from identified health facilities such as IDSP, IDSurv,
etc.
3) Sentinel surveillance: where clinical cases are reported
after lab confirmation from selected health institutions
in relation to HIV, Rotavirus (IRSN), Hib-surveillance
etc.
IRSN : Indian Rotavirus Surveillance Network
5. 4) Population based surveillance: Conducted for selected
groups with active diseases in a well-defined
area/populations, such as Leprosy surveillance done by
health worker in the village
5) Outbreak surveillance: where notification is done only
whenever there is cluster of cases as per predefined
norms, such as measles surveillance, diseases reported
through IDSP and Fever surveillance done by PSM
Dept. in New Civil Hospital campus in 2014.
Surveillance methods cont…
6. 6) Case-based surveillance: where any suspected case
is immediately notified for further investigations like
AFP and AES surveillance.
7) Zero reporting: means reporting even when there is
no case found like AFP surveillance.
Surveillance methods cont…
8. Why VPD surveillance is necessary?
The goals of an effective disease surveillance system should serve the
following functions:
To define epidemiology of a disease
To identify high-risk populations and regions having high
transmission of the disease
To monitor progress of a disease control program
To specify and monitor molecular epidemiology of an infectious
disease including identification of circulating strains of the
pathogen responsible for the infectious disease
To monitor impact of the vaccination program on overall disease
(VPD) epidemiology.
9. Current status of VPD surveillance in India
Vaccine preventable diseases (VPDs) are still responsible for
over 500,000 deaths annually in India1.
There is lack of disease burden data on many important VPDs
in India that results in the perception that the disease is not
important public health problem.
Lack of baseline surveillance data also is a bottleneck in
introduction of many new vaccines in the national
immunization program (NIP) and also in monitoring the
impact of vaccination provided through UIP
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
Following are the key surveillance systems in India:
1) IDSP: (Integrated Disease Surveillance System) Nationwide outbreak
surveillance system. Including measles, diphtheria, pertussis, AFP,
hepatitis and AES.
2) CBHI/SBHI: (Central and State Bureaus of Health Intelligence)
Nation-wide passive reporting system of suspected cases.
3) MEASLES: ICMR Selected practitioners and institutions provide
clinical samples to NIV-Pune for measles virus isolation and
genotyping. A type of case-based surveillance system.
4) AES / JE: NVBDCP and ICMR Facility based surveillance for acute
encephalitis syndrome in endemic areas. It is run by Government of
India under National vector-borne diseases control program.
AES: Acute Encephalitis syndrome, NIV Pune: National Institute of Virology, Pune
11. 5) Multi centre PNEUMONIA and MENINGITIS surveillance :
Established in preparation for Hib vaccine probe study. A type of
case-based surveillance.
6) WHO-NPSP supported surveillance systems : Three different models for
three different VPDs.
a) AFP and lab surveillance for poliovirus: Global eradication
program.
b) Fever and rash for measles/rubella: National mortality reduction
target; may be scaled up to a regional elimination goal.
c) Acute Encephalitis Syndrome (AES) for JE: Control program for
endemic districts.
7) IDSurv― An Innovative Project to Report Infectious Diseases : IAP in
collaboration with its Kutch branch, has started an Infectious Disease
Surveillance and AEFI reporting system for reporting serious AEFI,
known as IDSurv.org.
VPD Surveillance systems in India
12.
13. History
Initially IDsurv.org was designed only for Kutch district
Indian Academy of Pediatrics in collaboration with its
Kutch branch has started reporting system for the Infectious
Disease Surveillance and serious AEFI
The standard case definitions for all the diseases covered
under this project are provided on the website.
All the cases reported through various methods are collected
in a single database in real time and reports are sent to all
users on weekly basis.
AEFI: Adverse Event Following Immunization
14. In case a disease outbreak is recorded on the system, email
and SMS alert are sent to all users instantaneously.
After interest shown in this project by IAP COI and CIAP.
MOU was signed between IAP Kutch Branch and CIAP to
make this project available nationwide for all IAP
members.
Initially only 9 diseases where under surveillance.
Hepatitis and acute encephalitis surveillance was added
later on
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
Recently they have started surveillance for AEFI on the IDsurv platform
with support Government of India. Only serious AEFI reported that
include:
Death
Hospitalization
Clustering of cases
Disabilities
7. Typhoid
8. Pneumonia
9. Hepatitis
10. Measles
11. Mumps
At present only eleven key infectious diseases are 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. Reporting a case through website: First, one should go to the site www.idsurv.org
and click on login and a panel will open. Enter your Username and Password. You
will be redirected to your account. Click on Report a Case’. Select the diagnosis.
Enter patient's details including all other details and click on submit. A reference
number will be generated for the patient and given to you.
19. 2. Reporting case through mobile:
In mobile there are two methods
i. Log in to your account on
m.idsurv.org. Click on report a
case and fill up the form and
click on submit.
ii. Download mobile Application
named “IDsurve’’
20. 3. Reporting a case through sms : Type 'IT' space 'IDS' space 4-
letter 'code of the disease' space 'age' in months space 'sex' space
'severity of disease' space ‘microbial diagnosis established’ space
‘immunization status’ space ‘outcome’ and send it to 57333. The
details about SMS codes are provided on the website.
4. Reporting a case through IVR To report a case using IVR
system, call 02653090533 using your registered mobile number
and follow the instructions. It usually takes less than 2 minutes to
register the case. You can enter the details later.
21.
22. How to report an Adverse Event Following Immunization
(AEFI)?
An AEFI is defined as “a medical incident that takes place after an
immunization
Only serious AEFI that includes deaths, hospitalization, clustering of
cases, and disability is reported to the system.
To report serious AEFI cases click on “report an AEFI” and fill in all
the fields regarding patient, AEFI and the vaccine, and then click on
“save”.
One can view the AEFI cases reported by clicking on 'View/ Update
AEFI cases reported by me'.
Once a serious AEFI reported through this system, automated e-mail
intimation is sent to the designated government authority for further
necessary actions.
23.
24. Who can see the cases reported by me?
Anybody who opens idsurv.org can see the cases
But the identity of the doctor and patient is kept confidential and
provided only to Government authorities if requested by them.
How to view surveillance data available at IDSurv?
The data can be viewed either on a map, table or charts.
Google map showing total number of cases along with break-up of
the cases reported from a particular district.
The charts display the total number of all the eleven ID cases
reported so far along with data
25.
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33. An early warning system (IDsurv alerts) is being
introduced on the site
When the system detects unusually high number of
cases being reported of a particular disease in a
geographical area in a short period of time, an automatic
(SMS and Email) alert is sent to all the registered users
and government authorities in that area and same is also
reflected on the website.
Early warning system/ IDsurv alerts
34.
35. The IDSurv has a great potential in fulfilling the need of infectious
disease surveillance of the country. It can provide VPD reporting in
the country especially amongst the practicing pediatricians.
The user-friendly system and easy display of the data should
provide motivation to pediatricians in private sector.
So far, 10,146 cases of all the eleven IDs are reported through this
project from all over the country2.
The total number of registered users is only 602 that represent
around 3% of total membership of IAP in the country2.
The majority of cases register either had no immunization or were
only partially immunized.
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
All VPDs (Vaccine Preventable Diseases) are not covered under
IDsurv.
Most of the Pediatric doctors are not aware about this surveillance
system. Only few Pediatric doctors are aware about this project
and doing regular reporting.
Registering of the cases on this website require the motivation and
support form the private Pediatric doctors.
Registering of cases not done from the Government hospitals.
