Kathleen F Cavallaro1, Hardeep S Sandhu2, Terri B Hyde2, Barbara W Johnson3, Marc Fischer3, Leonard W Mayer4, Thomas A Clark4, Mark A Pallansch5, Zundong Yin6, Shuyan Zuo7, Stephen C Hadler7, Serguey Diorditsa8, A S M Mainul Hasan9, Anindya S Bose10, Vance Dietz2. 1. Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: KCavallaro@cdc.gov. 2. Global Immunization Division, United States Centers for Disease Control and Prevention, Atlanta, GA, USA. 3. Division of Vector-Borne Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. Division of Bacterial Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, USA. 5. Division of Viral Diseases, United States Centers for Disease Control and Prevention, Atlanta, GA, USA. 6. National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. 7. World Health Organization, Beijing, People's Republic of China. 8. World Health Organization, Dhaka, Bangladesh. 9. World Health Organization, Male, Maldives. 10. National Polio Surveillance Project, World Health Organization, New Delhi, India.
Abstract
BACKGROUND: Surveillance for acute flaccid paralysis with laboratory confirmation has been a key strategy in the global polio eradication initiative, and the laboratory platform established for polio testing has been expanded in many countries to include surveillance for cases of febrile rash illness to identify measles and rubella cases. Vaccine-preventable disease surveillance is essential to detect outbreaks, define disease burden, guide vaccination strategies and assess immunization impact. Vaccines now exist to prevent Japanese encephalitis (JE) and some etiologies of bacterial meningitis. METHODS: We evaluated the feasibility of expanding polio-measles surveillance and laboratory networks to detect bacterial meningitis and JE, using surveillance for acute meningitis-encephalitis syndrome in Bangladesh and China and acute encephalitis syndrome in India. We developed nine syndromic surveillance performance indicators based on international surveillance guidelines and calculated scores using supervisory visit reports, annual reports, and case-based surveillance data. RESULTS: Scores, variable by country and targeted disease, were highest for the presence of national guidelines, sustainability, training, availability of JE laboratory resources, and effectiveness of using polio-measles networks for JE surveillance. Scores for effectiveness of building on polio-measles networks for bacterial meningitis surveillance and specimen referral were the lowest, because of differences in specimens and techniques. CONCLUSIONS: Polio-measles surveillance and laboratory networks provided useful infrastructure for establishing syndromic surveillance and building capacity for JE diagnosis, but were less applicable for bacterial meningitis. Laboratory-supported surveillance for vaccine-preventable bacterial diseases will require substantial technical and financial support to enhance local diagnostic capacity. Published by Elsevier Ltd.
BACKGROUND: Surveillance for acute flaccid paralysis with laboratory confirmation has been a key strategy in the global polio eradication initiative, and the laboratory platform established for polio testing has been expanded in many countries to include surveillance for cases of febrile rash illness to identify measles and rubella cases. Vaccine-preventable disease surveillance is essential to detect outbreaks, define disease burden, guide vaccination strategies and assess immunization impact. Vaccines now exist to prevent Japanese encephalitis (JE) and some etiologies of bacterial meningitis. METHODS: We evaluated the feasibility of expanding polio-measles surveillance and laboratory networks to detect bacterial meningitis and JE, using surveillance for acute meningitis-encephalitis syndrome in Bangladesh and China and acute encephalitis syndrome in India. We developed nine syndromic surveillance performance indicators based on international surveillance guidelines and calculated scores using supervisory visit reports, annual reports, and case-based surveillance data. RESULTS: Scores, variable by country and targeted disease, were highest for the presence of national guidelines, sustainability, training, availability of JE laboratory resources, and effectiveness of using polio-measles networks for JE surveillance. Scores for effectiveness of building on polio-measles networks for bacterial meningitis surveillance and specimen referral were the lowest, because of differences in specimens and techniques. CONCLUSIONS: Polio-measles surveillance and laboratory networks provided useful infrastructure for establishing syndromic surveillance and building capacity for JE diagnosis, but were less applicable for bacterial meningitis. Laboratory-supported surveillance for vaccine-preventable bacterial diseases will require substantial technical and financial support to enhance local diagnostic capacity. Published by Elsevier Ltd.
Entities:
Keywords:
Japanese encephalitis; Meningitis; Surveillance; VPD; Vaccine preventable diseases
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