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Surveillance System in the Philippines

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Presentation on theme: "Surveillance System in the Philippines"— Presentation transcript:

1 Surveillance System in the Philippines
DEPARTMENT OF HEALTH RESEARCH INSTITUTE FOR TROPICAL MEDICINE Surveillance System in the Philippines Ebola Training 11-13 November 2014

2 Outline Brief Background Information IHR
Surveillance Systems in the Philippines 2. Surveillance and Response for EVD

3 Our world is changing as never before
Populations grow and move… Microbes adapt… Public health risks increase… Diseases travel fast… Health security is at stake

4 International Health Regulations (2005)
World Health Organization 15 April, 2017 International Health Regulations (2005) A global legal instrument for global public health security Came into force on 15 June 2007* Preventing the international spread of disease while avoiding unnecessary interference with international transport and trade Legally binding for 194 countries and WHO that have agreed to play by the same rules to secure international health. 4

5 New IHR – New obligations
Designation of responsible authorities Functional national IHR Focal Points Consultations, notification, verification, information sharing Assessment and public health response Strengthening of the core capacity for surveillance &response Points of entry core capacity Public health measures health documents (Ship Sanitation Control Certificate…) Charges Collaboration and assistance Human rights, including treatment of personal data Transport and handling of biological substance and materials IHR Expert Roster, Emergency/Review Committee Other legal aspects: rejection/reservation, disputes etc

6 IHR requirements on POE




10 Statement on the 3rd meeting of the IHR Emergency Committee regarding the 2014 Ebola outbreak in West Africa It was the unanimous view of the Committee that the event continues to constitute a Public Health Emergency of International Concern (PHEIC). The Committee reiterated its recommendation that there should be no general ban on international travel or trade Recommendations for States with intense Ebola transmission (Guinea, Liberia, Sierra Leone) States should maintain and reinforce high-quality exit screening of all persons at international airports, seaport, and major land crossings, for unexplained febrile illness consistent with potential Ebola infection Other details

11 Surveillance Systems in the Philippines
Indicator based - PIDSR Event-based – ESR, SPEED

12 Trigger events for strengthening Surveillance

13 What is PIDSR

14 Components of PIDSR Case-based/Indicator-based Event-based a. ESR

15 Figure 2: Conceptual Framework for the Philippine Integrated Disease Surveillance and Response (PIDSR)

16 Category 1 – Immediately reportable diseases/syndromes/events
Acute flaccid paralysis “hot case” Anthrax Human avian influenza Severe acute respiratory syndrome (SARS) Adverse event following immunization (AEFI) Any disease outbreak Any clustering of patients with similar disease,symptoms or syndromes Meningococcal disease Immediate reporting upon laboratory confirmation Poliomyelitis Cholera Measles HIV/AIDS (HIV Registry)

17 Category 2 – Weekly reportable diseases/syndromes/events
Acute bloody diarrhea Acute hemorrhagic fever syndrome Acute viral hepatitis Acute flaccid paralysis Bacterial meningitis Cholera Dengue Diphtheria Influenza Japanese encephalitis Leptospirosis Malaria Neonatal tetanus Non-neonatal tetanus Paralytic shellfish poisoning Pertussis Rabies Typhoid and paratyphoid fever



20 Event-based Surveillance & Response (ESR)
Complements existing indicator-based disease surveillance (PIDSR) in detecting IHR events w/ added advantage of rapid reporting, greater geographic spread & relatively low cost Can be rumours & other reports transmitted through routine reporting system or reports from media, health workers & NGOs Reports may be formal or informal through phone calls or text messages


22 Surveillance in Post Extreme Emergencies and Disasters (SPEED)
Objectives Detect early unusual increase of communicable and non-communicable conditions related to emergencies and disasters Monitor health trends for appropriate public health action Enable identification of appropriate response to handle the emergency A tool for decision-making in disaster response


24 Surveillance Systems Time O EVENT 24 hrs 48 hrs 72 hrs Day 4 ...Day N
PIDSR ESR RAPID ASSESSMENT Early Warning System SPEED Activated Deactivated There are information management systems in place e.g. the Philippine Integrated Disease Surveillance and Response System (PIDS –R) and the Health Emergency Management Staff Health Emergency Alert Reporting System. In health emergencies, within hours, a Rapid Assessment is conducted. At the 48 hr, an early warning system (SPEED) is activated , which continues until conditions are seen that will need to deactivate the system. 24

25 Ebola Virus Disease Surveillance and Reporting

26 Possible points of detection of EVD cases
National surveillance systems should be capable of detecting suspected cases Clinicians and health care workers understand and implement: EVD case definition Safe specimens collection and shipment for laboratory confirmation Reporting mechanism, including IHR notification to WHO Any case with Ebola virus infection (i.e. suspect, probable, confirmed), any unusual health event possibly associated with Ebola virus infection, should be reported to WHO through the National International Health Regulations (IHR) Focal Point. Source: WHO

27 Case Definition

28 Case Definition

29 Case Definition

30 EVD Surveillance Procedure

31 EVD Surveillance Procedure

32 Roles of Hospitals and Other Health Facilities

33 EVD Surveillance Submit Case Notification Form w/in 24 hrs PUI
EVD Cases NEC Collection of specimen PUI EVD suspect/ probable RITM Fill out & submit Case Investigation Form & Laboratory Request Form 2 days Release of results to PUI/patient. Reporting Unit, NEC

34 Surveillance Flow Chart

35 Control the outbreak National leadership and risk communication
Outbreak control measures to stop transmission: Clinical Management and IPC Epidemiological investigation, surveillance and laboratories Behavioral and social interventions Logistics

36 General strategy to CONTROL Ebola outbreak
15/04/2017 General strategy to CONTROL Ebola outbreak Women, associations Traditional healers Opinion leaders Anthropological evaluation Infection control Triage In/out Barrier nursing Behavioural and social interventions Psycho- social support Formal and informal modes of communication Clinical case Management Organize funerals Social and Cultural practices Clinical trials Ethics committee Ethical aspects Communication Press Journalists Medias Coordination Duty of care Research Active case-finding Security Police Control of vectors and reservoirs in nature Epidemiological investigation, surveillance and laboratory Figure 7. Structure organisationnelle des différents comités intervenant dans les activités de lutte contre les épidémies de fièvres hémorragiques à virus Ebola ou Marburg Logistics Lodging Food Follow-up of contacts Social and Epidemiological mobile teams Specimens Laboratory testing Finances Salaries Transport Vehicles Search the source Database analysis

37 Why do we need to prepare?
Past experiences clearly demonstrated that emerging diseases/events will continue to occur… Emerging diseases are unpredictable in the changing world… Effective preparedness planning definitely minimize the impact on health, economic and social disruption

38 Thank You

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