1. Integrated disease surveillance program
Presenter- Dr. Vaishali
Moderator- Dr. A. M. Mehandale

2. Framework Introduction Mission Objective Milestones Program Components
Organization structure
Data Management

3. introduction
is a decentralized, state based surveillance program in the country
detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner
Provide essential data to monitor progress of on-going disease control program and help allocate health resources more efficiently.

4. mission To strengthen the disease surveillance in the country
by establishing a decentralized State based surveillance system for epidemic prone diseases
to detect the early warning signals,
so that timely and effective public health actions can be initiated in response to health challenges in the country at the Districts, State and National level.

5. Objectives
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system
for epidemic prone diseases
to monitor disease trends and
to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)

6. milestones SR NO. YEAR EVENTS 1 Nov. 2004
IDSP  Launched with world bank assistance 2
Apr, 2006
Data reporting through 3
June, 2006
administratively and financially merged with NCDC 4
Sept, 2007
Weekly reporting of disease alerts/ outbreaks  5
Feb, 2008
24X7, toll free call centre (1075 6
April/May, 2008
Data reporting  on Portal ( 7
July 2008
Media Scanning and Verification Cell 8
Oct,. 2012
under NHM with outlay from domestic budget 9
2013
The Strategic Health Operations Centre 10
2015
Block level data entry in phased manner 11
Offline data entry at IDSP portal in phased manner
SHOC is established under IDSP to strengthen the outbreak detection and response capacities of the states and districts by utilizing state-of-the-art information technology.

7. Program Components
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Information Communication Technology - for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories
Inter sectoral Co-ordination for zoonotic diseases

8. ORGANIZATION STRUCTURE
CSU-Integrated administratively and financially with National Centre for Disease Control (NCDC), Delhi. SSU-One in each State/UT with a regular officer identified as State Surveillance Officer (SSO) Supported by 7 contractual staff. Con (Vet) added in DSU-One in each district with a regular officer as District Surveillance Officer (DSO). Supported by 3 contractual staff

9. Central Surveillance Unit
A senior officer from NCDC- National Program Officer
coordinate the project activities under six sections
Advisor Epidemiologist, Advisor Microbiologist, Management Expert, Documentation Officer, Communication Officer, and Consultant (IT) Team leader, Epidemiologists, Consultant (HR), Microbiologist and Media Scanning Assistant
six sections=Budget & Finance, Laboratory strengthening, Information Technology and Communication, Data Management and Monitoring, Human Resource Development and NCD Surveillance.

10. State Surveillance Unit
State surveillance officer
Administrative assistant
Consultant (technical)
Consultant (finance)
Data manager
Data entry operator

11. District Surveillance Unit
District surveillance officer –Dr. Ajay Dawale
Epidemiologist- Dr. Vinit Zalke
Data manager- Jawahar Shelokar
Data entry operator- Narayan Jawade

12. District rapid response team
District health officer-Dr. DG Chavan
District surveillance officer- Dr. Ajay Dawale
Epidemiologist- Dr. Vinit Zalke
Epidemic MO- Dr. Akare
Peadiatrician- Dr. Sanjay
Disrict malaria officer- Dr. P. Dhakate
Chief bacteriologist- Smt. Rekha Dwidedi

13. Conditions under surveillance
Regular surveillance
Sentinel surveillance
Regular periodic surveys
Vector Borne Disease
Sexually transmitted diseases/Blood borne diseases
NCD Risk Factors
Water Borne Disease
Other Conditions -Water Quality, Outdoor Air Quality
State specific diseases
Respiratory Diseases
Vaccine Preventable Diseases
Diseases under eradication
Other Conditions –RTA
Other International commitments : Plague, Yellow fever
Unusual clinical syndromes (Causing death / hospitalization):

14. Types of Surveillance in IDSP
Syndromic – Diagnosis made on the basis of symptoms/clinical pattern by paramedical personnel and members of the community.
Presumptive –Diagnosis made on typical history and clinical examination by Medical Officers.
Confirmed – Clinical diagnosis confirmed by an appropriate laboratory test.

15. District Public health Lab.
FLOW OF INFORMATION
CSU
SSU
DSU
Private hospitals
PHC
CHC
District Hospital
District Public health Lab.
Medical college
Sub-centres

16. Data REPORTING Weekly (Monday–Sunday) Data compilation & analysis
S form
P form
L form
Data compilation & analysis
District/State Surveillance Units

17. Reporting IN OUTBREAK
Daily reporting in outbreak to monitor the situation
Weekly reporting after the outbreak has subsided, for at least two incubation period of the disease.
A Unique code (outbreak ID) from 1st week of January 2016 to each outbreak in the Weekly outbreak Report for easy data storage and retrieval
State/code of District/ Year/Week/4-digit number for the Disease outbreak
E.g. MH/WD/2017/21/0001
For example, for an outbreak reported in week 1 by Rohtak district of Haryana will reflect as HR/ROH/2016/1/0023

18. Reporting units in Wardha
Sr. No.
Block
No. of Reporting units
S Form
P form
L form 1
Wardha 27 7 8 2
Deoli 24 4 3
Hingaghat 5
Seloo 6
Samudrapur 22
Karanja 18
Ashti 16
Arvi 23
Total
181 38 28

19. Training in idsp TOT- Six days TOT program
health personnel and members of rapid response team. 
Introduction to surveillance with special reference to IDSP, basic epidemiology, collection and transmission of laboratory specimens and bio-safety issues and details in response to outbreaks.
FETP- two week training
DSOs/ Epidemiologists to enhance their epidemiological skills in outbreak investigations.
Induction training
Microbiologists, Entomologists, finance consultant and other support staff under IDSP.

20. MEDIA SCANNING AND VERIFICATION CELL
 established on 24th July 2008 under IDSP at NCDC, Delhi
 It is “Early Warning System”
It works  through daily screening of press both local and national, TV (national and regional channels), Radio and other media channels which reports on suspected outbreaks or unusual health events.
The information is shared to the districts affected and DSO is expected to investigate and revert through the internet about the correctness and action taken
is managed by trained Epidemiologists and Public Health Consultants working in Central Surveillance Unit of IDSP
Media Surveillance increases the sensitivity of the official surveillance systems.
monitors Global and National Media sources such as National and Regional print media, news on internet, newswires and websites, news channels and news shared by partners like Global Public Health Intelligence Network (GPHIN), Canada, WHO and other International and national agencies

21. INFORMATION,COMMUNICATION TECGNOLOGY
Satellite connectivity Indian Space Research Organization
broadband connectivity through BSNL
online data entry (IDSP Portal
A 24X7 call centre
toll free number 1075
Video conferencing at State Surveillance Units and Central Surveillance Units
800 BY BROADBAND, 400 BY BROADBAND & SATELLITE

22. Idsp PORTAL

26. Strengthening of public health laboratories
Strengthening of district public health labs
equipment, manpower and funds for consumables
Perform testing for lab confirmation of epidemic prone diseases
Support outbreak investigations in the district
Report weekly surveillance data on L forms.
a) Blood culture for Typhoid
b) Stool culture for cholera and other common enteropathogens
c) IgM ELISA for Dengue (in endemic areas)
d) ELISA for Hepatitis A & E
e) ELISA / rapid test for Leptospirosis (in endemic areas)
f) Tests for other outbreak prone diseases prevalent locally

27. Strengthening of public health laboratories
Referral lab network
for investigation of outbreaks in the linked districts.
- Cholera and other enteropathogens : culture and sensitivity and serotyping
- Typhoid: Blood Culture & antimicrobial sensitivity (including isolate confirmation with specific antisera
- Bacterial meningitis-rapid latex agglutination test, CSF examination- wet mount, gram stain and culture    & antimicrobial Sensitivity
- Hepatitis A&E- IgM ELISA
- Measles- IgM ELISA
- Dengue- IgM ELISA
- Leptospirosis-ELISA/Rapid test
- Diphtheria-Smear examination, culture and toxigenecity testing
- Any other tests for locally prevalent epidemic prone disease (to be identified by the state)

28. REFERENCES
National center for disease control. Ministry of health & family welfare.
National center for disease control. Directorate general of health services. Ministry of health & family welfare, GOI. ncdc.gov.in

29. Directorate general of health services (Ministry of health & family welfare
NCDC
Organogram
National centre for disease control
Director
Centre for medical entomology & vector management
Centre for AIDS& related diseases
Division of epidemiology
Division of zoonosis
Division of microbiology
Integrated disease surveillance project
Division of planning, budget & administration
Division of parasitic diseases
Division of malaria coordination
Division of biochemistry & biotechnology

30. Cd alert monthly newsletter by NCDC
disseminate information on various aspects of communicable diseases to medical fraternity and health administrators. 
The first issue was published in August 1997 on emerging and reemerging diseases
give an inside view of the disease including the global scenario, Indian scenario and also the diagnostic facilities of the particular disease within our country.
 tool for the Rapid response Teams for management and containment operations in outbreak/ epidemic situations

31. History
IDSP launched in 2004 with world bank assistance for a period upto March 2010.
The project was restructured and extended up to March 2012
Earlier World Bank funds were available for Central Surveillance Unit (CSU) at NCDC & 9 identified states
rest were funded from domestic budget
continues during 12th Plan ( ) under NHM with outlay of Rs Crore from domestic budget only
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts.
Uttarakhand, Rajasthan, Punjab, Maharashtra, Gujarat, Tamil Nadu, Karnataka, Andhra Pradesh and West Bengal

32. History CONT…
  IT network connecting 776 sites in States/District HQ and premier institutes has been established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing and outbreak discussion
data on epidemic prone disease are being collected from reporting units including  government and private sector hospitals and medical colleges on ‘S’ syndromic, ‘P’ probable & ‘L’ laboratory formats using standard case definitions through e- mail/portal (
reporting units such SC, PHC, CHC

33. History CONT… analyzed by SSU/DSU for disease trends
investigated by the RRT to diagnose and control the outbreak
 A 24X7 call center to receive disease alerts on a Toll Free telephone number (1075)- February 2008
Media scanning and verification cell was established under IDSP in July 2008
It detects and shares media alerts with the concerned states/districts for verification and response
District laboratories are being strengthened for diagnosis of epidemic prone diseases.  2 lakh per annum per lab for reagents and consumables. 
In 9 States, a referral lab network has been established by utilizing the existing 65 functional labs in the medical colleges and various other major centers in the States and linking them with adjoining districts for providing diagnostic services for epidemic prone diseases during outbreaks