Global surveillance of communicable diseases Summary of presentations for weeks 1 and 2 Seminar PubHlth 796, Fall 2006 Friday 11:15-12:05 Section A 12:15-1:05 Section B Room 120 Arnold

Instructor – Martha Anker Office Address:424 Arnold Office Mailbox:4 th Floor Arnold Office hours:By appointment

Course Description This is a 1 credit course that will meet weekly. It is comprised of seminars on global surveillance and response to infectious diseases.

Requirements Attendance and participation –Registered students will be required to attend 11 of the 13 seminars in order to receive course credit. Attendance is defined as presence for the entire class session. –Active participation and reading of the session material is required. –Commentary on readings The course will be graded on a pass/fail basis

Readings for weeks 1 and 2 Week 1 Readings for first four weeks of Seminar Thacker, Stephen B, Historical Development, in Teutsch and Churchill eds, Principles and Practice of Public Health Surveillance, second edition, Oxford University Press, pp Handout on first day. Week 2 Wilson and Anker, Appendix to chapter entitled Disease surveillance in the context of climate stressors: needs and opportunities, in: Ebi, Smith, and Burton (Eds.): Integration of Public Health with Adaptation to Climate Change: Lessons Learned and New Directions. Taylor and Francis, London, 2005 p PDF file posted on course website.

Course Objectives A major aim of this course is to familiarize students with current issues involving surveillance and response to infectious diseases at the local, national and international levels. A secondary aim is to familiarize students with the new International Health Regulations due to take effect in June Topics covered will include: – how national surveillance systems operate in terms of structure and practices –problems posed by emerging infectious diseases; media communication during outbreaks –new developments in global surveillance –the International Health Regulations and their recent revision due to take effect in June –The course will include specific examples of how surveillance system operates vis-à-vis diseases of international concern such as Polio, SARS, avian influenza and Dengue fever.

Outline of course Principles and basic building blocks of communicable disease surveillance systems –Overview of surveillance, what is it, why is it needed –Types surveillance and sources of data Special problems of surveillance in low income countries. International mechanisms for surveillance and response to infectious disease threats Novel methods of global surveillance ( Read EID perspectives article April 2000) –New international health regulations in June 2007 –International surveillance networks – fluNet, dengueNet Special topics –Outbreak communication –Gender perspective during outbreaks of infectious disease –Surveillance systems for particular diseases –How to examine the costs and benefits of surveillance systems

What is Public Health Surveillance all about? Public health surveillance is the means by which public health departments keep informed about the health of the population, and about real and potential problems they may face. Involves systematic collecting, interpreting, distributing health information to others so that informed decisions can be made affecting public health. Sometimes called “data for decision making”. “The continuing scrutiny of all aspects of the occurrence and spread of disease that are pertinent to effective control” (Last J, A Dictionary of Epidemiology 4 th edition, Oxford University Press, 2001)

Definition of public health surveillance “Public health surveillance is the ongoing systematic, collection, analysis, and interpretation of outcome-specific data for the use in the planning, implementation, and evaluation of public health practice.” 1 Public health surveillance is the “continuing scrutiny of all aspects of the occurance and spread of disease that are pertinent to effective control.” 2 1 Thacker SB, Berkelmand RL, Public Health Surveillance in the United States. Epidemiol Rev 1988:10: Last J, A dictionary of epidemiology, 4 th ed. Oxford University Press, New York, 2001.

Examples of uses of surveillance data Identify/assess health problems –Estimate the magnitude of a health problem –Detect epidemics –Documentation of the distribution and spread of a health event Portrayal of the natural history of disease.

Examples of uses of surveillance data continued Facilitate research –Testing hypotheses –Laboratory and epidemiologic research Evaluation of control and prevention measures. Monitoring changes –in infectious agents and antimicrobial resistance –in health practice. Planning Source: adapted from - Teutsch and Churchill: Principles and Practice of Public Health Surveillance

Methods of surveillance/sources of data Passive surveillance routine reporting from health facilities Active surveillance – Intentional gathering of data about a specific disease or syndrome Sentinel surveillance –Selected sites that serve as early warning systems or gather more in depth data Birth and death surveillance –Civil registration –Verbal autopsy - interviews with next of kin to establish cause of death Disease registries –Usually used for chronic diseases, follow patients over long periods of time – but also used for infectious diseases with long term consequences Longitudinal demographic surveillance systems –Geographically defined and research-oriented field sites Census data Population surveys (may or may not be part of surveillance)