1. Adding a new component to surveillance

2. Gastroenteritis: “viral infection” Only a few could be cultured Little knowledge of specific causes or epidemiology Prevention by public health/hygeine Treatment symptomatic

3. Game Changers Development of new lab technology Possibility of immunization – Rotavirus, norovirus – Based on work largely in developing countries – Hospitalised children

4. Research Questions What is the epidemiology of each of the G- E infections – in Alberta? – Time, place, person What is the possible effect of immunization?

5. Lilly Pang Bonita Lee

6. Community Pediatric Gastroenteritis Surveillance Where are we going?

7. Sentinel program: building on Tarrant Measure community incidence, Virological causes Water supply effects Severity of illness First Nations?

8. Design: surveillance in community practices. Population: children < 6 with Gastroenteritis Case Def: 3+ watery stools, and/or forceful vomiting within 24 hr period Exclusions Chronic (> 14 days) Other cause likely: e.g. acute abdomen

9. New Sentinel program Ethics approval granted Pilot stage: volunteer physicians – Testing use of rectal swabs – Forms and consent – Acceptability and feasibility – Systems for collection, and transport

10. After the pilot… Enrolment of sentinels – Around the province Negotiation about First Nations Development of reporting framework to Alberta Health Analyses

11. Long term Develop case-control study Evaluate vaccine effectiveness