DISEASE SURVEILLANCE SYSTEM
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- Title
- DISEASE SURVEILLANCE SYSTEM
- extracted text
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DISEASE SURVEILLANCE SYSTEM
GUIDELINES FOR MEDICAL OFFICERS AND
REPORTING FORMATS
4
K
1
KARNATAKA HEALTH SYSTEM DEVELOPMENT PROJECT
*
PREFACE
This manual has been prepared for guiding the medical officers of all primary
and secondary level health institutions in Karnataka on surveillance of infectious
diseases and non-infectious diseases of public health importance.
This manual includes the basic information on disease surveillance, method of
reporting case definitions, types of surveillance and reporting formats for various
diseases.
The medical officers are requested to study this manual carefully and
understand the importance of accurate and timely reporting, so that, timely and
appropriate measures can be taken by the designated agencies to control the diseases.
4
\
1
GUIDELINES FOR SURVEILLANCE
Burden of Diseases:
The burden of infectious diseases in the state is very high. Infectious diseases
are major causes of morbidity and mortality in children as well as all hospital
admissions. Tuberculosis and malaria are leading causes of death. Diseases, hitherto
unknown to Karnataka, such as Japanese Encephalitis and Dengue fever are spreading.
The population is undergoing socio-economic transition or change on account
of urbanisation, increased travel, reduced physical activities, changing food and
lifestyles. This has resulted in the increased prevalence of non-infectious diseases like
-coronary thrombosis, hypertension, diabetes, cancer etc..
Outbreaks of epidemics and increased prevalence of non-infectious diseases
cause heavy human and economic burden. Due to increased international travel there
is high risk of importing new infections with potential for an explosive outbreak e.g.,
X.
yellow fever. International health agencies such as WHO, enforce member countries to
comply with International Health Regulations so that the risk is minimised.
Need for Disease Control:
There is urgent need for disease control.
Some of the approaches for
controlling diseases which has been adopted so far are as follows:-
1. Prophylactic immunizafion (primary prophylaxis)/E.g., vaccine preventable
childhood diseases like Measles, Diphtheria, Pertussis, Tetanus, Polio.
2. Early diagnosis and prompt treatment (secondary prophylaxis). E.g., TB,
Leprosy.
3. Vector control. E.g., Malaria.
4. Cost effective treatment have drastically reduced mortality due to some
diseases like Cholera and Plague.
I
5. Improving food hygiene, ensuring safe drinking, zoo prophylaxis prevent
outbreak of diseases like food and water borne diseases, flurosis rabies etc..
Disease Surveillance:
*
Any of these interventions are possible only when all the information pertaining
to the disease and its outbreak is available. Sporadic cases of infectious diseases turn
into epidemic outbreaks due to amplification and transmission of infectious agents
which happens silently.
Detecting diseases, its origin, distribution and clustering
(unusual occurrence of disease in many people at a time and place) are essential steps
to understand the phenomenon of amplification and transmission.
The word
surveillance is used for this process of reporting diseases of public health importance,
giving details of who is affected, how many, with what, where, when and how, to
institutions which takes measures. Surveillance is the first essential step before taking
action to control diseases. Continuous monitoring of the background phenomenon of
diseases are essential for early warning signals of any outbreak.
Diagram : Importance of Surveillance
Recognition
(quality of diagnosis
Reporting (Complete
and Timely)
Successful
Surveillance
Successful prevention and
> control of diseases
Response
(Effectiveness)
Importance of Disease Surveillance:
F
Surveillance is necessary for achieving disease eradication.
Systematic
surveillance of Acute Flaccid Paralysis (AFP) is required for polio eradication.
Similarly, measles which is now targeted for eradication requires surveillance.
Surveillance helps to document impact of national programmes. Surveillance
system is essential to identifying the areas of low coverage and potential risk of
outbreaks. E.g., diphtheria.
Types of Surveillance:
Information regarding occurrence of diseases and their background may be
collected by two types of surveillance:
a) Passive surveillance: Where data is collected at sub-centre, PHC/PHU, CHC or
other health institution by health workers whenever a patient reports with a
particular disease under surveillance programme.
b) Active surveillance. Information gathered about a disease when a health worker
visits a household and collects data.
'w
(
Type
Reasons
1. Infectious
• Caused by a single agent.
• Easily preventable.
• Significant from public health view.
a. Targeting diseases for eradication.
E.g., polio,
measles.
b. Targeting diseases for elimination / control.
E.g., malaria.
c. Targeting for local control measures (outbreaks).
E.g., Gastroenteritis.
2. Non-infectious
F
a)
• Caused by multiple agents (factors).
• Requires designing of control strategies.
E.g., coronary heart disease, diabetes.
Diseases included for Surveillance:
Diseases which are being brought under district and state surveillance system
»
through KHSDP are as follows.
1. AIDS
9. Meningococcal disease
2. Bacillary dysentery
10. Neonatal tetanus
3. Cholera
11. Pertussis
4. Dengue
12. Plague
5. Diphtheria
13. Rabies
6. Japanese Encephalitis
14. Salmonellosis
7. Hepatitis
15. Syphillis
8. Measles
16. Tuberculosis
Reporting Diseases under Surveillance:
For effective surveillance, information has to flow continuously from the
peripheral health care services to the central agency. Three levels of reporting are
recognised:-
i.
Peripheral: Consisting of sub-centres of PHC/PHUs.
ii. Intermediate at District level.
*
iii. Central level: At Directorate of Health & Family Welfare Services.
Two types of reporting are essential for diseases:
a) Case based reporting: On occurrence of some diseases e.g., Cholera, Plague,
Japanese Encephalitis, which need constant monitoring and early & effective
control measures.
t
b) Aggregated monthly reporting:* For all diseases under surveillance.
The table below gives detail about reporting of diseases.
*
Level of
Person
Information
Person/s
Reporting
Responsible
Available
Receiving
Taking
Report
Action
Person
Periodicity
1. Periphery :
a) Sub-centre
JHA (M & F)
Anganwadi
A.M.O.(PHC)
Teachers etc.
Case based
A. M. O.
reporting:
within 24
b) PHC
A. M. O. (PHC)
-do-
D.S.O.,
hrs of case
D. S. O.
DH&FWO
occuring.
DH&FWO
Taluka MO
Aggregate
report
monthly
2. Intermediate
3. Central
DH&FWO
AD(CMD)
D.S.
DH&FWO
DH&FWO
Director General
-do-
AD(CMD)
H&F WS,
Govt. Of India
The success and sustainability of the surveillance system will depend largely on
the appropriateness and timeliness of responses elicited by disease reports,
Three
types of responses are expected from agency receiving the report:-
• Information feedback “
• Investigation for aetiology or risk factors
• Interventions for disease control
This critical link between information and action is often weak in surveillance
system and which needs to be strengthened.
Disease Surveillance Programme under KHSDP.
This is one of the main objective of
k
Acute bloody diarrfr
°ea
Acute bloody diarrhoea (children under 5)
rationale for surveillance--------------------------------------------------------------------Bloody orarrnoea in children is usually a sign of invasive enteric infection that carries a substanti i
---------------------- ---------------------------------------
Hez
Chi
20
. E-’
Laboratory criteria for diagnosis
XXZ “ “sM ,0 “”’6™ p°ss,bte Od“r!aks °' s’eefc d»rrt’“a’«*
Te
F?
D
2
E
Case classification
Not applicable
RECOMMENDED TYPES OF SURVEILLANCE
Patient records should be maintained at peripheral level.
m^nthly
°f ag9re9ated data from Penpheral level to intermediate and central level
programme 2
su^HIance to complement routine data and for evaluation of control
Note:
dysM‘1 stoM
RECOMMENDED MINIMUM DATA ELEMENTS
Case-based data at peripheral level
Unique identifier, age, sex, geographical area
Date onset, date treatment
Treatment given (Y/N), kind of treatment
Hospitalised(Y/N)
Outcome
Aggregated data for reporting
Number of cases < 5 years by geographical area
Number of deaths < 5 years by geographical area
RECOMMENDED data analyses,
, PRESENTATION, REPORTS
'
---------------Number of cases by month, geographical area, age group
Comparisons with same month and geographical area in previous years
^easonal and secular data (best presented as line graphs)
Monthly surveillance summanes should be produced nationally and regionally and fed back
uarte y or annual overview is helpful in trying to identify areas of concern and set priorities
WHO Recommended Surveillance Sondards
SP£C
AnaV
suspt
settle
COb
Reg
See
Sk chiH Thpdnr
'S P?mOtS Sn inteSrated arable approach to the management of the
ck child, i he primary objective is to reduce morbidity and mortality.
RECOMMENDED CASE DEFINITION
Clinical case definition
Acute diarrhoea with visible blood in the stool
pRlNC
. Me
. Idt
October 97
117
-------------- Bacillary dysenter
A 03
r
____
Bacillary dysentery
(ca us ed by Shigella dysenteriae type f)
I1 ^noNALE forsurveillance-------- ---------- ——___ ____
I Since the early 1990’s -bp a
NCE
-------------------------- —
I antibiotics, has become a 2>'^ergerice of strains of Shigella dysentenh^ h
most
------------------------------------- —
Diarrhoea with visible blood in the stool
rea
Laboratory criteria for diagnosis
Isolate °f5.dysenfensetype1fromstoo(s
Case classification
Suspected:
A case that meets the
clinical case definition
Probable:
^ot applicable
Confirmed:
A suspected case
that is laboratory-confirmed
recommended typesT^
—
OF SURVEILLANCE
.......
-J “ CM™J,0
unated
D
central
*
Note:
______ _____ _ ______________
-- -------------------
1C),
■ JXeen,9ta"(Y'N1' k«Lf£:S’'““S5--S^=ograpf,ita„„famafcn
Aggregated data for
reporting
Number of cases
hospitalisations, number of deaths
!2re.“"X’rmM,b>a9e9™’1«" or over 5 years), number of
V
26
Rec.
°mmend=d Surveillance s^da.-cs
October 97
27
Cholera
AOO
■
Cholera
Case report universally required by International Health Regulations
'aphical
a,
RATIONALE FOR SURVEILLANCE
------ -----------------------------------Cnolera causes an estimation of 120 000 deaths per year and is prevalent in 80 countnes. In Africa
ec.demics have become more frequent and case fatality rates higher. The world is currently
exoeriencing the 7th pandemic. Refugee or displaced populations are at major risk of epidemics due
tc the conditions prevailing in the camps (unsafe water, poor sanitation and hygiene). Control of the
cisease requires appropnate surveillance with universal case resorting. Health education of
peculation at risk and improvement of living conditions of population are essential preventive
measures.
._____________ ___________________________________
’ RECOMMENDED CASE DEFINITION------------------------------------------------Clinical case definition
• In an area where the disease is not known to be present, severe dehydration or death from acute
watery diarrhoea in a patient aged 5 years or more or
• • In an area where there is a cholera epidemic, acute watery diarrhoea, with or without vomiting in
a patient aged 5 years or more*
iimals
Laboratory criteria for diagnosis
Isolation of Vibno choleras 01 or 0139 from stools in any patient with diarrhoea
Case classification
Suspected:
A case that meets the clinical case definition
Probable:
Not applicable
Confirmed:
A suspected case that is laboratory-confirmed
■ted
Note: in a cholera-threatened area, when the number of "confirmed" cases rises, shift should be
made to using primarily the “suspected “case classification.
'Cholera does appear in children under 5 years, however, the inclusion of all cases of acute watery
diarrhoea in the 2-4 year age group in the reporting of cholera greatly reduces the specificity of
resorting. For management .of cases of acute watery diarrhoea rn an area where there is a cholera
epidemic, cholera should be suspected in all patients.
RECOMMENDED TYPES OF SURVEILLANCE
Routine surveillance (this may be integrated with surveillance of diarrhoeal diseases: see acute
watery diarrhoea).
Immediate case-based reporting of suspected cases from periphery to intermediate level and central
level. All suspected cases and clusters should be investigated.
Aggregated data on cases should also be included in routine weekly/monthly reports from peripheral
to intermediate and central level.
International:
The initial suspected cases should be reported to WHO (mandatory).
Aggregated data on cases should be reported tc WHO (mandatory).
Outbreak situations:
• During outbreak situations surveillance should be intensified with the introduction of active case
finding
• Laboratory confirmation should be performed as soon as possible
• i hereafter weekly repons of cases, ages, deaths, regions, and hospital admissions should be set
up
0
WHO Recommended Surveillance Standards
October 97
31
COMMUNICABLE DISEASES SURVEILLANCE PROGRAMME
Aggregated Data Report From District Surveillance Unit For
________ Cho era, Bloody Dysentery, Acute Bloody Diarrhoea
No. of Talukas
District
Code
B
SL
No.
Name
Name of D H & F W 0
Month
Year
Copy to:
Cholera
No. of Confirmed Cases
< 6 years
M
F
Reporting
Reported
Aggregated Monthly Data Submitted tb:
Taluka
Signature
> S years
M
F
No. of
Deaths
Zero
Report
Bloody Dysentery
No. of
No. of Confirmed Cases
deaths
< 6 years
> 5 years
Zero
Report
Acute Bloody Diarrhoea
No. of
No. of Confirmed Cases
Deaths
< 5 years
> 5 years
Zero
Report
FAD-5
COMMUNICABLE DISEASES SURVEILLANCE PROGRAMME
Daily case based data for Cholera / Gastro Enteritis
__________________(To be submitted by Health Workers (M/F) to the PHC on occurrence of every suspected case)
Name of the reporting S.C.:
x
Date & month of reporting:
Name of the Officer or information:
Signature:
Report submitted to:
Copy to:
T
SI.
No.
Name of the patient
Age (yrs)
& Sex
(M/F)
Date of
onset
Identified by
Signs &
symptoms
Treatment
given
Geographic information
S.C.
Village
Motion
samples
collected
or not
Water
sample
collected
or not
Total sample
collected
Motion
Water
It-
i
Address:
Signature of reporting Authority
Date:
FCB-7
COMMUNICABLE DISEASES SURVEILLANCE PROGRAMME
Daily case based data for Cholera / Gastro Enteritis
(To be submitted by the Administrative Medical Officer of all the Medical Institutions in the district to the District Surveillance Units and D.H.& F.W.O. on
_ ____ _ _________ occurrence of every suspected / confirmed case)
_______
Name of the reporting institution:
Date & month of reporting:
Name of the Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
A
n
U_
0)
ro
Q.
(D
£
w
0)
E
CTJ
z
X
0)
(f)
od
'w'
£
On the day
Up to date
Geographic information
CD
o
I
2
0)
3c
0)
o
E
03
Q
c
o
>
Attacks Deaths Attacks Deaths Village
CD
<
i
SC
PHC Hospital
ro
E
H
Samples
collected for
culture &
examination
Cholera cases
Water samples
collected
No. of
Motion Cholera
Attacks
Deaths
samples
samples +ve
examined
Lab
results
I
Signature of the Administrative Medical Officer
(Note: Fill up the relevant columns applicable to their institutions)
FCB-8
Karnataka Health Systems Development Project
Surveillance of Communicable Diseases
Case report for Gastro Enteritis / Cholera
(To be filled up by the Medical Officer for every suspected case I contacts he examines)
A. Village
Sub-centre
Taluka
_____ District___________
PHC
Name of MO with signature:
B. Personal history of case
Name:________
Age:
Marital Status
Father / Husband
Education
Married / Single
c.
Sex: Male / Female
Primary
Nil
Occupation:_________
Address:
No. of family members:
No. having same complaints:
Secondary
University
Case History
Complaints:
Watery diarrhoea / Vomiting / Fever
Date of onset:
Last food eaten at:
Whether moved out during last 15 days:
Date:
Yes / No.
If Yes, Village/s visited:
Reasons for visit: Work / Meeting relatives / Festivals / Other (specify):
Source of drinking water: Well / Tap / Lake / River / Hand pump
Food consumed: Home made / Community food / Hotel food
Had contact with person/s with same symptoms (shared food/water/utensils): Yes / No
If Yes, Name and address of that person/s:
Type of latrine used: Open field / Service / Sanitary / Community latrine
-
Practices handwashing following defaecation: Soap / Ash / Mud / Only water__________ _
Case informed to J.H.A. at Sub-centre, Village Headman, Anganwadi, Teacher, other (specify)
Past history:
Date:
Treatment: TakerU Not taken. If taken, by whom: Pharmacy/Private practitioner/Sub-centre/Qther (specify)
D. Treatment details: Specific (Antibiotics):
Non-specific (Fluids, Antidiarrhoeals etc.):
Examination report
E. General condition:
Pulse:
Ambulent / critically ill (low BP, dehydration, signs of shock)
Temp:
BP:
Degree of dehydration: Mild / Moderate / Severe
Specific signs if any
Investigations: Vomitus sample / Stool sample
|F- Outcome
Recovered with Date:
Died (Date):
CR-1
Note: Please fill all columns. Where multiple responses/findings are given, put (^) against response
given/finding observed.
Diphtheria
A36
Diphtheria
occurs
jue*
k
reas
d cases
I
RATIONALE FOR SURVEILLANCE
-------------------------------------------- -----------—
I Dionthena is a widespread severe infectious disease that has the potential for epidemics '
i ne control o, diphtheria is based on the following three measures 1) primary prevention of disease
.y ensunng nigh populat.on immunity through immunization; 2) secondary prevention of spread bv
.ne rapid investigation or close contacts, to ensure their proper treatment. 3) ternary prevention of
“X X w i
3
dia9n°SiS 3nd pr°per cement. Surveillance data can be
used to monitor levels or immunization coverage (Target > 90%) and disease, to predict epidemics
and to monitor the impact of control programmes. Recent epidemics have highlighted the need for
scecuate surveillance and epidemic preparedness.
RECOMMENDED CASE DEFINITION
Clinical case definition
An illness characterised by laryngitis or pharyngitis or tonsillitis, and
an adherent membrane of the tonsils, pharynx and/or nose
Laboratory criteria for diagnosis
• isolation of Corynebacterium diphtheriae from a clinical specimen or
’
T T!- ifL lenjm antibOdy■(bUt only if both serurn samP'es were
the administration of diphthena toxoid or antitoxin)
before
<
Case classification
Suspected:
Not applicable
Probable:
A case that meets the clinical description
Confirmed:
A probable case that is
.o laboratory-confirmed or linked epidemiologically to a
laboratory-confirmed case
j
?gypti
Note:
Asymptomatic persons with positive C. diphthenae cultures (i.e. asymptomatic carriers)
should not be reported as probable or confirmed diphtheria cases -
RECOMMENDED TYPES OF SURVEILLANCE
--------------------- -----------------------------------Routine monthly reporting o, aggregated data of probable or confirmed cases from peripheral level
t£ intermediate and central level. . - .
Ail outbreaks should be investigated immediately and case-based data collected
International:'
Aggregated data of probable or confirmed cases from national reports should
be reported monthly to the WHO regional offices.
RECOMMENDED MINIMUM DATA ELEMENTS
Aggregated data for reporting:
• Number of cases
• DiP doses administered to infants
Case-based data
• Unique identifier
• Geographical information
• Date of birth
• Date of onset
• Date of first treatment
| • i reatment type (antibiotic & antitoxin/antibiotic only/antitoxin Only/no or other treatment/unknowr
36
HO Recommences Surveillance Standards
October 97
37
Measles
BOS
Measles
i RATIONALE FOR SURVEILLANCE
“
?
| Measles is targeted for elimination (9GPW 6.2). Surveillance for measles should evolve with each
phase of measles control. Countries in the “measles control" phase are endemic and should
concentrate on raising routine measles immunization coverage and focusing extra immunization
efforts in areas with high measles morbidity. Countnes in the more advanced “measles outbreak
prevention phase" are achieving high routine measles coverage and low incidence with periodic
outbreaks. Surveillance in these countries should be used to predict potential outbreaks and identify
risk outbreak. Countries in the most advanced “measles elimination phase" in which the objective is
to completely interrupt measles transmission require very intensive case-based surveillance to
detect, investigate, and confirm every suspect measles case in the community.
RECOMMENDED CASE DEFINmON
"
Clinical case definition
Any person with:
• fever, and
• maculopapular (i.e. non-vesicular) rash, and
• cough, coryza (i.e. runny nose) or conjunctivitis (i.e. red eyes).
or
Any person in whom a clinician suspects measles infection
Laboratory criteria for diagnosis
2 At least a four-fold increase in antibody titre or isolation of measles virus or
• Presence of measles-specific IgM antibodies
Case classification
Clinically confirmed: A case that meets the clinical case definition
Probable:
Not applicable
Laboratory-confirmed A case that meets the clinical case definition and that is laboratory
<
confirmed-or linked epidemiological tc-a laboratory-confirmed case
RECOMMENDED TYPE(S) OF SURVEILLANCE
“
Control phase: When measles is endemic, routine monthly reporting of aggregated data of clinical
cases from peripheral to intermediate and central level. Only outbreaks (not each case)
should be investigated.
International: routine monthly reporting of aggregated data specifying geographical area
and month of onset from central level to WHO regional offices.
Outbreak prevention phase: When low incidence is achieved with periodic outbreaks due to
accumulation of susceptibles, routine monthly reporting of aggregated data of clinical cases
from peripheral to intermediate and central level. All suspected outbreaks should be
investigated immediately and case-based data collected. Suspected epidemics should be
confirmed by conducting serology on the first few cases only.
International: routine monthly reporting of aggregated data of clinical cases specifying
geographical area, month of onset, age group and immunization status
Elimination phase: Case-based surveillance should be conducted and every case reported and
investigated immeciately from peripheral level to intermediate level, and also included in the
weekly reporting system. Laboratory specimens should be collected on every case.
WHO Recommended Surveillance Standards
October 97
73
zz
A37.0
Pertussis
(Whooping cough)
^RATIONALE FOR SURVEILLANCE------------------------------------------------------
neurological sequelae. Case fatality in devXinc rn n
'
50 000 develoP '°ng-term
with effective vaccine is the mainstay of prevention Surve H 030
j the ^pactoj Nation on diseasZincSe^^
15%' H'9h r0Ufine coveraSe
I RECOMMENDED CASE DEFINrfioN---------------Clinical case definition
A person with a cough lasting at least 2 weeks with
one of the following
• paroxysms (i.e. fits) of coughing,
inspiratory “whoop"
™in 9
Laboratory criteria for diagnosis
• isolation of Bordete/la pertussis, or
antigen (FHA/
antigen (FHA).
d'rected toward Pertussis toxin (PT) or filamentous hemagglutinin
Case classification
Suspected:
A case that meets the clinical case definition >
Confirmed:
laboXio'aboratcr^nfirrned or linked epidem.ologica! to a
’3^MENDE5^PES^FsURVEliOT^------ -------- -------------- —---------- —
cases from peripheral
where coverage is >80%).
*
e e in countries with low pertussis incidence (usually
«“ “,”™d
In.ematona!:
«
y survei,lance reports of all countnes to WHO regional offices.
"RECOMMENDED MINIMUM DATAELEMENTS---------------------------------------------- ----Aggregated data for reporting
Number of cases
Completeness/timeTessSSirrElrtr6^^5
(DTP3) administered t° infants
Case-based data for investigation and reporting
dos^s.
October 97
85
Communicable Diseaes Surveillance Programme
Case-based Data for Diphtheria (A 36)
(To be submitted by Administrative Medical Olllcers of all I lealth Institutions from Pl 1C/CI IC/ll.! I/Any other 1 lealth Institutions to District Surveillance Ollleer & DI IX1WO
on (Kcurancc of every
_____ __________________
suspectcd/confirmed case)
Name of Reporting Institution:
Month & Year of Reporting:
Name of Adm. Medical Officer:
Report submitted to:
SI.
No.
Name
Signature:
I
Copy to:
Age (Yrs.)
Identified
& Sex (M/F)
Outcome :
Died-D,
Cured-C,
Referred-R
(name ref.)
Date of
onset
Geographic Information
Treatment
I
Village
Sub-center
Date started
Antibiotic &
Antitoxin
Type
Antibiotic
alone
No or other
treatment
DP f Vaccine
Whether
received
Y/N. If Y
Date of Last Dose
total doses
received.
FCB-3
Dengu^
A90, A91
definite
ase of
mcally
Dengue Fever (A90J, including Dengue Haemorrhagic Fever and
Dengue Shock Syndrome (DHF & DSS, A91)
>
----------------------- ------------—___________
, RATIONALE FOR SURVEILLANCE
IS »e«S jJXSXST"
Dgicai
j
VW asease »o«.
? tropical and
J
S t0 accelerate the final development of attenuated dengue vaccine.
jhted
RECOMMENDED CASE DEFINITION
--- -------------- -------- —
i DENGUE FEVER
! Clinical description
iy of
.
yaigia, artfiralgia, rash, haemorrhagic manifestations, leucopenia
Laboratory criteria for diagnosis
one or more of the following:
• Isolation of the dengue virus from serum, plasma, leukocytes, or autopsy samples
• Demonstration of a fourfold or greater change in reciprocal IgG or IgM anfcody Xes to
more dengue v.rus antigens in paired serum samples
9M antibody titres to one or
Demonstration of dengue wrus antigen in autopsy tissue by immunohistochemistrv or
immunofluorescence or in serum samples by EIA
unonisrocnemistry or
■
ciSeql'en“S in au“^
Case classification
Suspected:
A case compatible with the clinical description
Probable:
t CTuennoZ^ble 7lth
CliniCal descnPtion
sampies p, p0,ymen,se
one or more of the following:
supportve serology (reciprocal haemagglutination-iohibition antibody titre >
Confirmed:
conval^r PThe-'9G EiA
°r P°SitiVe 'gWan^ody test in late acute or
convalescent-phase serum specimen)
>
A caTe^nmnlfhi SaTe l.OCatiOn and t,me as Otfler confirmed cases of dengue fever
case compatible with the clinical description that is laboratory-confirmed
§.X™XRoXXXEMORRHAG'c fever and dengue sh°<* syndrome
A probable or confirmed case of Dengue
and haemorraghic tendencies evidenced by
one or more of the following
positive tourniquet test
petechiae, ecchymoses or purpura
bleeding from mucosa, gastrointestinal tract, injection sites or other sites'
• haematemesis or melena
and thrombocytopenia (100 000 cells per mm3 or less)
and evidence of plasma leakage due to increased vascular permeability manifested
•
•
H
by one or more one of the following:
a rise in average haematocrit for age and sex > 20%
to"baselint™13
haemat0Cnt fol,owin9 volume replacement treatment compared
•
signs of plasma leakage (pleural effusion, ascites hypoproteinaemia)
WHO Reoc.-r.mended Surveillance Standards
October 97
35
Dengue shock syndrome-.
?
------- —
All the above criteria for DHF plus evidence of circulatory failure manifested by
rapid and weak pulse, and narrow pulse pressure (<20 mm Hg)
or
hypotension for age, and cold, clammy skin and restlessness
RECOMMENDED TYPES OF SURVEILLANCE
--------------------------------------------Areas where no dengue transmission has been detected but where Aedes aegypti occurs
Surveillance of suspected cases with investigation of clusters of suspected cases for dengue.
Countries where disease is endemic with seasonal increases in transmissio
n and areas
where epidemic dengue occurs
Routine weekly/monthly reporting of aggregated data of suspected, probable and confirmed cases
from penpheral to intermediate and central level.
RECOMMENDED MINIMUM DATA ELEMENTS
Date of onset
Hospitalised (Y/N)
Outcome
2 week travel history
Aggregated data for reporting
Number of cases by age group
Number of confirmed (and serotype)
Number of DHF/DSS cases by age group
Number of hospitalisations and deaths
RECOMMENDED DATA ANALYSES, PRESENTATION, REPORTS
Percentage of DHF/DSS cases and of hospitalisations'
Case fatality
PRINCIPAL USES OF DATA FOR DECISION MAKING
• i ar9et high risk areas for intervention
• Monitor changes in serotype and rate of DHF/DSS
• Monitor trends in endemic disease or re-emergence of disease
SPECIAL ASPECTS
7
- -------------- —------------------------------------------------------ ::—
Parallel to disease surveillance, vector surveillance of both larval and adult populations of~A. aegypti
C O NTA CT
--------------- -------------------------Regional offices
See Regional Communicable Disease contacts on pages 15-20
Headquarters
WHO Division of emerging and Other Communicable Diseases Surveillance and Control (EMC)
20 Avenue App.a, CH-1211 Geneva 27, Swteerland
I tc-mail: arthurr@who.ch / outbreakemc@who ch
i Tel: (41 22) 791 2658/2850/2111
' Fax: (41 22) 791 4878
■A'HO Recommended Surveillance Siandards
October 97
36
Communicable Diseases Surveillance Programme
Dengue Fever Including Dengue Haemorrhage Fever (DHF) and Dengue Shock Syndrome (DSS)
Case based data for reporting and Investigation : All PHCs/PHUs submit to Dlst.
Surveillance M.O and copy to T.M.O on occurance of suspected case
|
Code
I
B
SI.
No.
Name
Age(Yrs)
& Sex
(M/F)
Case
classification :
suspected (S)
Probable (P)
Date of
onset
I
Identifier
Geographic Information
Village
Subcenter
2 Wk. Travel
History (Name all
places visited)
DHF/DSS
Present
Y/N
Whether
Outcome: Died-D
Hospitalized
Cured - C
Y/N
Referred - R
(Mention Place)
GZ —
3
v___
A
FCB-1
Communicable Diseases Surveillance Programme
Aggregated Data for Monthly reporting
Dengue Fever including Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome
_______________ To be submitted by Administrative Medical Officers of all Health Institutions on occurance of every suspected/confirmed case
Name of Reporting Institution:
Month & year of reporting:
Name of Administrative Medical Officer:
*
Signature:
Report submitted to:
SI.
No.
___ Number of all cases
15 yrs
> 15 yrs
Copy to;
No.
Confirmed
Total
No.
Hospitalized
No. of Cases
DHF
15 ^rs
> 15 yrs
< 15 yrs
15 yrs
No. of Deaths
DSS
< 15 yrs
Zero Report. (If no cases
occurred mentiond NIL)
> 15 yrs
FAP&D-2
Rabies
A82
Rabies
1 RATIONALE FOR SURVEILLANCE
~
man deaths are ^Imated to occur
' each year world-wide most cXm n m h
a..ee.
i5
RECOMMENDED CASE DEFINITION
~
-------- -—-----------------Clinical description
'
acu‘e neuro'o9,cal syndrome (encephalitis) dominated by forms of hyperactivity (furious rabies)
or para yt.c syndromes (dumb rab.es) that progresses towards coma and death usuady bv
or scratch from a suspected anim I
'
u
intensive care are instituted. Bite
or scratch from a suspected animal can usually be traced back in the patient medical history The
.ncubation penod may va^ from days to years but usually falls between 30 to“s
Laboratory criteria for diagnosis
one or more of the following
Section Sv JUA°reSTnt ant'bOdy (FA) On brain
brain tissue
coi,ec;ed post
P^t mortem)
mortem)
tissue ((collected
Detection by FA on skin or corneal smear (collected ante mortem)
• FA positive after inoculation of brain tissue,
.
sa,jva or CSF in cell culture, mice or suckling mice
• Detectable rabies-neutralising antibody titre in CSF of
an unvaccinated person
• Identification of viral antigens by PCR on fixed tissue collected post m.ortem or in a clinical
specimen (brain tissue or skin, cornea or saliva)
t
. • -
Case classification
HUMAN RABIES:
Suspected:
A case that is compatible with the clinical description
Probable:
^suspected case with an history of contact with a suspected rabid animal
Confirmed:
A suspected case that is laboratory-confirmed
HUMAN EXPOSURE TO RABIES:
Possibly exposed: A person who had a close contact (usually a bite or scratch) with a rabies
susceptible animal in/or originating from a rabies infected area '
Exposed:
A person who had a close contact (usually a bite or scratch) with a laboratoryconfirmed rabid animal.
RECOMMENDED TYPES OF SURVEILLANCE
----------- - ----------------SURVEILLANCE IN HUMAN POPULATION:
SUrVreeporro^Xmac:n e*P°SUre to rabies: At PeriPheral level especially in rabies infected area,
P
of patients with a history or animal contact (usually a bite/scratch) should b*
bTpri Ann ya 'nves^^ed snd when re^uired they should be treated as an emergency. Case
level
Sgregated data must oe sent regularly from peripheral to intermediate and central
WHO Recommenced Sun-eillxnce S:xidards
Oc:ober 97
93
Human Rabies (A 82)
Case-based data on Human Rabies Exposure on Suspected/Probable cases
To be submitted by all Health Institutions Monthly (i’HC and above)
Name of Reporting Institution:
Month & Year of Reporting:
Name of Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
I
SI.
No.
Name
Age
Identifier Geographical Information Information on
(Yrs.)
Village
Sub-center
Date
Immunization History
Place Vaccination Serum
Biting Animal
Outcome:
Vaccinated
Died-D,
Y/N
Alive-A
Treatment
Local
Outcome:
Died-D,
Alive-A
System
I
FCB-4
Aggregated data on Human Rabies Exposure (Dog Bite)
To be submitted by all Health Institutions Monthly
Name of Reporting Institution:
Month & Year of Repprting:
Name of Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
SI.
No.
4———.
Place
Exposed to Bites
Biting Animal
__ _________________________ Ou tco m e
Man: Died-D, Alive-A, Unknown-U Animal : Died-D, Alive-A, Unknown-U
I
FAP&D-3
’
t
Acute lower respiratory tract infections (aLRTI) and Pneumonia
Acute lower respiratory tract infections (aLRTI)
and Pneumonia
| -RATIONALE FOR surveillance----------------------------------- --------- ----------- ---------------------------
recommended case definition------------------------------------------------------------ ---Clinical case definition and classification
PNEUMONIA
Symptoms Cough or difficult breathing and
Signs:
and
breathing faster than 50/min for child 2-12 months
breathing fasterthan 40/min for child 1-5 years
No chest indrawing, stridor or danger signs
SEVERE PNEUMONIA
Symptoms : Ccugh^ or difficult breathing + any danger sign or chest indrawing or stridor
Danger Signs:
For child 2 months to 5 years
Not able to dnnk or breast feed, vomits everything, convulsion, lethargic or
unconscious
For child under 2 months
stopped feeding well, convulsions, lethargy or unconscious, wheezing fever or low
body temperature
a
■
Note: Chest indrawing + recurrent wheeze = asthma, probably not pneumonia
RECOMMENDED TYPES OF SURVEILLANCE
-------------------------------------- ----------------r
"e r2ontflfy aggregated reporting from penpheral level to intermediate and central level
programme IrtvE
SL'rVei"ance t0 “mPlement routine data and for evaluation of control
I
Sentinel surveillance reporting monthly to intermediate and central level.
uarteriy reporting of community/household surveys from penpneral to central level.
RECOMMENDED MINIMUM DATA ELEMENTS
-----------------Aggregated data for reporting
Number of cases by age, severity , geographical area, treatment(Y/N), hospitalisation (Y/N),
outcome
WHO Recommended Surveillance Standards
October 97
113
Acute Lower Respiratory Tract Infection (ALRTI) & Pneumonia
Aggregated Monthly Data Reporting from all Health Institutions (PHC to District Hospital)
Name of Reporting Institution:
Month & Year of Reporting:
Name of Administrative Medical Officer
Signature:
Report submitted to:
Copy to:
A
SI.
Name of unit
No.
Number of Cases
Pneumonia____________
______ Age Grou )________ # treated # Hospitalized
upto 1 yr 1-3 yrs 3-5 yrs
# Died
Severe Pneumonia
Age Group_______ # treated # Hospitalized //Died
upto 1 yr 1-3 yrs 4-5 yrs
t
FAP&D-l
Foodborne diseases
Foodborne diseases
"’rationale for surveillance
----------------------------------------- —
A foodborne disease is a disease, usually either infectious or toxic in nature caused bv aq=nts that
I X u
y troU9 .:n9eSt'On Of f00d or ^nk'ng-water. In addition to diseases ment.on'd’m the
| manual (e.g. salmonellosis, cholera, shigellosis, hepatitis A...) surveillance of other foodbofne
j
Ch
6 Camed °ut- The surveil|ance helps to determine the magnitude and trend of
• oodborne diseases and to monitor and evaluate food safety.
Surveillance is also needed for early detection and control of outbreaks, and identification of risk
-actors, as well as planning and evaluation of interventions.
! RECOMMENDED CASE DEFINITION
Clinical case definition
i he clinical case definition varies with the specific disease
Laboratory criteria for confirmation
isolation of pathogen
Case classification
Suspected:
A case that meets the clinical case definition of a specific foodborne disease
Probable:
Not applicable
Confirmed:
A suspected case in whom laboratory investigation confirms the presence of one or
more foodborne pathogens in a clinical specimen
Outbreak:
An incident in which two or more persons experience a similar illness after what is
thought to have been a common exposure (ingestion of the same food or inqestion
of water of the same source)
RECOMMENDED TYPES OF SURVEILLANCE
d'ate leve'(not,ficat'ons). Routine weekly reporting of aggregated data on suspected and
confirmed cases from penpheral to intermediate and central level
.nJ>pUrtmLW!ek'y2aSe'baSed °r a99re9ated sporting from laboratories on. confirmed cases to
intermediate and central level
Sentinel surveillance (utilising reporting physicians or laboratories) '
• Community studies
^rnrnKel|SUrVe'illalCe °r cornmunity studies can provide more detailed epidemiological and
imoact of A
lnforrTlatlon- ^ese systems may give a better picture of the true incidence and
noueoresent
defined poPulatlon- However they are likely to miss outbreaks and as such do
Oi represent a vahcLapproach.to outbreak detection.
All outbreaks should be investigated and notified to the intermediate and central level.
International: All major foodborne disease outbreaks, particularly those implicating a commercial
product, should be reported to the Programme of Food Safety and Food Aid, WHO
(Global databank on foodborne diseases (notified cases); global databank on
foodborne disease outbreaks (underdevelopment), and regional programmes for
surveillance of foodborne diseases).
Note : A minimum data set should be collected on each outbreak at intermediate and central level
I his should be done after the outbreak investigation and should include key vanaoles
describing the nature and extent of the outbreak.
WHO Recommended Surveillance Standards
October 97
129
FOOD BORNE DISEASES
Case-based data at PHC : For records
Name of Reporting Institution:
Month & Year of Reporting:
Name of Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
*
SI.
No.
Name
Age
(Yrs.) &
Identifier Geographical Information Date of
Sex
Onset
(M/F)
Village
Sub-center
Diagnosis
Travel History
Food
Nature
Place
purchased
prepared &
consumed
t
FCB-5
FOOD BORNE DISEASES
Aggregated Monthly Data Reporting from PHC
Name of Reporting Institution:
Month & Year of Reporting:
Name of Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
*
SI.
No.
Sub-centre
Number of cases
1-15 yrs.
Age group
16-45 Yrs.
Sex
>45 Yrs.
M
F
T
!
FAP-1
FOOD BORNE DISEASES
Aggregated Monthly Data Reporting from District
Name of Reporting Institution:
Month & Year of Reporting:
Name of Administrative Medical Officer:
Signature:
Report submitted to:
Copy to:
£
SI.
No.
Taluka
Number of cases
1-15 yrs.
Age group
16-45 Yrs.
Sex
>45 Yrs.
M
F
FAD-1
FOOD BORNE DISEASES
Aggregated data from District Laboratory
Name of Reporting Institution:
Name of Adm. Med. Officer:
Report submitted to:
“sT
No.
Taluka
Month & Year of Reporting:
Signature:_____
Copy to;
PHC
Number of confirmed cases
-----
1-15 yrs.
M
F
Age group
J6-45 Yrs.
M
F
Name of Organism
>45 Yrs.
M
'F
i
FAD-2
Plague
A2Q
Plague
(human)
I
CaSe repOrt univerS3Uy required by international Health Regulations ’
.
^RATIONALE FOR SURVEILLANCE
- ----------------------------------- ----------- -
animal disease is imporTa^topreX^and 0^^3 epidem'C Potent'al- Surveillance of human and
report universe «
'^StionXSth^^XX?
meaSUrSS CaSe
“recommended castdefinition----- -----------------------------------------Clinical description
opx^enxv° xxr1'a,rea
weaM—
or respiratory
°nset fever’ chills, headache, severe malaise, prostration with
for Pnelrmoniff eXtreme painful swelling of lymph nodes (buboes)
orm. cough with blood -stained sputum, chest pain, difficult breathing
Laboratory criteria for diagnosis
: speelfe
S2X for Fl artgeo of Y pek (H1 SSf'S
4 C.SF or“SMi
”
“X
“’H8’ " an6b°dY
Case classificatio n
Suspected:
A case compatible with the clinical description
coccoS ?n°tr?e-STP0?d by 'abOratOry find'ng of GrarT1 stain negative bipolar
Probable:
’
du5?'76 FA teSt for Y- pestis in clinical specimen or '
F1 «sen of Y.p«s
‘ as dXS Sh*''
or
Confirmed:
Epidemiological link with a confirmed case.
A suspected or probable case that is laboratory-confirmed
recommended typeTof surveillance---------- -------------------- ---------------------intemSe a^ceSaltev^Laborl^T 9 °?USpeCted 03563 from Peripheral level to
pertain in all situations
' Lab0rat0ry ba3ed reP°rting of all confirmed cases should
DunSe^ab™rka^tsrsz:S"?es™"8 and “bBa
environmental measures and community education" "a363
35 ^''h9
ssummarize
.. *5Zcontrol
oSS'XwTZ
±?Xac2as 85'r','men'stt,us a"d Ytei
measures taX and thnX 7 Sl<m(manze the outbreak situation and
insures taxon and those planned to interrupt the outbreak.
International: Mandatory reporting of all suspected and confirmed cases within 24 hours to WHO.
WHO Recommended Surveillance Standards
October 97
87
Plague (Human) (A 20)
Case based data for reporting and investigation : PHC
Name of Reporting Institution:
Month & Year of Reporting:
Name of Adm. Medical Officer
Signature:
Report submitted to:
Copy to:
SI.
No.
Name
---------Age (yrs)
& Sex
(M/F)
Identifier
Geographical
Information
Clinical Syndrome
Bubonic: B
Pneumonic: P
Contact
with
Flea bites
Rodents
Y/N
Y/N
Household contact
Previous
week Y/N
Name
Place
l
FCB-6
Plague (Human) (A 20)
Case based data at District level
Name of Reporting Institution:
Month & Year of Reporting:
Name of Adm. Medical Officer:
Signature:
Report submitted to:
Copy to:
*
SI.
No.
Name
Age (yrs) &
Sex (M/F)
Identifier
Geographical Area
Taluka
PHC
Sub-center
No. of contacts
Village
Identified
T reated
I
l
FCB-6
ANNEX 1
Surveillance Definitions
Active case-finding The dynamic identification of the occurrence of a disease or health event under
surveillance, (e.g. house visits by community workers to identify cases of tuberculosis).
Active surveillance FRoutine surveillance where reports are '
' ' dynamically
'
sought
from participants in
the surveillance systemi on a regular basis (e.g. telephoning each participant monthly to ask about
t new
cases).
Aggregate surveillance The surveillance of a disease or health event by collecting summary data on
groups of cases (e.g. in many general practice surveillance schemes clinicians are asked to report the
number of cases of a specified diseases seen over a period of time)
Attack rate i he proportion of those exposed to an infectious agent who become (clinically) ill.
Case A person who meets the case definition.
Case definition
A set of diagnostic criteria that must be fulfilled to be regarded as a case of a
bS“a " “ Cn""a'
’
ase classification Gradations in the likelihood of being a case (e.g. suspected/probable/confirmed)
This is particularly useful where early reporting of cases is important (e.g. Ebola haemorrhagic fever)
and where there are difficulties in making definite diagnoses (e.g. specialised laboratory tests
required).
1
Case-based surveillance The surveillance of a disease by collecting specific data
on each case (e.g.
collecting details on each case of Acute Flaccid Paralysis in polio surveillance)
Case fatality rate The proportion of people who die
as a proportion of all cases. This will vary
depending on the case definition used.
Cluster The occurrence of an unusual number of cases in person, place or time.
Community surveillance Surveillance where the starting point is a health event occurring in the
community and reported by a community worker or actively sought by investigators. This may be
particularly useful dunng an outbreak ancTwhere syndromic case definitions can be used, (the active •
i entification of community cases of Ebola virus infection in Kikwit was an example of this type of
surveillance)
7
Comprehensive surveillance The surveillance of a specified disease or health event in the whole
population at nsk format event, (e.g. AFP surveillance)
Contact An individual who has had contact with a case in a way that is considered to have cause
significant exposure and therefore risk of infection.
Due dates The dates by which reports from a specified penod should be received by the each level of
a surveillance system, (used to calculate timeliness)
Endemic The constant presence of a disease within a given geographic area or population group.
Enhanced surveillance
The collection of additional data on czccc
cases reported under routine
surveillance. The routine surveillance is a starting point for more specific data
-------collection
—on a given
health event. This information may be sought from the reporter, the case, the laboratory or from
anothe.' surveillance data set.
Epidemic ’The occurrence of cases of an illness clearly in excess of
expectancy. This is often
referred to as3 an outbreak (more neutral).
WHO Recommended Surveillance Siandards
October 97
131
Epidemiological case definition The definition of a case used for rerorrinn ‘n thQ
system. The definition may be clinical, laboratory or both. It may relate to a
meas es, yellow fever) or may identify a syndrome (e.g. meningitis, AFP)
,sease (e-S-
Exception nagging (reporting) system an automatec system of data
analysis which calculates
mresholds for unusual events or exceptions.
Exposure Someone who has met with an infectious agent in a way that we from
experience know
may cause disease has been exposed.
Feedback The regular process of sending analyses
and surveillance reports on the surveillance data
back through all levels of the surveillance system so i
at ail participants can be informed of trends and
performance.
Health event Any event relating to the health of
an individual (e.g. the occurrence of a specific
disease or syndrome, the administration of a vaccine
or an admission to hospital)
Hospital surveillance Surveillance
f
where the staring point for a report is the admission of a patient
to hospital with a particular disease or syndrome.
Incidence The number of persons who fall ill with
a certain disease during a defined time period
Intensified surveillance The upgrading from a passive to an active surveillance system for a
specified reason and penod (usually because of an outbreak). It must be
noted that the system
becomes more sensitive and secular trends may need to be interpreted carefully.
Laboratory surveillance Surveillance where the starting point is the identification
or isolation of a
particular organism in a laboratory, (e.g. surveillance of salmonellosis)
where for examole a hp^th
th
em where reP°^n9 is by law. Another may occur
diseases. Thls
Is us^
Notifiable disease A disease that must be reported to the authorities by law or ministerial decree." ' -
Outbreak The occurrence of two or more linked cases of an communicable disease
sp=k
Routine surveillance where reports are awaited and
no attempt make actively
seek reports from the participants in the system.
> a parficular cfisease'or svnd
Where the stann9
a report is a new consultation for
particular disease or syndrome with a pnmary care physician or health worker at a clinic.
Performance indicators Specific agreed measurements of how participants
areoffunctioning
within
■ ie surveillance system. These indicators may measure both' the process
r-nnrtinn
n
“,ion Bten «
•>
InSion <K % Jses
a
.
..IScl,e a0/d the l,T,Pact of surveillance and control measures on the disease or syndrome in
stion (e.g. A of outbreaks detected by ths system, % drop in cases over a specified time penod).
yearoSthI o* weekT
Prevalence
WHO
" fePeatin9
°f eXCSSS CaSeS'
rePe3ter Can be in
The number of persons who have a disease at a specific time
Pr0p0rf°n Of a,! ex3ec:sd reP°*s th3t
-commenced Sun'cillance Staodzrds
October 97
actually received (usually
132
So
statec as "% completeness as of a certain date").
Reporting timeliness Proportion of all expected reports that were received by a certain due date.
w
Reporting system The specific process by which diseases-.or health events are reported. This will
v depend on the importance of the disease and the type of surveillance
Routine surveillance
—r
sp
Pr
The regular systematic collection of specified data in order to monitor a
S':
disease or health event.
Sentinel surveillance The surveillance of a specified health event in only sample of the population at
risk using a sample of possible reporting sites. The sample should be representative of the total
E
n
E
l
population at risk.
i
Serosurveillance The surveillance of an infectious disease by measuring disease specific anybodies
in a population or sub-population
Surveillance The systematic collection, collation and analysis of data and the dissemination of
information to those who need to know in order that action may be txiken.
Surveillance report A regular publication with specific information on the disease under surveillance.
It should contain updates of standard tables and graphs as well as information on outbreaks etc. In
addition it may contain information on the performance of participants using agreed performance
indicators.
Surveillance sensitivity The ability of a surveillance system to detect an outbreak. (The proportion of
all outbreaks that could have been detected by the system)
Surveillance predictive value The likelihood that an “outbreak" selected by a surveillance system is
truly an outbreak
'
-
Survey An investigation in which information is systematically collected. It is usually carried out in a
sample of a defined population group and in a defined time period. Unlike surveillance it is not ongoing
though it may be repeated. If repeated regularly surveys can form the basis of a surveillance system.
■>
Unusual event The occurrence of a disease or health in excess of the expectation. This expectation
is a either a static or dynamic threshold set by the system
-------> have been detected by the participant,
Zero reporting The reporting of zero cases when no
cases
the participant has not sent data that has been
This allows the next level of the system to be sure that
t
lost or has foi^otten to report
-•
•
►
WHO Recommended Surveillance Standards
October 97
133
R
Reporting Formats
SI.
Disease
Type of Formats
No.
Case based data
Aggregated Monthly Report__
Periphery (PHC/PHU)
Intermediate (District)
1
Dengue Fever
FCB-1
FAP&D-2
FAP&D-2
2
Diphtheria
FCB-3
FAP-2
FAD-4
3
Measles
FAP-2
FAD-4
4
Pertussis
FAP-2
FAD-4
5
Japanese Encephalitis
6
Acute Viral Hepatitis
7
Meningococcal Disease
8
Rabies
9
Acute Lower Respiratory Infection & Pneunonia
10
Food Borne Diseases
11
Cholera
12
Bloody Dysentery
FAD-5
13
Acute Bloody Dysentery
FAD-5
14
Plague
FCB-6
15
Cholera & Gastro Enteritis
CR-1
FCB-2
FAD-3
i
FAD-3
FAD-3
FCB-4
FCB-5
FCB-7, FCB-8
FAP&D-3
FAP&D-3
FAP&D-1
FAP&D-1
FAP-1
FAD-1, FAD-2
FAD-5
- Media
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