Upload
zenagit123456
View
218
Download
0
Embed Size (px)
Citation preview
8/2/2019 7. Surveillance
1/33
Su r v e i l l ance f o r Hu m an Cases o fAv i an I n f lu e n za
8/2/2019 7. Surveillance
2/33
Manag in g Hum an Av ianI n f lu enza: St r a t eg ies a t a Glan ce
An im a l H ea lt h D ep t t .
Quarantine of bird
Culling of bird
Mopping-up
Disinfection & sanitisation
Vaccination of bird
Poultry surveillance
Other aspects
H um an Heal t h D ep t t .
Quarantine of human populations
Surveillance:
Active (0-3 km & 3-10 km)
Passive (0-10 km)
Health monitoring Chemoprophylaxis
Case management:
Isolation
Antivirals Ventilatory support
Lab investigation
Control room set-up
IEC
Logistics
8/2/2019 7. Surveillance
3/33
Ev en t Based Hu m an Su r v e i l l an ce
Outbreak
Outb reak
Ou t b reak
Outb reak
Outb reak
Outb reak
Outb reak
Outbreak
8/2/2019 7. Surveillance
4/33
Tr igg er Po in t f o r Cent r a l RRT
Report ofdetecting HPAI
from HSADLBhopal; NIV,Pune
Report of bird
death from District
Animal Husbandry
Officer/ChiefVeterinary Officer
Report of influenzalike illness with
travel history orcontact historysuggestive of avianinfluenza exposure
A V I A NI NFLUENZ
AMONI TORI
NGCELL,
NICD, Delhi
RapidResponse
Team
Media or otherreport
8/2/2019 7. Surveillance
5/33
W h at i s Su r v e i l l an ce?
Surveillance of disease is the continuing scrutiny of
all aspects of occurrence and spread of a disease
that are pertinent to effective control
Keeping a close watch
8/2/2019 7. Surveillance
6/33
Com po n en t s o f Su r v ei l l an ce
1. Collection of data
2. Compilation of data
3. Analysis of data
4. Interpretation
5. Action/Intervention
6. Feedback
8/2/2019 7. Surveillance
7/33
Dat a Co l lect ion Pr ocedu r es
1. Passive surveillance
2. Active surveillance
3. Sentinel surveillance
4. Outbreak investigation
5. Surveys
8/2/2019 7. Surveillance
8/33
Su r v e i l l ance f o r Hu m an Caseso f Av i an I n f l u en za Fever with ARI + history of contact
with dead/sick poultry
Passive: any in no. of cases in
OPDs of health facilities/privatepractitioners
Act i ve :
house to house
0-3 km & 3-10 km About 95% of targeted population
covered in 0-3 km daily up to 10days after last culling
3-10 km: one round completed in 3-4 days
500 popn=1HW; 4 HW=1 HS; 4 HS=1 MO
8/2/2019 7. Surveillance
9/33
Proforma: line list format
Name of affected area
No. of surveyed villages No. of houses: Total & visited
Population: Total & visited
No. of fever & ARI cases No. of fever & ARI cases, who handled dead birds
No. of houses having birds & observed death of
birds in last 10 days
Contact tracing
Act iv e Su r v e i l l ance
8/2/2019 7. Surveillance
10/33
Av i an I n f l u en za Ou t b r eak Dai l y Repor t i ng Fo r m at
8/2/2019 7. Surveillance
11/33
Av i an I n f l u e n za Ou t b r eak Da i l y Repor t i ng Fo r m at
8/2/2019 7. Surveillance
12/33
Act iv e Su r v e i l l an ce Lin e Lis t o f Cases
8/2/2019 7. Surveillance
13/33
Cas
eInv
estig
ation
She
et
N am e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Sex ___ ___
A ge i n Yea r s/ m o n t h s_ _ _ _ _ _
Cu r r e n t co n t a ct d e t a il s_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Fu l l ad d r e ss _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
T e l e p h o n e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
N at i o n al i t y _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
E t h n i c i t y _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Signs and sym p t om s :
Body t em pe r a tu r e h i ghe r t han 38 C Yes No Unkn ow n
Cough Yes No Unknow n
Sore th roa t Yes No Unknow n
Shor t ness o f b rea th Yes No Unknow n
Dat e of o nset o f i l ln ess ( d d / m m / y y yy ) _ _ _ _/ _ _ _ _/ _ _ __
History of travel.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hist or y o f o ccup at ion al ex po sur e.. . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .
Hist or y of ex posu re t o af f ected pou l t ry . . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .
His tor y o f exp osure t o w i ld / dom est ic an im als .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
Hist or y of ex posu re t o possib l e h um an cases.. . .. .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. .
8/2/2019 7. Surveillance
14/33
902208
1622879
2525087
852563
1304284
2156847
0.41%
0.08%
0.21%
0
500000
1000000
1500000
2000000
2500000
3000000
0-3 Km 3-10 km Total
Area
To
talPopulation&Surveyed
0.00%
0.05%
0.10%
0.15%
0.20%
0.25%
0.30%
0.35%
0.40%
0.45%
%F
ever-ARIcase
s
Total Popn SUV Popn % Fever-ARI cases
Act i ve Su r v e i l l an ce : Popu la t ionSu r veyed & I n cidence Ra t es o f
Fever-ARI Cases, Av ian I n f lu enzaOu t b r eak , Ja rg on , 2 0 0 6
94.5%
80.4%
85.42%
8/2/2019 7. Surveillance
15/33
8/2/2019 7. Surveillance
16/33
Con t act Tr acin g
Information about close contacts can be obtained from:
interviews of patient, family members, workplace
or school associates, or
others with knowledge about the patients recent
activities and travels
If no. of contacts requiring investigation is large or
personnel resources are limited - focus on contacts withthe highest risk of infection or exposure
8/2/2019 7. Surveillance
17/33
Con t act Tr acin g
Priority groups should be based on:
Heightened probability of infection, such as contact
with a laboratory confirmed case
Duration, spatial proximity and intensity of exposure
to the case patient (e.g. HCW, household contacts
sharing same sleeping/eating space, persons
providing bedside care)
Exposure in settings that could accelerate spread to
large numbers of contacts, e.g. when a confirmed
case worked in a school or attended a large
gathering
Likelihood that human-to-human transmission hasresulted from contact with the case patient
8/2/2019 7. Surveillance
18/33
Con t act Tr acin g
Whenever possible, cases should be isolated in health
facilities for strict infection control
Contacts should be advised to remain at home
(voluntary home quarantine) for at least 7 to 10 daysafter the last contact with a person under investigation
Should evidence of spread beyond the initial
containment zone emerge: containment areas designated for antiviral
prophylaxis should be re-defined
decision to be made in collaboration with local &national authorities and WHO
8/2/2019 7. Surveillance
19/33
8/2/2019 7. Surveillance
20/33
Con t act Tr acin g
For symptomatic persons:
refer persons with fever & respiratory illness for:
collection and laboratory testing of specimens and
appropriate medical care including antiviral
therapy
depending on the severity of illness and availability of
hospital beds, contacts that are ill may be isolated at a
healthcare facility or at home while awaiting test
results
8/2/2019 7. Surveillance
21/33
Con t act Tr acin g
For asymptomatic contacts:
initiate active monitoring (e.g. daily visits or
telephone calls) for the development of fever or
respiratory symptoms for 7 days after the last
exposure to the case patient
self-health monitoring with daily supervision may
be advised
administration of antiviral chemoprophylaxis
should be guided by an exposure risk assessment
8/2/2019 7. Surveillance
22/33
I m p or t an t Ter m s
I so la t i on : Separation (for the period ofcommunicability) of infected persons from others in such
places and under such conditions so as to prevent or limit
the direct or indirect transmission of the infectious agent
from infected to non-infected persons or who may spreadthe agent to others
Quaran t i ne : Restriction of the activities of apparently
healthy persons who have been exposed to a case ofcommunicable disease during its period of
communicability to prevent disease transmission during
the incubation period if infection should occur
Soc ial d is t anc ing : public health practice of encouraging
people to keep physical distance from each other during
disease outbreaks in order to slow the spread of infection
8/2/2019 7. Surveillance
23/33
Sel f Heal t h Mon i t o r i ng Pr o fo r m a
8/2/2019 7. Surveillance
24/33
Clu st e r Repor t in g For m at
8/2/2019 7. Surveillance
25/33
8/2/2019 7. Surveillance
26/33
Tr a in in g o f St a f f
W h o
Medical officers
Health supervisors Health workers
On W ha t
Case definition
Active surveillance Proforma
Chemoprophylaxis
IEC
8/2/2019 7. Surveillance
27/33
Deputation of health teams (MO, HS, HW)
Preliminary strategic meeting - briefing
Chemoprophylaxis & Health monitoring of staff IEC & risk communication
Logistics & supplies
Reporting, supervision, monitoring & coordination Control room
Ot h e r I m p o r t an t I ssu e s in Su r v e i l lan ce
8/2/2019 7. Surveillance
28/33
Chem opr ophy lax i s & Heal t h Mon i t o r i ng
To Whom:
Cullers
Helpers
Poultry farm workers
Household contacts
Surveillance teams
Others at risk
Oseltamivir, 75 mg OD
On DOTS pattern
Daily monitoring:
temperature & any flu like
symptoms
Any side effects
8/2/2019 7. Surveillance
29/33
Ch em opr oph y lax i s
Risk Gr ou p s
Antiviral chemoprophylaxis be considered according to
risk stratification:
High risk exposure groups
Moderate risk exposure groups
Low risk exposure groups
8/2/2019 7. Surveillance
30/33
High Risk Ex p osu r e Gr ou p s
Household or close family contacts of a strongly
suspected/ confirmed H5N1 patient:
Potential exposure to a common environmental orpoultry source
Exposure to the index case
8/2/2019 7. Surveillance
31/33
Moder a t e Risk Ex p osu r eGroups
Personnel involved in handling sick animals,
decontaminating affected environments (including
animal disposal), if PPE not used properly
Individuals with unprotected & very close direct
exposure to sick/dead H5N1 infected animals/birds
Healthcare personnel in close contact with strongly
suspected/confirmed H5N1 patient
Laboratory personnel might have unprotected exposure
to virus containing samples
8/2/2019 7. Surveillance
32/33
Low Risk Ex po su r e Gr ou ps
HWs not in close contact with a strongly suspected/
confirmed H5N1 patient
HWs who used appropriate PPEs during exposure toH5N1 patients
Personnel involved in culling (likely) non-infected animal
populations Personnel involved in handling sick animals or
decontaminating affected environments (including
animal disposal) who used proper PPEs
8/2/2019 7. Surveillance
33/33
Th an k You