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PUBLIC HEALTH SURVEILLANCE

Celso Pagatpatan, Jr., RN, DrPH

PUBLIC HEALTH SURVEILLANCE SYNDROMIC SURVEILLANCE

The on-going, systematic collection, analysis and  Focuses on the signs and symptoms of an illness rather
interpretation of health-related data essential to planning, than physician-diagnosed or laboratory-confirmed
implementation and evaluation of public health practice, illnesses. The case definition for a syndrome is never as
closely integrated with the timely dissemination of these specific as for a disease. Therefore, follow-up is always
data to those responsible for prevention and control. necessary to verify if an outbreak is actually occurring.
 It is the preferred method for bioterrorism.
Those in bold words are keywords  Advantage: reporting does not need to wait for diagnosis
to be made, which can add time and delay the reporting
Surveillance – from a French phrase meaning “to watch over” process.
(sur: “from above”, veiller: “to watch”)  It is used as a method of early detection to improve
situational awareness especially in the context of
TYPES OF PUBLIC HEALTH SURVEILLANCE bioterrorism because of its time-saving aspect.
 It has also been loosely applied to surveillance of school
 Most routine notifiable disease and work absenteeism, calls to 911 and over the counter
surveillance relies on passive medications (e.g. sharp increase in sales of anti-diarrheal
reporting. medications in a community can indicate an outbreak of
 Diseases are reported by health gastroenteritis)
care providers
 The physician, laboratory or
other health care provider takes PUBLIC HEALTH SURVEILLANCE PROCESS
the initiative in submitting the
report by following the list of
Passive Surveillance reportable diseases in that Data Collection
state. The health department or
health agency waits for reports Data Analysis
to be submitted by others.
 This is the most common type
of surveillance. Data Interpretation
 Simple and inexpensive
 Limited by incompleteness of Data Dissemination
reporting and variability of
quality
 Active systems involve regular Link to Action
outreach to potential reporters
to stimulate the reporting of
specific diseases or injuries. DATA COLLECTION
 It can validate the
Before collecting data, decide on the overarching goal of the
representativeness of passive
reports. system.
 It is often used for brief periods
for discrete purposes such as  What will we monitor?
during outbreak investigations  Who will collect the data and how will it be collected?
Active Surveillance
or specific time-limited events  Who is the target population?
or for disease of special  Where do we implement the system?
interest.  Will the system be active or passive?
 Health agencies contact health  How will be the data be transmitted to the person
providers seeking reports
performing the analysis?
 Ensures more complete
reporting of conditions DATA SOURCES FOR PUBLIC HEALTH SURVEILLANCE
 Used in conjunction with
specific epidemiologic  Reported diseases or syndromes
investigation  Electronic health records (Hospital discharge data)
 Reporting of health events by  Vital Records (Birth and Death certificates)
health professionals who are  Registries (Cancer, Immunization)
selected to represent a  Surveys (National Demographic Health Survey)
Sentinel Surveillance geographic area or a specific  Administrative data systems (Billing records)
reporting group
 Laboratory surveillance (PulseNet)
 Rigid way of collecting data
 Environmental, vector or animal surveillance (Mosquito
 Can be active or passive
trapping for West Nile virus)
 Other (Pharmacy, Laws and Policies , 911 calls)

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NOTIFICATION OF DISEASES WEEKLY REPORTABLE DISEASES
 Mandatory reporting of diseases that have particular 1. Acute bloody diarrhea
public health significance. 2. Acute hemorrhagic fever syndrome
 Potential for outbreak 3. Acute viral hepatitis
 Vaccine preventability 4. Acute flaccid paralysis
 Emerging disease 5. Bacterial meningitis
 Republic Act 3573 (Law of Reporting Communicable 6. Cholera
Diseases) 7. Dengue
8. Diphtheria
 Section 1. Prophylactic inoculation
9. Influenza
 Section 2. Notice to the Philippine Health
10. Japanese encephalitis
Service about communicable diseases 11. Leptospirosis
 Section 3. A case of reportable or communicable 12. Malaria
disease defined. 13. Neonatal tetanus
 Section 4. Penalties 14. Non-neonatal tetanus
 Section 5. Act shall take effect on approval. 15. Paralytic shellfish poisoning
16. Pertussis
17. Rabies
NOTIFIABLE DISEASE WITHIN 24 HOURS (2008) 18. Typhoid and Paratyphoid fever
1. Acute Flaccid Paralysis
2. Adverse Events Following Immunization (AEFI) FLOW OF WEEKLY REPORTING OF NOTIFIABLE DISEASES
3. Anthrax
4. Human Avian Influenza
5. Measles
6. Meningococcal Disease
7. Neonatal Tetanus
8. Paralytic Shellfish Poisoning
9. Rabies
10. Severe Acute Respiratory Syndrome (SARS)

FLOW OF NOTIFICATION FOR IMMEDIATELY NOTIFIABLE


DISEASES, SYNDROMES AND EVENTS

INTERNATIONALLY NOTIFIABLE DISEASES


- Reporting to WHO is required for cases of:
1. Smallpox
2. Poliomyelitis (wild type)
3. Human influenza caused by any new subtype
4. Severe acute respiratory syndrome (SARS)

WORLD HEALTH ORGANIZATION (WHO)


Is a United Nations agency that coordinates international
health activities and helps governments improve health
services.

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DATA ANALYSIS LINK TO ACTION

 Who will analyze the data? Public health surveillance should always have a link to action.
 What methodology will they use?
 How often will they analyze the data? Link to action is the final and a required step in the public
Daily, weekly, monthly or some other time frame? health surveillance process because without action, the
collection serves no real purpose.
It usually includes descriptive information consisting of time,
place and person. However, other analytic methods are often “The reason for collecting, analyzing and disseminating
used. information on a disease is to control that disease. Collection
and analysis should not be allowed to consume resources if
DATA ANALYSIS BY PLACE action does not follow.” - William Foege, 1976
Is the usual method used to examine reports either by where
the cases was reported or ideally, by where the illnesses William Foege - former CDC director and a person who
occurred. It allows prevention resources to be directed to played a substantial role in the global smallpox eradication.
where the exposure occurred.
END OF TRANSCRIPTION
DATA ANALYSIS BY PERSON
Consider variables like age, sex, race etc.
Notice patterns in the rates. “Be strong and courageous. Do not be afraid; do not be
discouraged for the Lord your God is with you wherever you go.”
Joshua 1:9
DATA INTERPRETATION
Transcription Team 2019
Transcribed by: Trisha Mae M. Bongcales
It is closely coupled with data analysis. By identifying the
References: Lecture notes, PPT,
person, place and time, you can more easily determine how World Wide Web
and why the health event happened. Remarks: Please refer to the ppt
for some examples.
Suppose that the data analysis identifies an apparent increase
in reported cases of a disease under surveillance. Less time to mourn
More time to grind
What can account for this increase? #LABAN2019 
Possible reasons include:
 Increased access to health care Knowledge Check
 A change in reporting procedures or surveillance system 1. Choose the option that is NOT a part of the public health
surveillance process.
 A change in case definition
A. Data Dissemination
 Improvement of laboratories B. Data Storage
Not considered true outbreak. Diseases may be present in C. Link to Action
the past but were detected due to improved technology. D. Data Collection

2. In data interpretation, by identifying the _____, _____ and ____,


DATA DISSEMINATION you can more easily determine how and why the health event
occurred.
It describes how to distribute information to those who need A. Disease, risk, occurrence
to know. B. Person, protocol, risk
C. Person, place, time
METHODS OF DISTRIBUTION D. Risk, protocol, disease
 Health agency newsletters, bulletins or alerts 3. Choose the option that is NOT a source of data used for public
 Surveillance summaries and reports health surveillance
 Medical and epidemiologic journal articles A. Administrative data systems
 Press releases and social media B. Vital records
C. Newspaper articles
D. Disease notifications
TARGET AUDIENCES
 Public health practitioners
 Clinicians and other health care providers
 Policy and other decision makers
 Community organizations
 General public

Providing feedback to those who report the data is crucial


because it improves the acceptability of the surveillance
system and data reporters are more likely to cooperate if
they know their efforts are being tabulated, analyzed and
used.

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