Transcript Slide 1
Surveillance Working Group
Anne-Luise Winter
OAML Pandemic Planning Educational Day
Toronto
June 16, 2005
OHPIP Development Structure
OHPIP Steering Committee
Public Health Subcommittee
Operations Subcommittee
Communications Subcommittee
Surveillance
Working Group
Laboratory
Working Group
Vaccines/Antivirals
Working Group
Supply/Equipment
Working Group
Public Health Measures
Working Group
Health Human Resources
Advisory Working Group
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Assumptions of Pandemic Planning
• Epidemiology of the Pandemic strain will be similar to
current circulating strains
• Individuals who recover from the Pandemic strain will be
immune from further infection from that strain
• Laboratory testing is required for definitive diagnosis,
testing is limited in capacity and will be done during initial
phases only
• Health care and public health resources are limited and
often overwhelmed even in the inter-pandemic phase
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Objectives of Pandemic surveillance
• To detect early the entry of the Pandemic strain in Ontario
• To track the occurrence, severity, and progression of influenza
outbreaks, based on WHO/Canadian pandemic phases
• To detect unusual events (new strains including epizoonotic
strains, antigenic drift/shift, unusual outcomes or syndromes,
unusual severity, unusual distribution)
• To compare new strains with vaccine composition and
recommendations
• To estimate the impact of ILI in terms of attack rate, outpatient
visits, hospitalizations, and case fatality rate
• To describe affected population/s in order to identify high risk
groups, modes of transmission, and risk and protective factors
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Interpandemic/pandemic alert (seasonal)
surveillance components
PHAC:
Laboratory surveillance
Sentinel physician ILI Surveillance
Ontario
• Influenza activity reporting
• Reports of laboratory-confirmed sporadic cases of
influenza through RDIS/iPHIS
• Respiratory infection outbreaks in institutions
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Pandemic surveillance components
• Laboratory
• Disease/epidemiological
• Animal health
• Vaccine and antiviral uptake
• Adverse events
• Communication
• Data collection system/s
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Interpandemic Period
• No new influenza virus subtypes detected in humans A
circulating animal influenza virus subtype poses a
substantial risk of human disease
Surveillance:
• Routine influenza surveillance with layered progression of
activities
• Communication of phase progression
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Pandemic alert
• Human infection/s with a new subtype. Rare limited
larger cluster/s of human to human spread
Surveillance
• Detection of the novel strain (e.g. FRI/SRI surveillance)
• Ongoing review of case definition
• Continue with heightened surveillance until no longer
sustainable
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Pandemic
• Increased and sustained transmission in general
population
Surveillance:
• Utilization of pandemic reporting tools
• Monitor uptake, efficacy, adverse events associated with
vaccines and antivirals
• Ongoing evaluation of epidemiology, to direct priorities to
high-risk groups
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Postpandemic Period
• Recovery/Resolution
Surveillance:
• Estimate burden of disease
• Evaluate surveillance systems
• Eventual resumption of interpandemic activities
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Next steps for SWG
• Working on identifying specific data elements to be
collected for different settings (institutional and community)
• How best to track vaccine and antiviral uptake
• Need to address gaps in current system
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Conclusions
• Maximize efficiency of surveillance system/s to avoid
undue burden on data collectors
• Surveillance data provides the “trigger for action”, hence
accurate and timely data needs
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