Epidemiological intelligence
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Transcript of Epidemiological intelligence
Definition
Epidemic Intelligence can be defined as the process to detect, verify, analyze, assess and investigate public health events that may represent a threat to public health and Providing early warning signals is a main objective of public health surveillance systems.
EPIDEMIOLOGICAL INTELLIGENCE
SURVEILLANCE• Multifaceted• Long term• Some directed
action
INTENSIVE FOLLOW-UP• Focussed effort• Short duration• More flexible
SURVEILLANCE
Surveillance means an active intelligence and accounting process intended to continuously monitor the overall disease and health status of a population or a group of population
Components of surveillance
1.Collection of data2.Collation and analysis of data3.Expression , interpretation
and prompt distribution of disease intelligence information
1) Collection of dataOur main focus s’d be• Animal identification• Disease nomenclature• Disease classificationOther consideration• Data availability• Data quality
Animal identification2 types• Herd basis• Individual basisWhy animal identification required?1. To show ownership2. To know breeding status3. Part of some testing or disease
control effort4. Tracing back origin (slaughter
house)
Various methods of identification
A. FirebrandsB. Ear notchingC. Paint marksD. Ear tagsE. Neck chainsF. Freeze brandsG. Detailed physical appearanceH. TattoosI. Electronic identification(s/c implantation of a
transponder) by electronic interrogatorJ. M.C.I. system of cattle identification in USA
DISEASE NOMENCLATURE AND
CLASSIFICATIONRequirement1. Computer processing of disease data2. Numerically coded classification of diseases
Basis of nomenclature and classification
Standard Nomenclature Of Veterinary Diseases And Operation(S.N.V.D.O.)
It is accepted by WHO as a standard Consists of two four digit series(0000-0000) First instance for topographic classification Second instance for etiological designation
Surveillance data sources
A. Mortality registrationB. Ongoing morbidity incidence reportingC. Diagnostic laboratory records of
morbidity and mortalityD. Special programmes for incidence dataE. Morbidity prevalence monitoring or
surveyF. Interview approachG. Other than diagnostic data
A. Mortality registration
• Public health agency- registration of human deaths in government agency
• For veterinary1. Periodic livestock census and survey2. Routine mortality data (heard health
type veterinary practice)3. Intensive follow-up studies of
veterinary outbreak4. Bread registration
A. Mortality registration
4. Herd improvement schemes5. Population based disease registries6. Life table and other summaries
B. Ongoing morbidity incidence and reporting
It is considered as backbone of public health
• Sources1. Farm records (production
records ,reproduction records, vital statistics)2. Individual herd surveillance
programme(disease recording and analysis by veterinarian)
3. Individual farm unit surveillance programme4. Institutional veterinary hospital
DAIRY HERD
RECORD
ANIMAL IDENTIFICA
TION
MAN
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MORBID
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DATA MARKET
INFORMATI
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B. Ongoing morbidity incidence and
reporting• ConstraintsA.Mostly depends upon voluntary
reporting of casesB.Lack of laboratory facilitiesC.Lack of co-operation among
reporterD.Incompleteness of reporting
• Steps to improve incidence reporting
A. Better communication(use of telephone communication)
B. Efforts to improve co-operation among reporter
C. Providing good diagnostic lab facilityD. Govt. lab s’d provide subsidized
services for specific diseases to improve surveillance
E. Encourage reporting of unusual/exotic diseases
Problem oriented medical records
Aim- To improve recording system in medical and veterinary hospital
• It consists of 4 parts1. Data base2. Problem list3. Initial plan4. Progress note
1.Data base
• It consists of following components
I. Patient complaintII. Patient profileIII. Past history & system reviewIV. Physical examinationV. Baseline lab examination
2.Problem list• It is core of problem oriented medical
record• Begins with a numbered index
list(patients past and present medical problems + highest possible level of diagnostic precision)
• Problems may be classified asI. Primary/secondary/predisposing/
contributingII. Inactive/active/resolvedIII. Minor/temporary
2.Problem list
• Problem list always needs revision and modification• It provides a key or index for
action to be taken
3. Initial plan
• It follows problem list• Plan is according to
diagnostic effort required and management• Different possibility s’d be
ruled out by using specific tests
4. Progress notes• Consists of results or data produced• The progress notes again to problem
lists then to plan of action• All new data s’d integrated to records
One of the most pre requisite in use of institutional record is record abstracting and retrieval system
C. Diagnostic laboratory record for morbidity and
mortality• It includes 1. Sero-epidemiologic survey2. Special investigation3. Intensive follow up of outbreak• Needs adequate laboratory back-
up• Most useful on unset of outbreak• Laboratory records based on
disease nomenclature and classification
C. Diagnostic laboratory record for morbidity and
mortality• Data of an herd health
represents1. Disease of ill animal2. Patterns of disease in herds
• Sampling must be adequate for laboratory diagnosis
• Must not be limited to micro org. isolation ,toxin detection and pathologic changes
D. Special programmes for incidence data
• Examples1. Almora and contra costa animal
tumour registries• It includes epidemiologic information in
neoplasm in cat and dog
2. Quebec animal health insurance programme
• This animal health insurance programme used as a disease surveillance programme
D. Special programmes for incidence data
• It uses invoice provided by veterinarians
• Invoice contains1. Identification of owner2. Identification of animal by
species ,age , breed , sex3. Diagnosis of disease4. It’s treatment5. cost
E. Morbidity prevalence monitoring or survey
• Most useful data for surveillance in veterinary epidemiology
• Periodic mass survey programme is backbone of livestock disease control programme
• Survey by following methods1. Immune diagnostic methods2. Other mass diagnostic tests3. Necropsy examination4. Diagnosis in abattoir
E. Morbidity prevalence monitoring or survey
• Shortcomings1. Abattoir diagnosis mostly confined to
consumer protection2. Potential case finding & infected herd
finding for epidemiological survey is neglected
3. Administrative separation of veterinary food protection service from animal disease control programme
Sero epidemiology(extended
use)1. Periodic or routine surveys for any infection
2. Prevalence estimate surveys (anaemia , nutritional deficiency disease, metabolic disease, toxicity etc.
3. Biological monitoring of environment4. Distribution and frequency genetic
marker( blood group, abnormal hb.)5. Banking of highly selected
specimen(future studies)
F. Disease intelligence by interview aproach
• Mostly Conducted by a veterinarian • Better co-operation than written
qustionare• E.g.- • California sheep industry pilot study.• It gives information about
1. Description of sheep industry2. Number and distribution of sheep3. Management and husbandry
practices
3. Management and husbandry practices
4. Productivity5. Major diseases and problems6. Morbidity and mortality data7. Prevention and control8. Costs and treatment
G. Surveillance data other than diagnostic
data• Monitoring of drug sales to
owner• Useful when diagnosis is made
by farmers• Unusual drug purchases/
unexpectedly large purchased drug indicates requirement of intensive study
Development and improvements of
organization of data sources• Development of a multifaceted
intelligence programmeA.Qualified epidemiologistsB.StatisticiansC.Disease economistsD.Diagnostic veterinary laboratoryE. Veterinary food protectionF. Extension service worker
2) Collation analysis of data
Data is collated and reduced
Subjected to immediate analysis
Data bank is provided
More detailed future analysis
Identification of disease determinants
Study of animal health economics
• Collection of data –government and non-govt agency
• Collation and analysis of data- surveillance agency
3) Expression interpretation and
prompt dissemination of data• Data is disseminated to
A.Who submitted the basic dataB.Who need to knowC.Who participate in directed
actionD.To public(for awareness)
Proper approach for dissemination of data
1. Current, cumulative, comparative tabular data of continuous surveillance
2. More in depth data for selected diseases
3. Ongoing reports of progressive control efforts
4. Alerts of existing/potential problems
5. Notice of relevant changes of legislation
6. Prediction of future disease patterns
7. informative synopsis of specific intensive follow-ups of cases and outbreaks
8. Official or other procedural recommendations
9. Significant literature abstracts or other disease intelligence information
Various media to express data
1. Press releases2. Audio tapes3. Video tapes4. Extension veterinarians5. Verbal or written dissemination
of data
Use of surveillance data
1. To identify diseases and identify determinants
2. Disease control strategy3. Prediction of future disease
incidence4. Inputs into decision making
models5. Evaluation of animal health
economics