Expansion of syndromic vaccine preventable disease surveillance to include bacterial meningitis and Japanese encephalitis: evaluation of adapting polio and measles laboratory networks in Bangladesh, China and India, 2007-2008.
BACKGROUND
Surveillance for acute flaccid paralysis with laboratory confirmation has been a key strategy in the global polio eradication initiative, and the laboratory platform established for polio testing has been expanded in many countries to include surveillance for cases of febrile rash illness to identify measles and rubella cases. Vaccine-preventable disease surveillance is essential to detect outbreaks, define disease burden, guide vaccination strategies and assess immunization impact. Vaccines now exist to prevent Japanese encephalitis (JE) and some etiologies of bacterial meningitis.


METHODS
We evaluated the feasibility of expanding polio-measles surveillance and laboratory networks to detect bacterial meningitis and JE, using surveillance for acute meningitis-encephalitis syndrome in Bangladesh and China and acute encephalitis syndrome in India. We developed nine syndromic surveillance performance indicators based on international surveillance guidelines and calculated scores using supervisory visit reports, annual reports, and case-based surveillance data.


RESULTS
Scores, variable by country and targeted disease, were highest for the presence of national guidelines, sustainability, training, availability of JE laboratory resources, and effectiveness of using polio-measles networks for JE surveillance. Scores for effectiveness of building on polio-measles networks for bacterial meningitis surveillance and specimen referral were the lowest, because of differences in specimens and techniques.


CONCLUSIONS
Polio-measles surveillance and laboratory networks provided useful infrastructure for establishing syndromic surveillance and building capacity for JE diagnosis, but were less applicable for bacterial meningitis. Laboratory-supported surveillance for vaccine-preventable bacterial diseases will require substantial technical and financial support to enhance local diagnostic capacity.
['Cavallaro|Kathleen F|KF|', 'Sandhu|Hardeep S|HS|', 'Hyde|Terri B|TB|', 'Johnson|Barbara W|BW|', 'Fischer|Marc|M|', 'Mayer|Leonard W|LW|', 'Clark|Thomas A|TA|', 'Pallansch|Mark A|MA|', 'Yin|Zundong|Z|', 'Zuo|Shuyan|S|', 'Hadler|Stephen C|SC|', 'Diorditsa|Serguey|S|', 'Hasan|A S M Mainul|AS|', 'Bose|Anindya S|AS|', 'Dietz|Vance|V|', '|||']
D001459:Bangladesh D002681:China D004660:Encephalitis D062665:Epidemiological Monitoring D006302:Health Services Research D006801:Humans D007194:India D008581:Meningitis D018571:Sentinel Surveillance
Vaccine preventable diseases Surveillance Meningitis Japanese encephalitis VPD