Gadgets! Gadgets! Gadgets! All About How Gadgets Can Make Life Better and More Enjoyable

Surveillance System

Surveillance System

Surveillance of Infectious Diseases in Mass gathering (MG): A literature review, what is the most used surveillance system in mass gatherings?

MGs are one of the areas that public health officials should pay special attention. All mass gathering do not need special public health surveillance arrangements, there are many factors such as duration of mass gathering geographical spread, number of international visitors, event duration and political and religious considerations. With a good surveillance system we can detect outbreaks and facilitate public health response to the outbreaks [[1],[2]].

 

Many types of public health surveillance used in the MGs, what is the best type of public health surveillance to implement in the MGs, keeping in mind factors such as existing public health surveillance systems, acceptability to the people working in the system, ability to pick the outbreak prone conditions and diseases and more.

 

Therefore a literature review conducted to see which type of public health surveillance has been used in the MGs and if was successful.

 

Literature review:

Since 1980s public health surveillance was used to detect outbreak prone diseases in the MGs, especially for sports events involving more than 25000 populations [[3]]. Many types of public health surveillance systems were used during MGs, below is a list:

1-      Statutory notification

2-      Laboratory-based surveillance

3-      Sentinel surveillance

4-      Syndromic surveillance alone or reinforced with active case finding[1]

5-      Toxic exposure surveillance(bullets 1-5)[[4]]

6-      Enhanced Surveillance [[5]]

7-      Injury surveillance [[6]]

Also other types of surveillance were used [[7]]:

8-      Enhancing existing surveillance systems

9-      Developing an additional community-based system

10-   Setting-up venue/event-specific surveillance systems

Materials and Methods

An internet based research conducted and the key words "Mass gathering", "Mass gathering surveillance", "surveillance for Mass gathering" and Surveillance for Hajj" was searched. These searches were filtered for the years of publication and presence of the phrases in the citation, abstract and the body of the articles. Only articles selected for review which published between years 2001-2010 in the major search engines, epidemiological, infectious disease and emerging infectious disease websites.

Ninety two articles found which include 26 articles in Medscape, 23 articles in Emerging Infectious Diseases, 20 articles in Eurosrveillance, 16 articles in Pubmed, 6 articles in Google Scholars and 1 article in Journal of Emergency Primary Health Care. Usually same articles were found in more than one search engines. Also some documents of World Health Organization (WHO) and Public Health Agency of Canada ware reviewed. Articles that did not discuss Public Health surveillance was discarded and only those articles that discussed the need for public health surveillance, types of surveillance, facilitation/detection and response to outbreaks and lessons learnt from public health surveillance systems during MGs were reviewed. Therefore only 33 articles, five reports and 2 guidelines were reviewed.

 

Results          

Out of 40 reviewed articles and documents, 28 articles talked about surveillance. Almost all documents and articles emphasized on preparation for mass gathering include a thorough risk assessment and using of adequate public health surveillance to detect disease outbreaks as early as possible[[8],[9],[10]]. However some of the articles set some conditions to implement public health surveillance for gathering and mentioned that all MGs do not need special surveillance considerations and response[[11],[12]], their suggested conditions were duration of gathering, whether gathering is in-door or outdoor and age categories of participants, these conditions helped determine the type and duration of public health surveillance.

 

The most used types of surveillance for MGs were enhanced surveillance plus active case finding after detection of first case related to a possible outbreak[[13],[14]], however other types of surveillance also used in MGs with a shorter duration e.g. daily syndromic surveillance, integrated surveillance etc.

 

Public Health Surveillance for Mass Gatherings should be tailored specific to the MG requirement, keeping in minds factors such as national and international participants, their sex, age, religion, endemicity of diseases in the country of origin and country of MG, nature of MG whether religious, sport event, cultural event, duration of MG, whether MG is indoor or outdoor, season, availability of services and availability of a strong surveillance system in the MG country.

 

 

Discussions:

Public health surveillance is a cornerstone for detection of outbreak prone diseases in the MGs. Different kind of MGs require different types of public Health Surveillance. In the MGs surveillance should be in three phases of pre-event, event and post event.  Transmission of highly infectious pathogens with shorter incubation period is likely to be enhanced in a mass gathering situation. Diseases that "cause severe illness and require investigation and/or the application of control measures" [[15]], those pathogens that difficult to treat or can be used as bioterrorism agent and those disease that are at the elimination or eradication stages should be at focus of the surveillance, this is to reduce human suffering and lose, reduce economically impact and contribute to the global surveillance and response of diseases.

 

References:

[1] -           Surveillance for Early Detection of Disease Outbreaks at an Outdoor Mass Gathering—Virginia, 2005 ,MMWR. 2006;55:71-74,

[2] -           S. Thackway, T.Churches, J. Fizzell, D. Muscatello, P. Armstrong, Should cities hosting MGs invest in public health surveillance and planning? Reflections from a decade of MGs in Sydney, Australia, Published: 8 September 2009 BMC Public Health 2009, 9:324 doi:10.1186/1471-2458-9-324, http://www.biomedcentral.com/1471-2458/9/324

[3]-            J. Lombardo, C. Sniegoski, W. Loschen, M. Westercamp, M. Wade, S. Dearth, and G. Zhang , Public Health Surveillance for MGs, Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)

[4] -           Surveillance system in place for the 2006 Winter Olympic Games, Torino, Italy, 2006 Eurosurveillance, Volume 11, Issue 6, 2006

[5]-            J. Lombardo, C. Sniegoski, W. Loschen, M. Westercamp, M. Wade, S. Dearth, and G. Zhang , Public Health Surveillance for MGs, Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)

[6] -           J. Lombardo, C. Sniegoski, W. Loschen, M. Westercamp, M. Wade, S. Dearth, and G. Zhang , Public Health Surveillance for MGs, Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)

[7] -           R Kaiser, D Coulombier (2006) Epidemic intelligence during MGs, 2006, Eurosurveillance, Volume 11, Issue 51, 21 December 2006

[8] -           L. Payne(2008) Preparedness activities ahead of the Beining 2008 Olympic Games-Enhancing  EU epidemic intelligence

[9] -           J. Lombardo, C. Sniegoski, W. Loschen, M. Westercamp, M. Wade, S. Dearth, and G. Zhang , Public Health Surveillance for MGs, Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)

[10]-          WHO Communicable disease alert and response for MGs Key considerations June 2008

[11] -         S. Thackway, T.Churches, J. Fizzell, D. Muscatello, P. Armstrong, Should cities hosting MGs invest in public health surveillance and planning? Reflections from a decade of MGs in Sydney, Australia, Published: 8 September 2009 BMC Public Health 2009, 9:324 doi:10.1186/1471-2458-9-324, http://www.biomedcentral.com/1471-2458/9/324

[12]-          Surveillance for Early Detection of Disease Outbreaks at an Outdoor Mass Gathering—Virginia, 2005 MMWR. 2006;55:71-74

[13]-          Gutiérrez , A. Litzroth, S. Hammadi, H. VanOyen, C. Gérard, E. Robesyn, J. Bots, M. Faidherbe, F.Wuillaume (2009) Community transmission of influenza A (H1N1)  virus at a rock festival in Belgium 2-5 July 2009, EUROSURVEI L LANCE Vol . 14 · Issue 31 · 6 August 2009 · www.eurosurveillance.org

[14] -         Epi-south (2009) Hajj 2009: a mass gathering the context of pandemic A(H1N1)2009 influenza

[15] -         WHO Communicable disease alert and response for MGs Key considerations June 2008

 

About the Author

Dr. Jawad Mofleh, born on 21st June 1974 in Herat Province of Afghanistan, graduated from Medical Faculty of Herat University on 1998. He also has an eMBA in Health Management and diploma in diagnostic ultrasonology. He worked for MSF-Holland, UNICEF-ACO and Ministry of Public Health Afghanistan in capacities of Medical Team Leader, EPI officer, Health and Nutrition officer, Avian Influenza Coordinator and Director for Disease Early Warning System/Surveillance. He also worked as temporary Advisor for WHO Pakistan.

He authored books titled poliomyelitis and measles for health care workers and families, he also edited the books and guidelines for Ministry of Public Health Afghanistan e.g. Guideline for Surveillance, specimen collection of Avian Influenza, Guideline for Surveillance, specimen collection and treatment of H1N1 influenza, DEWS guideline and Manual. He is author and co-author of over 14 articles which are published in national and international journals.

Setting up surveillance system that can be seen through the net?

I'm looking for a good surveillance system. That I can view through the internet. Does anyone know any good places to get one?

Sure...

I got mine at Fry's.

4 outdoor rated analog cameras with night vision = $150 each x 4 = $600
1 4-channel MPEG4 DVR = $500
1 500 gig hard drive for the DVR = $200

Add in $ for cabling, plugs, battery backup, baluns, tie wraps... I presume you are doing the labor yourself for the installation - otherwise, that will add more $ and how much will depend on how easy it is to get the cameras to the location(s) you need.

If you want to go "wireless", keep in mind that wireless cameras actually have more wires than wired... with wired cameras, the camera has one long cable back to the DVR. The video plug connects to the DVR, the power plug connects to power... but it is one long cable. With "wireless", only the video signal is wireless. The camera still needs power; the wireless signal its sent to a base station, the base station needs power and video cables. Summary: Wired = 1 cable; wireless = 3 cables.

In this case, the DVR has the IP address. When you access it from a computer, then you see the cameras the DVR controls. The cheap DVRs use a very specialized Windows client. No access for Macs or Linux... The better ones run on a Linux platform and fo not require a specialized client - any operating system can see the video assuming the security allows the computer's access.

If you want to go with an IP-based camera, then there is no DVR - but there is no saved video, either. If you want to record the video, you need a dedicated computer to be a video server that is always on, recording the video. The IP based cameras are pretty expensive - even the low-end, indoor, no night vision ones... If you want pan/tilt/zoom control, that adds more $.

In either case, it will be easiest to have the camera or DVR IP address in the "DMZ" section of the router associated with the local area network. Not very secure - but easiest. If you want secure, then the router needs to be set up for remote access and the IP camera or the DVR can just be another node on the LAN.

Frys, TigerDirect, bhphotovideo and LOTS of other places have all this stuff.

So... What is your budget?

Surveillance System Columbus Ohio