Technical Advisory Group (TAG) on Immunization and Vaccine Preventable Diseases in the Western Pacific Region (17th Meeting - 7-9 July 2008) - Meeting Report (Surveillance Workshop)
A Vaccine Preventable Disease (VPD) Surveillance Workshop was held from 9 to 11 July 2008, as a preliminary session of the Seventeenth Meeting of the Technical Advisory Group (TAG) on Immunization and Vaccine Preventable Diseases in the Western Pacific Region.The objectives of the workshop were:(1) to review surveillance needs for disease eradication, elimination and control;(2) to discuss country strategies and activities for VPD surveillance and identify best practices, and(3) to develop country workplans for VPD surveillance with special reference to measles, poliomyelitis and new vaccines.Recommendations resulting from the workshop were categorized by the disease(s) under surveillance. For measles and rubella, recommendations included intensification of case-based measles and rubella surveillance as the Region approaches the goal of measles elimination by 2012. Standard indicators and core variables should be used to monitor surveillance and programme quality and progress towards measles elimination and accelerated control of rubella. Member States with high incidence of endemic transmission may consider gradual intensification of surveillance and monitoring activities while focusing current resources on reducing measles virus transmission. Those with reduced incidence should collect and analyse core variable data at the subnational and local levels for analysis, and share core variable data with the Western Pacific Regional Office monthly. To increase surveillance sensitivity, reporting units should extend to the local level. Serologic testing for rubella should be conducted on all anti-measles IgM-negative specimens, and surveillance for congenital rubella syndrome should be developed. Regular communication and data sharing among immunization programme, epidemiology and laboratory staff were considered critical.Countries should strive to maintain high-quality acute flaccid paralysis (AFP) surveillance that satisfies standard WHO-recommended indicators at national and subnational levels. Neonatal tetanus surveillance should be strengthened at the district level so that case notification, investigation and response systems identify patterns of risk and focus elimination strategies. Countries and areas should consider conducting case-based surveillance for diphtheria and pertussis, particularly when DTP3 coverage reaches 90% or higher or if incidence of these diseases is believed to be low.Countries should develop and strengthen surveillance for diseases targeted by new and underutilized vaccines and include appropriate laboratory support. At least one national laboratory should be designated to test for pathogens targeted by priority new vaccines. As of 2008, these pathogens would include S. pneumoniae, Haemophilus influenzae, type b, Japanese encephalitis virus and rotavirus. Data collected through sentinel surveillance sites should be reported on a monthly basis to the Western Pacific Regional Office so that they may be shared with all Member States. Data should be used to estimate burden of disease and monitor impact of vaccine introduction on disease epidemiology. New vaccine surveillance systems should be incorporated into existing public health vaccine preventable disease surveillance systems in accordance with Global Framework on Immunization Monitoring and Surveillance (GFIMS) recommendations.Countries prepared provisional action plans for VPD surveillance strengthening. Total resource requirements for strengthening VPD surveillance from 2008 to 2012 were estimated to be US$ 36 125 000. Specific requirements by country were as follows: Cambodia, US$ 656 700; China, US$ 33 428 000; Lao People's Democratic Republic, US$ 627 100; Malaysia, US$ 429 700; Mongolia, US$508 000; Philippines, US$ 185 400; and Papua New Guinea, US$ 470 000.