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Paediatric Active Enhanced Disease Surveillance: A new surveillance system for Australia

Authors

  • Yvonne Zurynski,

    Corresponding author
    1. Australian Paediatric Surveillance Unit, Sydney, New South Wales, Australia
    2. The Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
    • Correspondence: Associate Professor Yvonne Zurynski, Australian Paediatric Surveillance Unit, Kids Research Institute, The Sydney Children's Hospitals Network (Westmead), Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 9845 3082; email: yvonne.zurynski@health.nsw.gov.au

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  • Peter McIntyre,

    1. National Centre for Immunisation Research and Surveillance, Kids Research Institute, Sydney, New South Wales, Australia
    2. The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
    3. The Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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  • Robert Booy,

    1. National Centre for Immunisation Research and Surveillance, Kids Research Institute, Sydney, New South Wales, Australia
    2. The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
    3. The Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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  • Elizabeth J Elliott,

    1. Australian Paediatric Surveillance Unit, Sydney, New South Wales, Australia
    2. The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, Australia
    3. The Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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  • PAEDS Investigators Group

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    • PAEDS Investigators Group:

      Dr Nicholas Wood, National Centre for Immunisation Research & Surveillance, The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney.

      A/Prof Kristine Macartney, National Centre for Immunisation Research & Surveillance, The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney.

      Dr Tom Snelling, National Centre for Immunisation Research & Surveillance, The Sydney Children's Hospitals Network (Randwick and Westmead), Sydney.

      A/Prof Jim Buttery, Immunisation Centre for Clinical Research Excellence, Infectious Diseases Unit, Murdoch Children's Research Institute, and The Royal Children's Hospital, Melbourne.

      Dr Jenny Royle, Immunisation Service, The Royal Children's Hospital, Melbourne.

      Dr Nigel Crawford, The Royal Children's Hospital; SAFEVIC, Murdoch Children's Research Institute; and Department of Paediatrics, University of Melbourne, Melbourne.

      A/Prof Michael Gold, Discipline of Paediatrics, University of Adelaide and Women's and Children's Hospital, Adelaide.

      A/Prof Helen Marshall, Director, Vaccinology & Immunology Research Trials Unit, Adelaide, Women's & Children's Hospital, Adelaide and the University of Adelaide, Adelaide.

      A/Prof Peter Richmond, School of Paediatrics and Child Health, University of Western Australia, and Princess Margaret Hospital for Children, Perth.

      Dr Christopher Blyth, School of Paediatrics and Child Health, University of Western Australia, and Princess Margaret Hospital for Children, Perth.

      A/Prof Michael Nissen, Queensland Paediatric Infectious Diseases Laboratory; Children's Medical Research Institute, Royal Children's Hospital; and School of Medicine, The University of Queensland, Brisbane.


  • Conflict of interest: The authors have no conflicts of interest.

Abstract

Aim

The Paediatric Active Enhanced Disease Surveillance (PAEDS) is described. PAEDS is active in four tertiary children's hospitals in four states of Australia and aims to address gaps in surveillance for severe vaccine-preventable diseases and adverse events following immunisation.

Methods

From August 2007 to December 2010, surveillance nurses actively identified and recruited children admitted with: acute flaccid paralysis, varicella infection, intussusception, seizures in infants and pandemic influenza (June–October 2009). Details of presentation, medical and immunisation history, outcome and laboratory results were collected. Completeness of ascertainment was estimated through audits of International Classification of Diseases 10th edition-coded medical records where possible.

Results

Seven hundred thirty-three cases matching case definition criteria for the four conditions were recruited. In addition, 601 cases of influenza were recruited during the 2009 pandemic. PAEDS enhanced acute flaccid paralysis surveillance by the Australian Paediatric Surveillance Unit; the World Health Organization surveillance target was met when Australian Paediatric Surveillance Unit and PAEDS cases were combined. Among 133 children hospitalised for varicella, only 16 were vaccinated; samples of vesicle scrapings were collected in 57% for genotyping. Of 122 infants presenting with seizures, only six (12%) had received a vaccine in the last 7 days. Intussusception was more frequent among infants receiving their first dose of either of the rotavirus vaccines. Results informed policy and education for parents and health professionals. Preliminary audits of medical records suggest excellent ascertainment through PAEDS.

Conclusions

PAEDS provides important, previously unavailable data to inform public health policy, clinical practice and community confidence. It has potential to respond quickly during outbreaks and epidemics.

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