Vaccine Preventable Diseases Surveillance

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1 Vaccine Preventable Diseases Surveillance Clinical Vaccinology Update 5 June 2015 Kylie Carville Communicable Diseases Epidemiology & Surveillance Health Protection Branch, Victorian Government Dept of Health and Human Services

2 Summary Surveillance of VPDs State, National, Global levels - Communicable Diseases Epidemiology and Surveillance, DHHS - Communicable Diseases Network of Australia (CDNA) - National Notifiable Diseases Surveillance Scheme (NNDSS) Successes of the national immunisation program Vaccine-preventable diseases surveillance in Victoria - Measles - Invasive meningococcal disease - Invasive pneumococcal disease - Pertussis

3 Communicable Diseases Epidemiology & Surveillance Monitor, prevent and control current and emerging communicable diseases within the Victorian community through the implementation of targeted strategies based on a partnership approach Legislative Framework: Public Health & Wellbeing Act 2008 Public Health & Wellbeing Regulations 2009 Emergency Management Act 1986 Quarantine Act 1908

4 Why follow-up vaccine preventable diseases? Public Health Followup Actions: understand the epidemiology determine the effectiveness of vaccination programs prevent secondary cases (or outbreaks) through contact tracing control outbreaks

5 Notifiable conditions

6 Victorian Infectious Diseases Epidemiology and Surveillance

8 Communicable Diseases Network of Australia (National Department of Health)

9 National Notifiable Diseases Surveillance System (NNDSS)

10 Global surveillance for VPDs

11 National immunisation program successes

12 Diphtheria Notifications per population diphtheria vaccination commenced DTP vaccination introduced

13 Tetanus Notifications per population DTP vaccination introduced

14 Poliomyelitis Notifications per population mass vaccination with IPV commenced OPV introduced

15 Haemophilus influenzae type b disease Notifications per population First Hib vaccines approved National Hib vaccination program commenced

16 Pertussis Notifications per population Mass vaccination with pertussis vaccine commenced DTP vaccination introduced

17 Vaccine-preventable diseases surveillance in Victoria

18 Jan 01 Apr 01 Jul 01 Oct 01 Jan 02 Apr 02 Jul 02 Oct 02 Jan 03 Apr 03 Jul 03 Oct 03 Jan 04 Apr 04 Jul 04 Oct 04 Jan 05 Apr 05 Jul 05 Oct 05 Jan 06 Apr 06 Jul 06 Oct 06 Jan 07 Apr 07 Jul 07 Oct 07 Jan 08 Apr 08 Jul 08 Oct 08 Jan 09 Apr 09 Jul 09 Oct 09 Jan 10 Apr 10 Jul 10 Oct 10 Jan 11 Apr 11 Jul 11 Oct 11 Jan 12 Apr 12 Jul 12 Oct 12 Jan 13 Apr 13 Jul 13 Oct 13 Jan 14 Apr 14 Jul 14 Oct 14 Jan 15 Apr 15 Number of notified cases Measles - cases 60 Notified cases of measles by month, Victoria, 1 Jan 2001 to 27 May Month of notification

19 Measles follow up Group A disease - urgent notification by telephone - Interview treating doctor - Arrange testing at Reference Lab confirmation required - Ascertain vaccination status - Determine onset of illness - Interview patient for thorough history of illness, travel - Perform contact tracing to prevent secondary cases - Vaccinate and/or arrange immunoglobulin - Provide information to case/contacts - Exclude cases/unimmunised contacts from school/work

Measles cluster 21M Burwood East Rash onset 1 Mar Travel: India 27M Box Hill South Rash onset 17 Mar Same flight Unknown intermediary 25F Northcote Rash onset 6 Apr No travel 21M Greensborough Rash

20 Measles cluster 21M Burwood East Rash onset 1 Mar Travel: India 27M Box Hill South Rash onset 17 Mar Same flight Unknown intermediary 25F Northcote Rash onset 6 Apr No travel 21M Greensborough Rash onset 8 Apr No travel 39M Roxburgh Park Rash onset 9 Apr No travel 29F Oak Park Rash onset 9 Apr No travel 35M Malvern Rash onset 18 Apr No travel 41F Roxburgh Park Rash onset 21 Apr No travel 30M Oak Park Rash onset 21 Apr No travel

14 12 10 8 6 4 2 0 (2008) 1 59 (2009) 1 59 (2010) 1 59 (2011) 1 59 (2012) 1 59 13 17 21 25 29 33 37 41 45 49 13 17 21 25 29 33 37 41 45 49 13 17 21 25 29 33 37 41 45 49 13 17 21 25 29 33 37 41 45 49

21 (2008) 1 59 (2009) 1 59 (2010) 1 59 (2011) 1 59 (2012) Number of cases genotyped Weekly distribution of measles genotypes identified at VIDRL Genotype data reviewed 354 cases positive by RT-PCR 293 cases genotyped as wt measles; 16 vaccine strains Measles detected all year round Multiple genotypes detected B3 D4 D5 D8 D9 G3 H1 Untypable Untyped (Year) Week number Slide from Thomas Tran (VIDRL), presented at Communicable Disease Control Conference, Brisbane, 1-2 June 2015

22 Number of notified cases Invasive meningococcal disease Confirmed and probable invasive meningococcal disease notifications by serogroup, Victoria, 1 Jan 1995 to 3 Jun MenCCV 12mo dose (from Jan 2003) catch-up 1-19yo's ( ) Unknown 29E Group Y Group W135 Group C Group B Group A * Year of notification

24 Clearance antibiotics for meningococcal disease CDNA National Guidelines for Public Health Units - Updated April 2015 Clearance antibiotic use - Childcare: at least 4 hours/day on average or 20 hours in total in the 7 days prior to the onset of the case s illness. - Healthcare workers: only those who have come into direct contact with the nasopharyngeal secretions of a case during a procedure such as intubation without wearing a surgical mask or mouth-to-mouth resuscitation

25 Invasive pneumococcal disease (IPD)

26 Number of cases IPD notifications aged <5 years, by vaccine type and date of notification, Victoria valent vaccine Non-typable valent vaccine Unknown Non-conjugate vaccine ST 13vPCV excl 7vPCV 7vPCV Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q Quarter and year of notification

27 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Qtr2 Qtr3 Qtr4 Qtr1 Number of cases Cases of IPD aged <5 years caused by sertoypes contained within the 13- valent conjugate vaccine (excluding 7-valent serotypes) valent vaccine valent vaccine F 6A 19A Quarter and year of notification

28 13v serotypes in 65 years and older 7 valent PCV on NIP 13 valent PCV on NIP

29 Jan 97 Apr 97 Jul 97 Oct 97 Jan 98 Apr 98 Jul 98 Oct 98 Jan 99 Apr 99 Jul 99 Oct 99 Jan 00 Apr 00 Jul 00 Oct 00 Jan 01 Apr 01 Jul 01 Oct 01 Jan 02 Apr 02 Jul 02 Oct 02 Jan 03 Apr 03 Jul 03 Oct 03 Jan 04 Apr 04 Jul 04 Oct 04 Jan 05 Apr 05 Jul 05 Oct 05 Jan 06 Apr 06 Jul 06 Oct 06 Jan 07 Apr 07 Jul 07 Oct 07 Jan 08 Apr 08 Jul 08 Oct 08 Jan 09 Apr 09 Jul 09 Oct 09 Jan 10 Apr 10 Jul 10 Oct 10 Jan 11 Apr 11 Jul 11 Oct 11 Jan 12 Apr 12 Jul 12 Oct 12 Jan 13 Apr 13 Jul 13 Oct 13 Jan 14 Apr 14 Jul 14 Oct 14 Jan 15 Apr 15 Number of notified cases Pertussis to <25 15 to <18 5 to <15 1 to <5 <1 Notified cases of pertussis by month and age group, Victoria, 1 January 1997 to 26 May Month of notification

30 Pertussis cases aged <6mo

32 Pertussis notifications by age group

33 Further information? Communicable Diseases Phone: (Afterhours):

34 Acknowledgements Laboratory notifiers primary labs Medical practitioner notifiers Reference laboratories: - Microbiological Diagnostic Unit (MDU) - Victorian Infectious Diseases Reference Laboratory (VIDRL) Public Health Officers and Immunisation staff in the Health Protection Branch, Department of Health

Invasive Bacterial Disease Surveillance Report Emerging Infections Program Minnesota Department of Health

Invasive Bacterial Disease Surveillance Report 2009 Emerging Infections Program Minnesota Department of Health Surveillance Methods Cases include Minnesota residents with invasive infections due to Group