Using Surveillance Indicators for Vaccine-Preventable Diseases (VPDs): National Notifiable Diseases Surveillance System (NNDSS)

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
• describe surveillance indicators
• understand surveillance indicator data for measles, mumps, rubella, pertussis, and Haemophilus influenzae
• discuss the utility of new surveillance indicators for varicella, invasive pneumococcal disease, and meningococcal disease

Background:
Vaccine-preventable disease (VPD) surveillance indicators assess the quality of national surveillance data, and identify components of surveillance that need improvement. Surveillance indicators can assess infrastructure, practices/procedures, thoroughness and appropriateness of case investigation, laboratory performance, and completeness of case reporting.
Variations in reporting for VPDs may be due to disease/condition characteristics (e.g., symptoms, incidence, severity), availability of laboratory diagnostics, patient and provider awareness, jurisdiction attributes (e.g., laws, regulations), disease transmission setting, and capacity for electronic data transmission.

Objectives:
N/A

Methods:
Analyses used data reported through the National Notifiable Diseases Surveillance System (NNDSS), including the National Electronic Telecommunications System for Surveillance (NETSS) and the National Electronic Disease Surveillance System (NEDSS). Analyses (1998-2007) included completeness of epidemiologically important information, timeliness of reporting, vaccination history, laboratory testing, importation status, and other indicators of investigative effort.

Results:
For H. influenzae, data completeness is very low, especially the percent of cases <5 years with serotype and with complete vaccine history. For measles, data completeness, determination of importation status, and laboratory testing at CDC must be maintained. For pertussis, enhanced documentation of adult and child vaccine history is needed, while building laboratory testing infrastructure. For rubella, data completeness should be enhanced, focusing on pregnancy status for females and importation status for all cases. For mumps, effort must be enhanced to achieve data completeness, and laboratory testing must be provided for case confirmation.

Conclusions:
Surveillance indicators can be monitored using national passive surveillance data collected electronically, to assess the quality of national surveillance data, and to identify components of surveillance that need improvement.