Zurynski Yvonne, McIntyre Peter, Booy Robert, Elliott Elizabeth J
Australian Paediatric Surveillance Unit, Kids Research Institute, The Sydney Children’s HospitalsNetwork (Westmead), Westmead, NSW 2145, Australia.
J Paediatr Child Health. 2013 Jul;49(7):588-94. doi: 10.1111/jpc.12282. Epub 2013 Jun 19.
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.
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.
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.
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.
介绍儿科主动强化疾病监测（PAEDS）。PAEDS在澳大利亚四个州的四家三级儿童医院开展工作，旨在填补严重疫苗可预防疾病监测和免疫接种后不良事件监测方面的空白。
2007年8月至2010年12月，监测护士积极识别并招募患有以下疾病的住院儿童：急性弛缓性麻痹、水痘感染、肠套叠、婴儿惊厥以及大流行性流感（2009年6月至10月）。收集临床表现、病史和免疫接种史、结局及实验室检查结果的详细信息。尽可能通过对国际疾病分类第10版编码的病历进行审核来评估确诊的完整性。
招募了733例符合四种疾病病例定义标准的病例。此外，在2009年大流行期间招募了601例流感病例。PAEDS加强了澳大利亚儿科监测部门对急性弛缓性麻痹的监测；将澳大利亚儿科监测部门和PAEDS的病例合并后，达到了世界卫生组织的监测目标。在133例因水痘住院的儿童中，仅16例接种过疫苗；57%的病例采集了水疱刮片样本进行基因分型。在122例出现惊厥的婴儿中，只有6例（12%）在过去7天内接种过疫苗。在首次接种任何一种轮状病毒疫苗的婴儿中，肠套叠更为常见。研究结果为针对家长和卫生专业人员的政策及教育提供了依据。对病历的初步审核表明通过PAEDS能够很好地确诊。
PAEDS提供了重要的、以前无法获得的数据，为公共卫生政策、临床实践和社区信心提供了参考。它有潜力在疫情和流行病暴发期间迅速做出反应。
