WHO Global Invasive Bacterial Vaccine-Preventable Disease and Rotavirus and Pediatric Diarrhea Surveillance Networks Bulletin
WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - August 2019

Dear Colleagues, We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This edition reports global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year of 2018. In this edition, we will also report on bacteriology laboratory capacity trainings, which support much of the surveillance work reported here. Each year, we are grateful to all of the people globally who make this possible, from staff at sentinel surveillance hospitals, to country, regional, and global partners, to funding agencies, all of whom recognize the ongoing importance of surveillance for vaccine-preventable diseases. This bulletin would not be possible without you. If you have questions or feedback, or would like to join the surveillance networks, please contact us using the link at the bottom. Warmest regards, The WHO Global Rotavirus and IB-VPD Surveillance Team

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - January 2019

Dear Colleagues,

 

We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This bulletin reports the most up-to-date global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year of 2017.  In this edition, we would like to highlight the WHO Global Rotavirus, Pediatric Diarrheal Surveillance, Invasive Bacterial Diseases, Laboratory and Disease Burden meetings that were held from 26th-30th November 2018 in Cape Town, South Africa. Global and regional reference laboratories, global partners, donors and WHO convened to review the current progress and future directions of the surveillance networks.  If you have trouble viewing the graphics in this bulletin, please open the bulletin in your browser or change your settings to allow image download (instructions here). Please forward the bulletin to other interested parties or share on social media. We appreciate feedback on the bulletin, and you can subscribe or unsubscribe using the link at the bottom. We also welcome new countries who would like to join the network. Thank you to everyone from staff at the sentinel surveillance hospitals to the country, regional and global partners who make this surveillance possible.

 We hope you enjoy the bulletin!

The WHO Global Rotavirus and IB-VPD Surveillance Team 

In 2017, the WHO Global Rotavirus Surveillance Network had data reported from 62 Member States.

* Graphs 1 & 2 include sites/countries meeting these performance criteria:Sentinel sites must report cases for at least 10 months of the year 2017 (including zero reporting, if reported to WHO)Countries must report a minimum of 80 cases (all sites combined) in 2017 unless rotavirus vaccine was introduced in the country prior to 2017 (i.e., in 2016 or earlier).

Update on the 2017  Rotavirus External Quality Assessment of Laboratory Performance

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - July 2018

Acknowledgements

WHO gratefully acknowledges the dedicated efforts of the numerous individuals and organizations involved with compiling this surveillance information, including Ministries of Health, sentinel hospitals, as well as the network of global, regional and national reference laboratories. WHO also gratefully acknowledges the financial support from Gavi, the Vaccine Alliance, that is provided to eligible countries and additional support from the U.S. Centers for Disease Control and Prevention and the Bill & Melinda Gates Foundation.

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

[Revised] WHO IB-VPD and Rotavirus Surveillance Bulletin - December 2017

(Revised version including data from Colombia which had been erroneously excluded)

Dear Colleagues, 

We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This bulletin reports the most up-to-date global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year of 2016.  In this edition, we would like to highlight the WHO Global IB-VPD Surveillance Strategic Review and the Global Rotavirus and Pediatric Diarrheal Surveillance Network meetings that were held from 14th-17th November 2017 in Geneva, Switzerland. Global and regional reference laboratories, global partners and WHO convened to review the current progress and future directions of the surveillance networks. As part of expanding the rotavirus surveillance network, the global pediatric diarrheal surveillance now allows identification of a wider range of diarrhea-causing pathogens. A more detailed description is provided below in the Global Rotavirus Surveillance Network section.  If you have trouble viewing the graphics in this bulletin, please open the bulletin in your browser or change your settings to allow image download (instructions here). Please forward the bulletin to other interested parties or share on social media. We appreciate feedback on the bulletin, and you can subscribe or unsubscribe using the link at the bottom. We also welcome new countries who would like to join the network. Thank you to everyone from staff at the sentinel surveillance hospitals to the country, regional and global partners who make this surveillance possible.

 We hope you enjoy the bulletin!

The WHO Global Rotavirus and IB-VPD Surveillance Team 

In 2016, the WHO Global Rotavirus Surveillance Network had data reported from 59 Member States and 134 sentinel surveillance hospitals.

* Graphs 1 & 2 include sites/countries meeting these performance criteria:Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO)Countries must report a minimum of 80 cases (all sites combined) in 2016 unless rotavirus vaccine was introduced in the country prior to 2016 (i.e., in 2015 or earlier).

Update on the 2016 Rotavirus External Quality Assessment 

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - December 2017

Dear Colleagues, 

We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This bulletin reports the most up-to-date global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year of 2016.  In this edition, we would like to highlight the WHO Global IB-VPD Surveillance Strategic Review and the Global Rotavirus and Pediatric Diarrheal Surveillance Network meetings that were held from 14th-17th November 2017 in Geneva, Switzerland. Global and regional reference laboratories, global partners and WHO convened to review the current progress and future directions of the surveillance networks. As part of expanding the rotavirus surveillance network, the global pediatric diarrheal surveillance now allows identification of a wider range of diarrhea-causing pathogens. A more detailed description is provided below in the Global Rotavirus Surveillance Network section.  If you have trouble viewing the graphics in this bulletin, please open the bulletin in your browser or change your settings to allow image download (instructions here). Please forward the bulletin to other interested parties or share on social media. We appreciate feedback on the bulletin, and you can subscribe or unsubscribe using the link at the bottom. We also welcome new countries who would like to join the network. Thank you to everyone from staff at the sentinel surveillance hospitals to the country, regional and global partners who make this surveillance possible.

 We hope you enjoy the bulletin!

The WHO Global Rotavirus and IB-VPD Surveillance Team 

In 2016, the WHO Global Rotavirus Surveillance Network had data reported from 59 Member States and 134 sentinel surveillance hospitals.

* Graphs 1 & 2 include sites/countries meeting these performance criteria:Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO)Countries must report a minimum of 80 cases (all sites combined) in 2016 unless rotavirus vaccine was introduced in the country prior to 2016 (i.e., in 2015 or earlier).

Update on the 2016 Rotavirus External Quality Assessment 

Among the rotavirus laboratories that participated in the external quality assessment (EQA) exercise in 2016, 100% (n=119) of the laboratories passed the enzyme immunoassay (EIA) exercise to identify rotavirus. Among the laboratories that have genotyping capacities, 88% (n=60) of the laboratories passed the genotyping exercise. The rotavirus proficiency testing panels consisted of lyophilized, non-infectious samples. Year by year, there has been a significant amount of improvement in the laboratories' capacities in EIA and genotyping for rotavirus. 

All laboratories received individual feedback as well as a global report that evaluated the overall EQA performance in 2016. The laboratories that had difficulties in the genotyping exercise have been followed up by each WHO Region and the rotavirus global reference laboratory at U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - June 2017

Dear Colleagues, 

We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This bulletin reports the most up-to-date global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year 2016. Please note that data included in this bulletin are preliminary and may be subject to change. Surveillance for vaccine-preventable diseases such as rotavirus and pneumococcus is critical to generate data on disease burden before vaccines are introduced and to monitor the short- and long-term impact of vaccines on disease and immunization programs. The data generated through surveillance should be used at a country, regional, and global level. In this edition, we highlight Armenia, a country who has been conducting high-quality surveillance that has generated data to help inform vaccine policy decisions. This example adds to the case study published in the last bulletin highlighting the use of sentinel surveillance data in another part of the world in Bangladesh. If you have trouble viewing the graphics in this bulletin, please open the bulletin in your browser or change your settings to allow image download (instructions here). Please forward the bulletin to other interested parties or share on social media. We appreciate feedback on the bulletin, and you can subscribe or unsubscribe using the link at the bottom. We also welcome new countries who would like to join the network. Thank you to everyone from staff at the sentinel surveillance hospitals to the country, regional and global partners who make this surveillance possible.

 We hope you enjoy the bulletin!The WHO Vaccine-Preventable Disease Sentinel Surveillance team 

In 2016, the WHO Global Rotavirus Surveillance Network had data reported from 58 member states and 134 sentinel surveillance hospitals.

* Graphs 1 & 2 include sites/countries meeting these performance criteria:Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO HQ)Countries must report a minimum of 80 cases (all sites combined) in 2016 unless rotavirus vaccine was introduced in the country prior to 2016 (in 2015 or earlier).

Global Invasive Bacterial Vaccine-Preventable Disease Surveillance Network

In 2016, the WHO Global Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Network had data reported from 56 member states and 123 sentinel surveillance hospitals.

** Graphs 5 & 6 include sites/countries meeting these performance criteria:Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO HQ)Tier 1 countries (conducting meningitis surveillance only) and Tier 2 countries (also conducting pneumonia/sepsis surveillance) must report respectively a minimum of 80 and 400 cases (all sites combined) in 2016 unless the pneumococcal conjugate vaccine was introduced in the country prior to 2016 (in 2015 or earlier).Armenia is a lower middle-income country with a population of 3 million people including around 200,000 children under-five years of age (1). In collaboration with the WHO, the country has been conducting sentinel surveillance for rotavirus which has played a key role in the national vaccine policy and decision making process. A great example of this is the successful use of WHO Global Rotavirus Surveillance Network (GRSN) data in the final decision to introduce monovalent rotavirus vaccine in the country in 2012. Sentinel surveillance data and data from other agencies were used in the economic evaluation of rotavirus vaccine introduction in Armenia, which showed that the vaccine would reduce health care costs and would be cost saving for the country in the long-term (2). Surveillance data were also used to show the dramatic impact of rotavirus vaccine in reducing rotavirus positivity by 48% in the first year and by ≥75% in the second and third year after rotavirus vaccine introduction among children hospitalized for acute gastroenteritis (1). Results of this study also showed ≥30% reduction of rotavirus positivity among children who are too old to be vaccinated indicating indirect protection provided by the vaccine (1).  The vaccine efficacy for 2 doses of rotavirus vaccine against severe rotavirus hospitalization was 79% among children 6-23 months of age. A study conducted in GRSN sites in Armenia also detected a significant burden of disease for other gastroenteritis viruses especially norovirus among patients who tested negative for rotavirus (3). Armenia continues to leverage the GRSN platform to monitor other gastroenteritis viruses through participation in the Global Pediatric Diarrhea TAC study. These steps are very important in the ongoing monitoring of gastroenteritis pathogens especially after rotavirus introduction and to prepare for future introduction of additional enteric vaccines already in the pipeline.

Armenia has also conducted surveillance for invasive bacterial vaccine-preventable disease that is key to the country monitoring pneumococcal disease before and after the introduction of pneumococcal conjugate vaccine. Armenia is currently in the accelerated transition phase of Gavi support and funding terminates at the end of 2017. Since Gavi has been the primary external funder of immunization, self-financing and sustainability of immunization activities including surveillance are matters of primary importance in the country.

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD and Rotavirus Surveillance Bulletin - November 2016

Dear Colleagues, The World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks include strong laboratories that generate high quality data to monitor disease trends over time. The IB-VPD laboratory network supports the laboratory confirmation of disease caused byStreptococcus pneumoniae, (Spn)Haemophilus influenzae(HI) andNeisseria meningitidis(Nm) and the identification of circulating serotypes/serogroups. Laboratory performance is monitored through quality assurance/quality control programmes and on-site assessment of the laboratories to ensure accurate data is collected. This bulletin highlights the 2015 laboratory data including the distribution of identified pathogens by bacterial culture, rapid diagnostic tests and polymerase chain reaction (PCR) assay and their serotype/serogroup distribution.  In 2015, the IBVPD laboratory network included 100 Sentinel Hospital Laboratories (SHL), 28 National Laboratories (NL), nine Regional Reference Laboratories (RRL), and one Global Reference Laboratory (GRL) (Figure 2). A total of 99 (84%) out of the 118 labs that could participate in the 2015 EQA survey had a passing score while 19 (16%) showed challenges to pass the EQA exercise and are implementing corrective actions to improve diagnosis capacities.

The rotavirus laboratory network included 123 SHLs, 48 NLs, 10 RRLs, and one GRL (Figure 1). Rotavirus ELISA (EIA) testing is done at the SHL and genotyping of positive rotavirus  is done at either the NL or RRL. A total of 113 out of 116 labratories (97%) that participated in EQA passed the EIA testing and 49 out of 54 labs (91%) with genotyping capacities had a passing score in the genotyping exercise. 

Both the IB-VPD and rotavirus laboratory networks have immensely improved their capacities for diagnosis and serotyping/serogrouping of pathogens from clinical samples with combined efforts at SHLs, NLs, RRLs, and GRLs. Consequently, this has significantly strengthened the overall surveillance network that will continue to contribute to countries’ decisions for vaccine introduction and monitoring vaccine use and impact.

If you have trouble viewing the graphics in this bulletin, please view our bulletin in your browser or change your settings to allow image download (instructions here). Please forward to other interested parties or share on social media. You can subscribe or unsubscribe using the link at the bottom. Please note that data included in this bulletin is preliminary and may be subject to change.

We hope you enjoy the bulletin!The WHO Vaccine-Preventable Disease Surveillance teamIn 2015, the WHO Global Rotavirus Surveillance Network had data reported from 56 member states and 124 sentinel surveillance hospitals.In 2015, the WHO Global Invasive Bacterial Vaccine Preventable Disease (IB-VPD) Surveillance Network had data reported from 53 member states and 121 sentinel surveillance hospitals.

Asia has major gaps in understanding the burden of invasive bacterial vaccine-preventable disease (IB-VPD) and showing the impact of vaccines such as pneumococcal conjugate vaccines. Bangladesh is an exception in the region. In collaboration with the World Health Organization, the country has been conducting surveillance for IB-VPD and building laboratory capacity for several years. As a part of the WHO-coordinated Global IB-VPD Surveillance Network (GISN), Bangladesh has emerged as a model surveillance site within GISN and has had several successes. Of these successes, the strongest is that surveillance data from Bangladesh has been used to inform national vaccine policy decisions. Following national introduction of Hemophilus influenzae type b (Hib) vaccine in 2009, surveillance of bacterial meningitis in infants showed the dramatic impact of the vaccine in reducing number of confirmed Hib meningitis cases (1). The availability of ongoing IB-VPD surveillance data was used in the recent decision to introduce the pneumococcal conjugate vaccine in 2015 and was cited in the country’s successful Gavi application for PCV introduction (2). Bangladesh is now well-placed to demonstrate the impact of PCV. Bangladesh has one of the 2 population-based surveillance sites currently in GISN. Data from population-based surveillance sites can generate incidence and mortality rates and can be used in comparing populations and monitor serotype replacement. The country also has high laboratory performance and capacity which has further improved through the support and training provided through GISN. The country uses a tablet based data-management system for data collection. Bangladesh is also an excellent example of how IB-VPD surveillance can be leveraged to identify other severe vaccine-preventable diseases in children. Building on longstanding work in the country, Bangladesh is a part of a pilot study currently ongoing to assess the feasibility of integrating surveillance of typhoid fever and other invasive salmonella infections in 4 GISN countries, including Bangladesh (3). In addition, results from a study conducted in Bangladesh showed that adding rotavirus surveillance onto existing IB-VPD surveillance was successful and passed all WHO target performance indicators (4).

 

References1) Sultana NK, et al. (2013) Impact of introduction of the Haemophilus influenzae type b conjugate vaccine into childhood immunization on meningitis in Bangladeshi infants. J Pediatr. 163 (suppl 1):S73–8.2) Gavi Alliance Application Form for Country Proposals, For Support to new and Under-Used Vaccines (NVS) Submitted by The Government of Bangladesh. 10 Oct 2016 http://www.gavi.org/country/bangladesh/documents/3) World Health Organization. WHO Global Invasive Bacterial Vaccine Preventable Disease and Rotavirus Surveillance Network Bulletin. April 2016. http://us13.campaignarchive1.com/?u=920b793663d2f2d5f22813b38&id=f7893814544) Tanmoy AM, et al. (2016) Rotavirus Surveillance at a WHO-Coordinated Invasive Bacterial Disease Surveillance Site in Bangladesh: A Feasibility Study to Integrate Two Surveillance Systems. PLoS ONE. 11(4): e0153582.

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WHO IB-VPD and Rotavirus Surveillance Bulletin Dan Admin

WHO IB-VPD & Rotavirus Surveillance Bulletin, April 2016

Dear Colleagues, We are happy to introduce an updated WHO Surveillance Bulletin. We’ve transformed the bulletin into an electronic format, and we are changing our bi-annual reporting to April and October to reflect when surveillance data are available. The bulletin still presents a summary of case-based Invasive Bacterial Vaccine-Preventable Disease and Rotavirus Surveillance Network data from all six WHO Regions, and will now include data from 2013 onward. In the future, we hope to increase the frequency of these bulletins and include other vaccine-preventable disease surveillance that is ongoing at WHO. 

Our new e-bulletin looks great on many computers, but some email programs have trouble viewing the graphics. If this is the case, please change your settings to allow image download or view our bulletin in your browser (instructions here). We would appreciate any feedback on our new bulletin. If you would like to unsubscribe at any time, please use the link in the email at the bottom. Please also feel free to forward to other interested parties or share on social media. We hope you enjoy the new bulletin!The WHO Vaccine-Preventable Disease Surveillance team

In 2015, the WHO Global Rotavirus Surveillance Network had data reported from 52 member states and 110 sentinel surveillance hospitals.Complete surveillance and laboratory data for 2015 will be received in July 2016. Decreases between 2014 and 2015 seen in the figures below may not reflect trends in disease, but rather the time lag in collecting the surveillance data. In 2015, the WHO Global Invasive Bacterial Vaccine Preventable Disease (IB-VPD) Surveillance Network had data reported from 54 member states and 116 sentinel surveillance hospitals.Complete surveillance and laboratory data for 2015 will be received in July 2016. Decreases between 2014 and 2015 seen in the figures below may not reflect trends in disease, but rather the time lag in collecting the surveillance data. Enteric Pathogens TAC Phase 1 Study

In 2014, 45,320 cases of diarrhea in children <5 years of age were reported in the WHO RV network. Nearly a third (31%) of these cases tested positive for rotavirus, but the cause of diarrhea in the remaining cases was unknown. In fact, there is limited knowledge about the causes of childhood diarrhea in much of the world. This study leveraged a novel diagnostic test, the TaqMan Array Card (TAC), to test specimens gathered as part of the surveillance network for more than 25 enteric pathogens other than rotavirus. With support from the Bill and Melinda Gates Foundation and partners at the University of Virginia and the U.S. Centers for Disease Control and Prevention, TAC laboratory testing capacity was built at 5 regional references laboratories globally. More than 1200 specimens were tested from 11 countries in Africa, Asia, and the Americas. The first phase of the project was completed in 2015 and showed that this novel diagnostic testing platform could be used successfully in many laboratories globally to identify the causes of diarrhea in children. Rotavirus, norovirus, Shigella, and E. coli were among the most common causes of diarrhea in children, which suggests that vaccines can be an effective tool to lower the global burden of diarrhea in children.

Enteric Fever Surveillance Pilot

WHO, in collaboration with the respective national governments and IB-VPD sentinel sites, is carrying out a one-year pilot to assess the feasibility of integrating surveillance of enteric fever and invasive non-typhoidal salmonella disease in the IB-VPD Network. The pilot is currently being conducted in three countries – Bangladesh, India  and Ghana – and will conclude in mid-2017. The focus of the pilot is on typhoid fever (for which licensed vaccines are available and introduction of the next generation conjugate vaccines is anticipated in the near term), however data will also be collected on paratyphoid fever and other invasive salmonella infections. Surveillance in this pilot is primarily based on the methods established in the IB-VPD surveillance network, specifically hospital-based blood culture confirmation of suspect cases in children aged up to 15 years of age. This pilot addresses one of the recommendations of the 2013 strategic review of the IB-VPD network to examine how the network can be leveraged for surveillance of other vaccine preventable diseases. A formal evaluation of the pilot will be conducted in 2017 and recommendations made to the technical advisory group for consideration.

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