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Front Portion of Surveillance Manual

Manual for the Surveillance of Vaccine-Preventable Diseases

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Title Pages

Manual for the Surveillance of Vaccine-Preventable Diseases

Edited by:
Sandra W. Roush, MT, MPH
Lynne McIntyre, MALS
Linda M. Baldy, MPH

Centers for Disease Control and Prevention
Department of Health and Human Services

Available on the internet at: http://www.cdc.gov/vaccines/pubs/surv-manual/

Suggested citation:
Centers for Disease Control and Prevention. Manual for the surveillance of vaccine-preventable diseases. Centers for Disease Control and Prevention, Atlanta, GA, 2008.
(Note: If referencing a specific chapter within manual, use the date next to chapter on index page.)

This manual is not intended to be a therapeutic guide; therefore, while dosages of antimicrobials and immunobiologics are discussed in the context of prophylaxis and treatment for case-patients and contacts, physicians and other health-care professionals should review the package inserts prepared by the manufacturers to determine appropriate dosages.

This manual is designed to provide general guidance regarding surveillance activities for vaccine-preventable diseases. Because recommendations for use of vaccines may change, readers should consult their local or state health departments or CDC’s Vaccines website at http://www.cdc.gov/vaccines/.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Public Health Service or the U.S. Department of Health and Human Services.

Acknowledgments:
This manual was prepared by the Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases.

We thank colleagues in the National Center for Immunization and Respiratory Diseases, CDC, and others who offered advice, made specific recommendations on format and content, reviewed drafts, or assisted in other ways in the preparation of this manual.

We particularly wish to acknowledge the valuable assistance of the following: Cathy Hogan and Curt Wommack

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Introduction

National Center for Immunization and Respiratory Diseases

This manual was first developed in 1996 to provide general guidance to state and local health department personnel who are involved in surveillance activities for vaccine-preventable diseases. This manual answers commonly asked questions regarding the surveillance and reporting of vaccine-preventable diseases and provides information on enhancing existing surveillance systems.

Several reference documents, tables, and worksheets have been included in this manual for your convenience and information. The worksheets in this manual are in the public domain and may be copied and distributed for use in public health surveillance activities.

Please forward any suggestions and comments regarding this manual to:

Surveillance Officer
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
1600 Clifton Road NE, MS-A27
Atlanta, GA 30333

Phone: 404-639-8746

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Acronyms

ACIP
Advisory Committee on Immunization Practices
APHL
Association of Public Health Laboratories
CDC
Centers for Disease Control and Prevention
CF
Complement fixation
CMV
Cytomegalovirus
CPHA
Commission on Professional and Hospital Activities
CRS
Congenital rubella syndrome
CSF
Cerebrospinal fluid
CSTE
Council of State and Territorial Epidemiologists
DAT
Diphtheria antitoxin
DFA
Direct fluorescent antibody
DHHS
Department of Health and Human Services
DRSP
Drug-resistant Streptococcus pneumoniae
DT
Diphtheria and tetanus toxoids
DTP
Diphtheria and tetanus toxoids and whole-cell pertussis vaccine
DTaP
Diphtheria and tetanus toxoids and acellular pertussis vaccine
EBV
Epstein-Barr virus
EIA
Enzyme-immunoassay
ELISA
Enzyme-linked immunosorbent assay
ELR
Electronic laboratory reporting
FAMA
Fluorescent antibody to membrane antigen
FDA
Food and Drug Administration
HA
Hemagglutinin
HAV
Hepatitis A virus
HBcAg
Hepatitis B core antigen
HBIG
Hepatitis B immune globulin
HBeAg
Hepatitis B e antigen
HBsAg
Hepatitis B surface antigen
HBV
Hepatitis B virus
HCV
Hepatitis C virus
HDV
Hepatitis D virus
HI
Hemagglutination inhibition
Hi
Haemophilus influenzae
Hib
Haemophilus influenzae type b
HMO
Health maintenance organization
IFA
Indirect fluorescent antibody
IG
Immune globulin
IOM
Institute of Medicine
IPV
Inactivated poliovirus vaccine
LA
Latex agglutination
MMR
Measles-mumps-rubella vaccine
MMWR
Morbidity and Mortality Weekly Report
MR
Measles-rubella vaccine
MSAEFI
Monitoring System for Adverse Events Following Immunization
NA
AmNeuraminidasee
NCCLS
National Committee for Clinical Laboratory Standards
NCHS
National Center for Health Statistics
NCIRD
National Center for Immunization and Respiratory Diseases
NCRSR
National Congenital Rubella Syndrome Registry
NCVIA
National Childhood Vaccine Injury Act of 1986
NEDSS
National Electronic Disease Surveillance System
NETSS
National Electronic Telecommunications System for Surveillance
NHANES
National Health and Nutrition Examination Survey
NHIS
National Health Interview Survey
NNDSS
National Notifiable Diseases Surveillance System
NVICP
National Vaccine Injury Compensation Program
OPV
Oral poliovirus vaccine
P&I
Pneumonia and influenza
PCR
Polymerase chain reaction
PHA
Passive hemagglutination
RASH
Rapid Surveillance Helper
RET
Reportable Events Table
RIA
Radioimmunoassay
SIDS
Sudden Infant Death Syndrome
SHC
State health coordinator
SPSS
Supplementary Pertussis Surveillance System
TIG
Tetanus immune globulin
TT
Tetanus toxoid
VAE
Vaccine adverse event
VAERS
Vaccine Adverse Event Reporting System
VAPP
Vaccine-associated paralytic poliomyelitis
VHSP
Viral Hepatitis Surveillance Program
VPD
Vaccine-preventable disease
VZIG
Varicella-zoster immune globulin
VZV
Varicella-zoster virus
WBC
White blood-cell count
WHO
World Health Organization

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Definition of Terms

Attenuated virus
A strain of virus whose virulence has been lowered by physical or chemical processes or by repeated passage through the cells of another species.
Breakthrough
The appearance of clinical disease in an individual who has previously been vaccinated against the agent causing the disease.
Clinically compatible case
A case featuring a clinical syndrome generally compatible with the disease, but for which specific clinical criteria may not have been met unless they are noted in the case classification.
Confirmed case
A case that is classified as confirmed for reporting purposes.
Contraindication
A characteristic or attribute of an individual that may be temporary or permanent that prohibits the administration of a drug, vaccine, or other therapeutic intervention.
Encephalitis
An inflammatory condition of brain tissue caused by a variety of infectious and non-infectious diseases. In varicella, influenza, and measles, this is sometimes referred to as post-infectious encephalitis.
Epidemiologically
linked case
A case in which the patient has or has had contact with one or more persons who have or have had the disease, and transmission of the agent by the usual modes of transmission is plausible. In general, a case may be considered epidemiologically linked to a laboratory-confirmed case if at least one case in the chain of transmission is laboratory confirmed.
Erythema
Redness (or inflammation) of the skin or mucous membranes that is the result of dilation and congestion of superficial capillaries.
Exanthem
A skin eruption or rash that may have specific diagnostic features of an infectious disease. Chickenpox, measles, roseola infantum, rubella, and smallpox are usually characterized by a particular type of exanthem.
Immuno-compromised
A state in which an individual has either a decreased or absent ability to mount an antibody and/or cell-mediated immune response to infectious agents.
Incubation period
The period of time from exposure to an infecting agent to the onset of symptoms of disease.
Laboratory confirmed case
A case that is confirmed by one or more of the laboratory methods listed in the case definition under “Laboratory criteria.” Although other laboratory methods may be used in clinical diagnosis, only those listed are accepted for laboratory confirmation for reporting purposes.
Line listing
A tool used during epidemiologic investigations to allow investigators to record case information and to review and follow up case reports or conduct data analysis.
Meets the clinical case definition
Meets precisely the clinical case definition. Although in clinical practice the diagnosis may be made with the use of other criteria, for reporting purposes the stated criteria must be met.
Primary vaccine failure
The absence of seroconversion after vaccination. This is manifest as the occurrence of disease in a vaccinated individual in which the disease occurrence closely resembles that found in natural infection with wild-type virus, i.e., more commonly moderate or severe disease.
Probable case
A case that is classified as probable for reporting purposes.
Secondary vaccine failure
Loss of immunity acquired after vaccination.
Sentinel event
A preventable disease, disability, or untimely death that serves as a warning signal of a possible underlying problem.
Sentinel surveillance
Activities focused on monitoring key health indicators in the general population or in special populations. The primary intent is to obtain timely information needed for public health or medical action in a relatively inexpensive manner rather than to derive precise estimates of prevalence or incidence in the general population.
Supportive laboratory results
Specified laboratory results consistent with the diagnosis but not meeting the criteria for laboratory confirmation.
Susceptible
Being sensitive to effects of an infectious disease, allergen, or other pathogenic agent; lacking immunity or resistance.
Thermolability
A characteristic of vaccines that cause them to lose potency when stored or held at temperatures other than that recommended by the manufacturer.
Vaccine coverage
The proportion or percentage of persons that have received a vaccine among all individuals in a particular group who are eligible to receive the vaccine.
Vaccine effectiveness
The ability of a vaccine to provide protection against disease when used under field conditions (e.g., use of the vaccine in routine practice).
Vaccine efficacy
The ability of a vaccine to provide protection against disease under ideal circumstances (e.g., during a clinical trial).

 

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