Surveillance of the emerging enterovirus D68 in Canada: An evaluation

In the fall of 2014, in response to outbreaks of an emerging respiratory pathogen enterovirus D68 (EV-D68) which affected mostly children, a rapid time-limited surveillance pilot for hospitalized cases was conducted in seven Canadian jurisdictions.

To evaluate whether the goals of the EV-D68 pilot were met and to determine the benefits of and lessons learned from a rapid-response surveillance system for emerging pathogens.

An evaluation survey was created and administered via a secure online link. All provinces and territories (PTs) and federal partners involved in the pilot were invited to complete one survey per jurisdiction (N=17). Proportions were calculated for responses to closed-ended questions and recurring themes were identified for open-ended questions.

Fifty four percent (7/13) of PTs and 50% (2/4) of federal partners completed the survey. All four goals of the pilot were met to some degree. All respondents agreed that there were important benefits to rapid surveillance initiatives for emerging pathogens including the capacity to: better understand the epidemiological and clinical features as well as the public health risk of emerging pathogens (66.7%); inform public health action (66.7%); collaborate and avoid duplication of work (11.1%); test and develop jurisdictional capacity (11.1%); and inform future response efforts (11.1%). Receiving timely case summaries (preferably weekly) was identified as important for 88% of respondents. In terms of lessons learned, more than half of respondents (66.7%) indicated that current processes needed to be improved in order to facilitate rapid surveillance initiatives within and across jurisdictions including the need to develop data-sharing agreements and have pre-existing protocols. Important factors identified for a surveillance data reporting platform included: ease of functionality, data security, jurisdictional control, web-based and flexibility to meet changing surveillance needs.

Evaluation results from the EV-D68 surveillance pilot will assist with future rapid surveillance initiatives. It is important that lessons learned be addressed prior to the emergence of the next emerging pathogen.