Paediatric Active Enhanced Disease Surveillance (PAEDS) 2017 and 2018: Prospective hospital-based surveillance for serious paediatric conditions
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Jocelynne E McRae1, Helen E Quinn2, Gemma L Saravanos3
1PAEDS Co-Manager, Clinical Nurse Consultant, National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research Institute, The Children's Hospital at Westmead, New South Wales.
Insights
The Paediatric Active Enhanced Disease Surveillance (PAEDS) network monitored serious childhood illnesses, including vaccine-preventable diseases and adverse events. Surveillance data from 2017-2018 highlighted variable influenza activity and suboptimal varicella vaccine uptake in children.
Area of Science:
- Paediatric infectious diseases
- Vaccine-preventable diseases
- Public health surveillance
Background:
- The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based system for monitoring serious childhood conditions.
- It focuses on vaccine-preventable diseases and potential adverse events following immunisation (AEFI).
- This report details surveillance data from 2017 and 2018.
Purpose of the Study:
- To present surveillance data for selected serious childhood conditions from the PAEDS network for 2017 and 2018.
- To contribute to national surveillance targets and vaccine effectiveness estimations.
- To evaluate parental attitudes towards vaccination.
Main Methods:
- Daily screening of hospital admissions, emergency department records, and laboratory data by specialist nurses in seven Australian paediatric tertiary referral hospitals.
- Surveillance included acute flaccid paralysis (AFP), acute childhood encephalitis (ACE), influenza, intussusception (IS), pertussis, varicella-zoster virus infections, invasive meningococcal disease, and invasive Group A streptococcus disease.
- A social research component assessed parental vaccination attitudes.
Main Results:
- PAEDS captured 1,580 cases in 2017 and 925 in 2018.
- Identified a human parechovirus outbreak linked to ACE and demonstrated season-dependent influenza vaccine effectiveness.
- Noted suboptimal varicella vaccine uptake and predominance of meningococcal serotype B (57%).
Conclusions:
- The PAEDS network provides valuable, policy-relevant data on serious paediatric conditions through hospital-based sentinel surveillance.
- Findings inform public health strategies for disease prevention and vaccination programs.
- Continued surveillance is crucial for monitoring disease trends and vaccine impact.
Introduction:
The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine-preventable diseases and potential adverse events following immunisation (AEFI). This report presents surveillance data for 2017 and 2018.
Methods:
Specialist nurses screened hospital admissions, emergency department (ED) records, laboratory and other data on a daily basis in seven paediatric tertiary referral hospitals across Australia to identify children with the conditions under surveillance. In 2017 and 2018 these included acute flaccid paralysis (AFP; a syndrome associated with poliovirus infection), acute childhood encephalitis (ACE), influenza, intussusception (IS; a potential AEFI with rotavirus vaccines), pertussis, varicella-zoster virus infection (varicella and herpes zoster), invasive meningococcal, and invasive Group A streptococcus diseases. An additional social research component was added to evaluate parental attitudes to vaccination.
Results:
PAEDS captured 1,580 and 925 cases for 2017 and 2018, respectively, across all conditions under surveillance. Key outcomes of PAEDS included: contribution to national AFP surveillance to reach the World Health Organization reporting targets; identification of a third human parechovirus outbreak among other infectious diseases linked to ACE; demonstration of variable influenza activity between 2017 and 2018, with vaccine effectiveness (VE) analysis demonstrating that the protection offered through vaccination is season-dependent. All IS cases associated with vaccine receipt were reported to the relevant state health department. Varicella and herpes zoster case numbers remained unchanged, with vaccine uptake found to be suboptimal among eligible children under the NIP. Enhanced pertussis surveillance continues to capture controls for VE estimation. Surveillance for invasive meningococcal disease showed predominance for serotype B at 57% over 2 years among 77 cases where serotyping was available, and surveillance for invasive group A streptococcus captured severe disease in children.
Conclusion:
PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using hospital-based sentinel surveillance.
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