Paediatric Active Enhanced Disease Surveillance (PAEDS) 2017 and 2018: Prospective hospital-based surveillance for serious paediatric conditions
DOI:
https://doi.org/10.33321/cdi.2020.44.49Keywords:
paediatric, surveillance, child, hospital, vaccine-preventable diseases, adverse event following immunisation, acute flaccid paralysis, encephalitis, influenza, intussusception, pertussis, varicella zoster virus, meningococcal, group A streptococcusAbstract
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.
Conclusions: PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using hospital-based sentinel surveillance.
Downloads
References
McRae JE, Quinn HE, Macartney K. Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2015: Prospective hospital-based surveillance for select vaccine preventable diseases and adverse events following immunisation. Commun Dis Intell Q Rep. 2017;41(3):E264–78.
Zurynski YA, McRae JE, Quinn HE, Wood NJ, Macartney KK on behalf of the PAEDS network. Paediatric Active Enhanced Disease Surveillance inaugural annual report, 2014. Commun Dis Intell Q Rep. 2016;40(3):E391–400.
McRae JE, Quinn HE, Saravanos GE, Britton PN, McMinn A, Wood N et al. Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2016: prospective hospital-based surveillance for serious paediatric conditions. Commun Dis Intell (2018). 2019;43. https://doi.org/0.33321/cdi.2019.43.5
Zurynski Y, McIntyre P, Booy R, Elliott EJ, on behalf of the PAEDS Investigators Group. Paediatric Active Enhanced Disease Surveillance: a new surveillance system for Australia. J Paediatr Child Health. 2013;49(7):588–94.
Roberts J, Hobday L, Ibrahim A, Aitken T, Thorley B. Australian National Enterovirus Reference Laboratory annual report, 2014. Commun Dis Intell Q Rep. 2017;41(2):E161–9.
World Health Organization. Global Polio Eradication Initiative, Surveillance. [Internet.] Geneva, Switzerland: Global Polio Eradication Initiative, World Health Organization. [Accessed: 30 July 2019.] Available from: http://polioeradication.org/who-we-are/strategic-plan-2013-2018/surveillance/
Paediatric Trials Network Australia. WebSpirit. [Internet.] 2013. [Accessed: 24 October 2017.] Available from: http://www.ptna.com.au/index.php/webspirit
Britton PN, Dale RC, Booy R, Jones CA. Acute encephalitis in children: Progress and priorities from an Australasian perspective. J Paediatr Child Health. 2015;51(2):147–58.
Elliott EJ, Zurynski YA, Walls T, Whitehead B, Gilmour R, Booy R. Novel inpatient surveillance in tertiary paediatric hospitals in New South Wales illustrates impact of first-wave pandemic influenza A H1N1 (2009) and informs future health service planning. J Paediatr Child Health. 2012;48(3):235–41.
Bines JE, Kohl KS, Forster J, Zanardi LR, Davis RL, Hansen J et al. Acute intussusception in infants and children as an adverse event following immunization: case definition and guidelines of data collection, analysis, and presentation. Vaccine. 2004;22(5-6):569–74.
Buttery JP, Danchin MH, Lee KJ, Carlin JB, McIntyre PB, Elliott EJ et al. Intussusception following rotavirus vaccine administration: post-marketing surveillance in the National Immunization Program in Australia. Vaccine. 2011;29(16):3061–6.
Carlin JB, Macartney KK, Lee KJ, Quinn HE, Buttery J, Lopert R et al. Intussusception risk and disease prevention associated with rotavirus vaccines in Australia’s National Immunization Program. Clin Infect Dis. 2013;57(10):1427–34.
Quinn HE, Wood NJ, Cannings KL, Dey A, Wang H, Menzies RI et al. Intussusception after monovalent human rotavirus vaccine in Australia: severity and comparison of using healthcare database records versus case confirmation to assess risk. Pediatr Infect Dis J. 2014;33(9):959–65.
Pillsbury A, Quinn HE, McIntyre PB. Australian vaccine preventable disease epidemiological review series: Pertussis, 2006–2012. Commun Dis Intell Q Rep. 2014;38(3):E179–94.
Marshall H, Quinn H, Gidding H, Richmond P, Crawford N, Gold N et al. Severe and complicated varicella in the post-varicella vaccine era and associated genotypes. [Conference presentation.] Presented at: 15th National Immunisation Conference; 7–9 June 2016; Brisbane.
Bilukha OO, Rosenstein N. Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2005;54(RR-7):1–21.
Peltola H. Meningococcal disease: still with us. Rev Infect Dis. 1983;5(1):71–91.
Trotter CL, Chandra M, Cano R, Larrauri A, Ramsay ME, Brehony C et al. A surveillance network for meningococcal disease in Europe. FEMS Microbiol Rev. 2007;31(1):27–36.
Borg J, Christie D, Coen PG, Booy R, Viner RM. Outcomes of meningococcal disease in adolescence: prospective, matched-cohort study. Pediatrics. 2009;123(3):e502–9.
Davis KL, Misurski D, Miller J, Karve S. Cost impact of complications in meningococcal disease: evidence from a United States managed care population. Hum Vaccin. 2011;7(4):458–65.
Wang B, Clarke M, Thomas N, Howell S, Afzali HH, Marshall H. The clinical burden and predictors of sequelae following invasive meningococcal disease in Australian children. Pediatr Infect Dis J. 2014;33(3):316–8.
Hoge CW, Schwartz B, Talkington DF, Breiman RF, MacNeill EM, Englender SJ. The changing epidemiology of invasive group A streptococcal infections and the emergence of streptococcal toxic shock-like syndrome. A retrospective population-based study. JAMA. 1993;269(3):384–9.
Steer AC, Danchin MH, Carapetis JR. Group A streptococcal infections in children. J Paediatr Child Health. 2007;43(4):203–13.
Beard F, Hendry A, Macartney K. Early success with room for improvement: influenza vaccination of young Australian children. Med J Aust. 2019:210(11):484–6.
Australian Bureau of Statistics (ABS). Regional population by age and sex, Australia, 2017. (Cat No. 3235.0) [Internet.] Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3235.02017?OpenDocument
Australian Bureau of Statistics (ABS). Regional population by age and sex, Australia, 2018. (Cat No. 3235.0) [Internet.] Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3235.02018?OpenDocument
Britton PN, Dale RC, Blyth CC, Clark JE, Crawford N, Marshall H et al. Causes and clinical features of childhood encephalitis: a multicentre, prospective, cohort study. Clin Infect Dis. 2019. https://doi.org/ https://doi.org/10.1093/cid/ciz685.
Carlson S, Scanlan C, Marshall H, Blyth C, Macartney K, Leask J. Attitudes about and access to influenza vaccination experienced by parents of children hospitalised for influenza in Australia. Vaccine. 2019;37(40):5994–6001.
Britton PN, Jones CA, Macartney K, Cheng AC. Parechovirus: an important emerging infection in young infants. Med J Aust. 2018;208(8):365–9.
Britton PN, Blyth CC, Macartney K, Dale RC, Li-Kim-Moy J, Khandaker G et al. The spectrum and burden of influenza-associated neurological disease in children: combined encephalitis and influenza sentinel site surveillance from Australia, 2013–2015. Clin Infect Dis. 2017;65(4):653–60.
Blyth CC, Macartney KK, McRae J, Clark JE, Marshall HS, Buttery J et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2017: results from the PAEDS-FluCAN collaboration. Clin Infect Dis. 2019;68:940–8.
National Influenza Surveillance Committee. 2017 Influenza Season in Australia. Australian Government Department of Health. [Accessed: 30 July 2019.] Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/097F15A91C05FBE7CA2581E20017F09E/$File/2017-season-summary-22112017.pdf
McRae, J. on behalf of the PAEDS and FluCAN Networks. Influenza hospitalisations of Australian Infants 2017: Epidemiology and maternal vaccine effectiveness. [Conference presentation.] Public Health Association of Australia: 16th National Immunisation Conference, June 2018, Adelaide.
National Influenza Surveillance Committee. 2018 Influenza Season in Australia. Australian Government Department of Health. [Accessed: 30 July 2019.] Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/CA086525758664B4CA25836200807AF9/$File/2018-Season-Summary.pdf
National Centre for Immunisation Research and Surveillance. Significant events in influenza vaccination practice in Australia. [Accessed: 30 July 2019.] Available from: http://ncirs.org.au/sites/default/files/2019-07/Influenza-history-July%202019.pdf
Blyth CC, Cheng AC, Crawford NW, Clark JE, Buttery JP, Marshall HS et al. The impact of new universal child influenza programs in Australia: vaccine coverage, effectiveness and disease epidemiology in hospitalised children in 2018. Vaccine. 2019. (Submitted.)
NNDSS Annual Report Working Group. Australia’s notifiable disease status, 2014: Annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell Q Rep. 2016;40(1):E48–145.
Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook. [Internet.] Canberra: Australian Government Department of Health; 2018. Available from: https://immunisationhandbook.health.gov.au/.
Amirthalingam G, Andrews N, Campbell H, Ribeiro S, Kara E, Donegan K et al. Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet. 2014;384(9953):1521–8.
Saul N, Wang K, Bag S, Baldwin H, Alexander K, Chandra M et al. Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: The NSW Public Health Network case-control study. Vaccine. 2018;36(14):1887–92.
Newcombe J, Kaur R, Wood N, Seale H, Palasanthiran P, Snelling T. Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals. Vaccine. 2014;32(48):6364–8.
Van Buynder PG, Carcione D, Rettura V, Daly A, Woods E. Marketing paediatric influenza vaccination: results of a major metropolitan trial. Influenza Other Respir Viruses. 2010;5(1):33–8.
Hale K. Survey of influenza immunisation uptake in ‘high risk’children. J Paediatr Child Health. 2006;42(5):321.
Chow MYK, King C, Booy R, Leask J. Parents’ intentions and behavior regarding seasonal influenza vaccination for their children: A survey in child-care centers in Sydney, Australia. J Pediatr Infect Dis. 2012;7(2):89–96.
Norman DA, Danchin M, Van Buynder P, Moore HC, Blyth CC, Seale H. Caregiver’s attitudes, beliefs, and experiences for influenza vaccination in Australian children with medical comorbidities. Vaccine. 2019;37(16):2244–8.
Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A. Increasing vaccination: Putting psychological science into action. Psychol Sci Public Interest. 2017;18(3):149–207.
Biezen R, Grando D, Mazza D, Brijnath B. Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers. Vaccine. 2018;36(6):859–65.
Frew PM, Lutz CS. Interventions to increase pediatric vaccine uptake: An overview of recent findings. Hum Vaccin Immunother. 2017;13(11):2503–11.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Communicable Diseases Intelligence

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
