Central Surveillance Unit, IDSP

Total no. of outbreaks reported through IDSP by the
States/UTs in 2008-2011 (till 26 th June 2011)
Year
2008
2009
2010
2011
(till 26th June )
All 35 States/UTs 9 WB funded States/UTs
553
799
990
699
400 (72%)
488 (61%)
619 (63%)
516 (74%)

Weekly EWS / Outbreak report submitting Status of States/UTs in
2011 (till 25 th week ending on 26 th June)
STATES / UTs EWS/OUTBREAK REPORT
SUBMITTING STATUS
> 80% times reported
(Consistently and timely reporting)
50 - 79 % times reported
25 - 49 % times reported
< 25 % times reported
Never reported
Andhra Pradesh, Arunachal
Pradesh, Assam, Bihar, Jammu &
Kashmir, Karnataka, Kerala,
Madhya Pradesh, Manipur,
Meghalaya, Orissa, Punjab,
Rajasthan, Tamil Nadu, Tripura,
Uttarakhand, West Bengal
Chandigarh, Daman & Diu, Goa,
Gujarat, Himachal Pradesh,
Maharashtra, Puducherry, Sikkim,
Uttar Pradesh
Chhattisgarh, Delhi, Haryana,
Nagaland
Lakshadweep, Mizoram, Jharkhand
Andaman & Nicobar, Dadra & Nagar
Haveli

State-wise total no. of outbreaks reported through IDSP by all States/UTs in
2008, 2009, 2010 & 2011 (till 25 th wk ending June 26 th 2011)
Sl. No.
State Total
25
26
27
28
29
30
19
20
21
22
23
24
31
32
33
34
35
6
7
8
9
10
11
1
2
3
4
5
12
13
14
15
16
17
18
Karnataka
Tamil Nadu
West Bengal
Gujarat
Andhra Pradesh
Maharashtra
Uttar Pradesh
Rajasthan
Madhya Pradesh
Assam
Kerala
Orissa
Uttarakhand
Punjab
Bihar
Haryana
Himachal Pradesh
Arunachal Pradesh
Chhattisgarh
Jharkhand
Meghalaya
Tripura
Puducherry
Chandigarh
Sikkim
Delhi
Goa
Manipur
Mizoram
Jammu & Kashmir
Nagaland
Daman & Diu
Dadra and Nagar Haveli
Andaman & Nicobar
Lakshadweep
Total
1
5
0
3
3
2
1
3
3
1
0
5
0
0
0
0
0
553
2008
54
50
49
24
72
99
40
8
16
16
17
17
27
17
1
10
3
6
2
0
2
2
0
0
2
4
2
2
4
2
2
1
1
0
0
990
Year
2010
90
90
89
83
75
65
98
84
70
53
53
19
25
18
21
18
7
6
2
0
0
0
1
3
2
2
3
7
5
3
1
1
0
0
0
799
2009
97
113
43
49
64
27
67
43
65
30
47
38
30
22
6
9
13
6
1
0
2
3
3
1
5
0
0
4
1
0
0
0
0
0
0
699
2011
110
49
90
101
39
32
10
50
24
39
19
33
21
24
25
7
1
5
6
5
4
8
7
6
14
10
10
10
9
8
3
2
1
0
0
3041
351
302
271
257
250
223
215
185
175
138
136
107
103
81
53
44
24
23

State-wise total no. of outbreaks reported through IDSP by the World Bank funded States in 2008, 2009, 2010 & 2011 (till 25 th wk ending June 26 th 2011)
Sl.
No.
State Year Total
2008 2009 2010 2011
1 Andhra Pradesh
2 Gujarat
3 Karnataka
4 Maharashtra
5 Punjab
6 Rajasthan
7 Tamil Nadu
8 Uttarakhand
9 West Bengal
Sub Total
90
25
89
619
75
83
90
65
18
84
113
30
43
488
64
49
97
27
22
43
50
27
49
400
72
24
54
99
17
8
24
50
49
21
90
516
39
101
110
32
302
103
271
2023
250
257
351
223
81
185

State-wise total no. of outbreaks reported through IDSP by the non-WB funded
States in 2008, 2009, 2010 & 2011 (till 25 th wk ending June 26 th 2011)
Sl. No.
State Total
1 Andaman & Nicobar
2 Arunachal Pradesh
3 Assam
4 Bihar
5 Chandigarh
6 Chhattisgarh
7 Dadra and Nagar Haveli
8 Daman & Diu
9 Delhi
10 Goa
11 Haryana
12 Himachal Pradesh
13 Jammu & Kashmir
14 Jharkhand
15 Kerala
16 Lakshadweep
17 Madhya Pradesh
18 Manipur
19 Meghalaya
20 Mizoram
21 Nagaland
22 Orissa
23 Puducherry
24 Sikkim
25 Tripura
26 Uttar Pradesh
Sub Total
5
0
17
3
3
1
40
153
0
0
17
0
16
1
5
2
10
3
0
3
1
0
2008
0
6
16
1
3
0
1
38
2
0
2
67
311
0
5
47
0
65
2
3
3
9
13
1
1
7
0
2009
0
6
30
6
3
Year
0
2
19
4
2
2
98
371
2
4
53
0
70
2
2
0
18
7
1
0
2
1
2010
0
6
53
21
2
136
0
175
6
10
5
3
107
9
8
10
215
1018
44
24
4
10
2
7
6
0
23
138
53
8
14
1
24
1
0
0
0
33
0
2
1
19
0
7
1
3
1
3
5
10
183
2011
0
5
39
25
0
4
0
0

Disease-wise total no. of outbreaks reported through IDSP by all States in
2008, 2009, 2010 & 2011 (till 25 th wk ending June 26 th )
Sl. No.
Disease/Illness
1
2
3
4
5
6
7
Acute Diarrhoeal Disease
Food Poisoning
Measles
Chicken Pox
Malaria
Viral Hepatitis
Viral Fever
8
9
Chikungunya
Dengue
10 Cholera
11 Enteric Fever
12 Acute Encephalitis Syndrome
13 Anthrax
14 Leptospirosis
15 Acute Respiratory Illness
16 Dysentery
17 Kalazar
18 Meningitis
19 Scrub Typhus
20 Acute Flaccid Paralysis
21 Mumps
22 PUO
23 Diphtheria
24 Rubella
25 Cremian-Congo Haemorrhagic Fever
26 Gas Poisoning
27 Acute Febrile Illness
28 Buffalo pox
29 Epidemic dropsy
30 Kyasanur Forest Disease
31 Pertussis
32 Viral Hepatitis B
33 Vitamin A Overdosage
Total
1
0
0
0
0
0
0
553
1
1
0
0
0
1
2
3
1
0
6
2
6
4
0
25
42
20
6
Year
2008 2009 2010
228 332 411
50 121 188
40
12
43
28
31
44
45
34
30
37
94
47
37
24
40
61
20
34
10
5
6
3
3
1
25
40
34
10
11
3
6
3
3
0
3
1
0
2
2
1
1
0
1
0
1
0
0
0
1
0
799
0
0
1
0
1
0
0
990
1
1
2
0
0
3
1
1
0
3
0
0
0
1
0
0
1
699
0
0
0
2
1
1
2
5
1
6
1
1
3
3
12
14
22
4
6
2011
220
158
103
47
23
46
16
Total
1
1
1
1
1
1
1
3041
4
3
3
2
2
7
7
7
6
6
1191
517
281
151
137
128
124
123
116
110
30
28
17
16
11
7

Disease-wise total no. of outbreaks reported through IDSP by all States in 2008, 2009, 2010 & 2011 (till 25 th wk ending June 26 th )
2008 2009 2010
Sl.
No.
Disease / Illness
1 Acute Diarrhoeal Disease
2 Food Poisoning
3 Measles
4 Chicken Pox
5 Malaria
6 Viral Hepatitis
7 Viral Fever
8 Chikungunya
9 Dengue
10 Cholera
11 Enteric Fever
12 AES / JE
13 Anthrax
14 Leptospirosis
15 Acute Resp. Illness
16 Dysentery
17 Kalazar
18 Meningitis
19 Scrub Typhus
20 AFP
21 Mumps
22 PUO
23 Diphtheria
24 Rubella
25 CCHF
26 Gas Poisoning
27 Acute Febrile Illness
28 Buffalo pox
29 Epidemic dropsy
30 Kyasanur Forest Disease
31 Pertussis
32 Viral Hepatitis B
33 Vitamin A Overdosage
Total
9 WB funded
States
0
0
0
0
0
0
2
1
0
2
5
3
0
0
0
0
0
0
0
0
4
6
1
26
22
30
9
177
38
22
7
29
16
400
Other
26
States Total
0
0
0
0
1
1
1
0
1
0
1
1
0
0
0
0
0
0
1
0
2
0
1
5
3
12
11
51
12
18
5
14
12
153
0
0
0
0
1
1
3
1
1
2
6
4
0
0
0
0
0
0
1
0
6
6
2
31
25
42
20
228
50
40
12
43
28
553
Other
26
States Total
1
0
0
2
0
1
1
0
0
2
1
0
0
0
0
0
0
0
0
0
2
4
4
9
8
7
8
115
54
25
29
20
18
311
1
0
1
2
2
1
1
0
0
3
3
3
1
0
1
0
0
0
0
1
37
61
20
34
10
5
6
332
121
44
45
34
30
799
9 WB funded
States
0
0
1
0
2
0
0
0
0
1
2
3
1
0
1
0
0
0
0
1
8
1
2
30
53
11
26
217
67
19
16
14
12
488
Other
26
States Total
1
0
0
1
0
1
1
0
2
1
1
2
2
0
0
0
1
0
0
0
8
8
13
13
7
10
2
101
80
53
34
21
8
371
2
0
0
3
1
1
1
0
3
1
6
3
3
1
0
0
1
0
0
0
40
25
40
34
10
11
3
411
188
94
47
37
24
990
9 WB funded
States
1
0
0
2
1
0
0
0
1
0
5
1
1
1
0
0
0
0
0
0
3
1
1
32
17
27
21
310
108
41
13
16
16
619
2011
9 WB funded
States
0
2
1
0
0
0
1
2
1
0
1
1
2
0
0
1
0
1
0
0
2
3
4
12
11
12
16
174
125
61
29
17
37
516
Other
26
States Total
4
6
6
16
12
14
22
220
158
103
47
23
46
2
5
3
1
1
0
1
1
3
0
0
0
1
0
0
1
3
2
1
0
0
1
0
0
0
0
0
0
0
2
3
2
2
6
4
1
46
33
42
18
6
9
183
0
2
1
0
0
1
0
0
1
699
Total no. of outbreaks reported
3
2
2
6
4
3
7
6
7
7
16
11
7
1
1
1
1
1
1
1
124
123
116
110
30
28
17
1191
517
281
151
137
128
3041

0
17
3
17
5
5
54
17
0
16
99
1
10
3
0
0
2
24
0
3
50
1
40
27
8
3
49
553
6
16
1
3
0
72
1
0
1 Andaman Nicobar
2 Andhra Pradesh
3 Arunachal Pradesh
4 Assam
5 Bihar
6 Chandigarh
7 Chhattisgarh
8 D & N Haveli
9 Daman & Diu
10 Delhi
11 Goa
12 Gujarat
13 Haryana
14 Himachal Pradesh
15 Jammu & Kashmir
16 Jharkhand
17 Karnataka
18 Kerala
19 Lakshadweep
20 Madhya Pradesh
21 Maharashtra
22 Manipur
23 Meghalaya
24 Mizoram
25 Nagaland
26 Orissa
27 Puducherry
28 Punjab
29 Rajasthan
30 Sikkim
31 Tamil Nadu
32 Tripura
33 Uttar Pradesh
34 Uttarakhand
35 West Bengal
Grand Total
Sl.
No.
No. of disease outbreaks for which Laboratory facilities accessed and etiology confirmed by the States/UTs through IDSP in 2008, 2009, 2010 and 2011 (till 26th June 2011)
State / UT
Total
0
4
2
2
1
1
0
8
19
3
44
1
7
0
0
0
1
7
0
3
16
0
2
12
2
1
13
168
1
8
0
3
0
7
0
0
2008
Lab Accessed
(includes lab confirmed)
20%
20%
0%
24%
67%
12%
35%
18%
0%
50%
44%
100%
0%
100%
50%
29%
70%
0%
0%
0%
25%
33%
32%
0%
5%
44%
27%
30%
0%
10%
17%
50%
0%
100%
0%
0%
Lab confirmed Total
1
8
0
3
0
3
0
0
0%
4%
17%
50%
0%
100%
0%
0%
0
3
2
2
1
1
0
8
12
2
37
0
6
0
0
0
1
3
0
3
14
0
2
11
1
1
13%
33%
28%
0%
5%
41%
43
0
113
2
67
30
7 14% 43
132 24% 799
20%
20%
0%
18%
67%
12%
22%
12%
0%
50%
37%
0%
0%
100%
50%
13%
60%
0%
0%
0%
1
38
2
22
3
0
97
47
0
65
27
2
9
13
0
5
3
49
1
1
6
30
6
3
0
64
7
0
1
21
2
15
3
0
94
35
0
56
21
2
8
12
0
4
2
45
1
0
37
0
99
1
24
22
39
643
3
25
3
2
0
61
5
0
2009
Lab Accessed
(includes lab confirmed)
Lab confirmed Total
0%
95%
50%
83%
50%
67%
71%
0%
2
8
3
1
0
7
0
0
0% 0
11% 75
33% 6
27% 53
50% 21
33% 2
0%
0%
2
1
100%
0%
100%
55%
100%
68%
97%
74%
0%
86%
78%
100%
100%
0%
67%
92%
89%
92%
0%
80%
86%
0%
88%
50%
36%
73%
8
0
19%
0%
84
2
22 19% 90
1
0
1
50%
0%
3%
2
98
25
91% 7 16% 89
80% 137 17% 990
2
0
0
4
0
0
0%
0%
1 33% 0
10 20% 83
1
0
22%
0%
0%
80%
18
7
2
4
0
7
24 25% 90
9 19% 53
0%
11%
0
70
11 41% 65
1 50% 2
1
0
2
0
67%
0%
1 100% 2
4 11% 19
50%
0%
4
18
2
0
2
4
4
11
0
0
79
39
0
43
47
2
16
5
2
2
0
62
0
0
63
0
68
0
13
11
54
622
2
45
9
2
0
35
1
1
2010
Lab Accessed
(includes lab confirmed)
0%
0%
100%
21%
100%
61%
88%
74%
0%
61%
72%
100%
0%
0%
0%
75%
89%
71%
100%
50%
75%
0%
76%
0%
13%
44%
61%
63%
0%
47%
33%
85%
43%
100%
50%
100%
Lab confirmed Total
0
0
0
3
0%
4%
0
39
1 17% 5
18 34% 39
3 14% 25
2 100% 0
0%
0%
4
0
4
1
1
2
0
0
0%
0%
0
3
0 0% 1
14 17% 101
22%
14%
50%
50%
7
1
2
1
19 21% 110
12 23% 19
0 0% 0
12 17% 24
11 17% 32
2 100% 1
0
0
0%
0%
2 100% 0
3 16% 33
0
0
4 100% 0
5 28% 24
1
3
9
0
11% 50
0% 3
15 17% 49
0 0% 5
1% 10
12% 21
6 7% 90
153 15% 699
0
5
0
14
0
0
0
3
72
7
19
0
3
1
1
0
0
46
0
3
28
2
1
8
12
0
24
302
2
25
5
0
0
19
2
0
2011
Lab Accessed
(includes lab confirmed)
0%
0%
0%
15%
0%
58%
65%
37%
0%
13%
59%
0%
0%
100%
0%
46%
43%
100%
50%
0%
24%
0%
57%
40%
10%
38%
27%
43%
0%
49%
40%
64%
20%
0%
50%
0%
Lab confirmed
Total no. of outbreaks reported by
State/UT
0
9
2
0
0
2
0
0
1
0
0
0
0 0%
3 100%
0 0%
13 13%
14%
0%
0%
0%
0
1
0
2
0
0
0
0
5
0
28 25%
4 21%
0%
0%
16%
0%
0%
0%
0%
3%
0%
8%
9
1
1
1
2
0
4 4%
88 13%
4%
0%
18%
20%
10%
5%
0%
5%
0%
23%
8%
0%
0%
0%
10
5
3
107
9
81
351
136
0
175
223
6
44
24
4
10
2
7
6
257
185
8
302
10
215
103
271
3041
0
250
23
138
53
8
14
1

Sl. No .
1
2
3
4
5
6
7
8
9
10
Competency Assessment Tool for
Outbreak Investigations
TOOL INDICATORS
Is it an outbreak?
Timeliness of Response by Rapid Response
Team
(Verification of rumor / media alert done or not)
Was the outbreak informed/ identified by weekly data analysis?
Period between date of start of outbreak and date of response (first reported to a health worker at any health facility)
Composition of outbreak response team
Laboratory confirmation of outbreak
Type of clinical specimen
Transport media
Results
What working case definition was used?
Case definition
Active case finding Was active house to house case search done?
What population was covered?
Line listing to compile cases from health facility records and active case search
Use of epicurve, spot map, graphs?
Description of cases in time, place and person
Conclusion
Specific public health intervention measures undertaken
Is source of the outbreak determined?
Is mode of transmission established?
Case management
Control measures
Outcome (CFR)
Recommendations
Feedback given or not
What recommendations were proposed?
Were they implemented?
Written feedback
Post- outbreak review

Quality Assessment of Outbreaks reported by all States in 2011 (till 26 June) using 3 Essential Criteria
Essential criteria % of response to disease specific outbreaks
(n=699)
Investigation within 48 hours of first case information • 510 (73%)
Adequate samples sent for lab investigation within 4 days
• In 302 (43%) outbreaks, appropriate human samples sent for lab investigation
• 88 (13%) outbreaks etiologically confirmed
Availability of final outbreak report • 5 %

Quality Assessment of Outbreaks reported by 9 WB funded States in 2011 (till 26 June) using 3 Essential Criteria
Essential criteria % of response to disease specific outbreaks
(n= 516)
Investigation within 48 hours of first case information • 385 (75 %)
Adequate samples sent for lab investigation within 4 days
• In 242 (47 %) outbreaks, appropriate human samples sent for lab investigation
• 66 (13 %) outbreaks etiologically confirmed
Availability of final outbreak report • 4 %

Improving Outbreak detection and reporting
1.
2.
3.
Early detection and response to outbreaks by identifying
EWS from routine analysis of surveillance (S,P,L) data at
DSU/CHC/PHC levels (by identifying any unusual rise in no. of cases)
Ensure 100% reporting of EWS/outbreaks by all
States/Districts (even “NIL” reporting is mandated)
• every week
•
• on time in the prescribed format
Avoid incomplete/incorrect data entry in the EWS format
–
–
Date of start & reporting of outbreak to be mentioned for all outbreaks
“Population affected” is the “Population at risk”

1.
2.
3.
4.
Lab confirmation of diagnosis needs appropriate clinical (human) samples to be sent for lab tests
Identification and Training of Epidemiologists,
Microbiologists, Entomologists and RRT members at
DSU / SSU levels
Existence of a written case management protocol for any epidemic should be made available by the State at each PHC/CHC/District level
Competency assessment tool to be utilized for improving the quality of outbreak investigations and reporting (by the Epidemiologists and Surveillance
Officers)