I. Executive Summary
VI. Country Reports
VII. Status of the Implementation of Surveillance for EID
VIII. Global & Subregional Surveillance
IX. Surveillance of Selected Diseases/Syndromes
X. Conclusions and Recommendations
List of Participants
Report: Third Meeting of the Surveillance Networks for Emerging Infectious Diseases in the Southern Cone and Amazon Regions
Atlanta, Georgia, 15-16 July 2000
The general objective of this meeting was to promote the enhancement of Emerging Infectious Diseases (EID) Surveillance Networks of the Amazon and Southern Cone (SC) regions. Participants of this meeting represented their respective countries' epidemiology and laboratory units of their disease surveillance system—thus promoting coordination and collaboration among them. The integration of epidemiology and laboratory diagnosis is critical for the strengthening of each region's disease surveillance network. For the first time, a representative from the Caribbean Epidemiology Center (CAREC) attended a meeting of this kind.
The specific objectives of this meeting were to
Several countries of the Amazon region network presented data obtained from syndromic surveillance conducted in sentinel sites. Most examined patients exhibited undifferentiated febrile syndromes where the majority of them were diagnosed with malaria. The remaining cases were attributed to dengue, leptospirosis and viral hepatitis. A significant number of cases however, remained without diagnoses. Cases of febrile icteric syndrome were also associated with malaria, leptospirosis and viral hepatitis.
Surveillance conducted in the SC identified an increasing number of cases of Hantavirus Pulmonary Syndrome (HPS) including some outbreaks where HPS had not previously been recognized. Certain countries have continued to strengthen their influenza surveillance. In addition, two countries have established laboratories to provide influenza diagnostic support. Efforts are also being made to improve or initiate Hemolytic Uremic Syndrome (HUS) surveillance.
As a result of the recommendations made during the second SC meeting in Brasilia, three regional workshops on Influenza, HUS and HPS took place (Buenos Aires). Each workshop dedicated one day to discuss aspects of strengthening disease surveillance epidemiologists and laboratory specialists. In addition, training for laboratory diagnosis of Influenza, HPS and HUS were offered. Proposals prepared per country for the implementation of HUS surveillance were developed as a consequence to this meeting.
During the third meeting in Atlanta, numerous recommendations and needs were identified by work groups (see Section X). No major changes were proposed to the Plans of Action approved in Tarapoto and Brasilia. In addition to previously selected disease syndromes for surveillance, it was suggested to include surveillance of environmental factors, food-borne pathogens and anti-malarial drug resistance. The participants reiterated the need for integration between laboratory and epidemiology and for strengthening of epidemiologic surveillance. It was also stressed that syndromic surveillance should be considered as a component of general surveillance and that it should be conducted in sentinel sites. The syndrome definitions and the algorithms for testing the samples should be adapted according to the epidemiological characteristics of each area. It was considered essential to develop mechanisms for dissemination of information and communication among the members of the network. On several occasions the need for standardized reagents, training and quality control programs was stressed. It was also recommended to include Ecuador, Suriname and Guyana in the Amazon Region network.
Finally, it was recommended that the two networks should continue to meet and that the next meeting should take place in Asuncion, Paraguay during the year 2001.