Overview of PIDSR Food
and Water-Borne
Diseases Surveillance
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Epidemiology Bureau
Overview of the PIDSR Food and Water Borne Diseases
Learning Objectives
By the end of this session the participants will be able to:
• Enumerate notifiable diseases under the FWBD cluster
• Identify cases using case definitions
• Detect, register and report FWBD cases using the PIDSR core
processes.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Philippine Integrated Disease Surveillance and Response
(Epidemic-prone Disease Case Surveillance (EDCS)
Food and
Vaccine Preventable
Water-borne Zoonotic Diseases Other Diseases
Diseases (VPD)
Diseases (FWBD)
Acute Flaccid Paralysis Acute Bloody Diarrhea Acute Meningitis
Chikungunya
Encephalitis Sydrome
Diphtheria
Acute Viral Hepatitis
Measles Dengue Influenza Like Illness
Neonatal Tetanus Cholera
Non-neonatal tetanus Leptospirosis Meningococcemia
Rotavirus
Pertussis
Severe Acute
Typhoid Fever Rabies
Rubella Respiratory Infection
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
What is Food and Water Borne Disease?
FOOD PRODUCTION COMMON SYMPTOMS
PATHWAY PRODUCTION
PROCESSING
DISTRIBUTION
ABDOMINAL
PAIN NAUSEA AND/OR
RETAIL RESTAURANTS VOMITING
CONSUMERS FEVER DIARRHEA
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Philippine Integrated Disease Surveillance and Response
(Epidemic-prone Disease Case Surveillance (EDCS)
Food and Water-Borne Importance of FWBD Surveillance
Disease Cluster (FWBD)
● To detect and provide data to control
outbreaks
Acute Bloody Diarrhea
● To provide valuable insights into the agents
Acute Viral Hepatitis-A and foods that cause illness and the
settings where contamination occurs
Cholera
● To guide public health decision-making on
Rotavirus the most appropriate intervention and
control strategy by using timely and
Typhoid Fever accurate surveillance data.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Case Detection and Reporting of Food and Water Borne Diseases
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
ACUTE BLOODY DIARRHEA
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Acute Bloody Diarrhea (ABD)
▪ Acute bloody diarrhea is also called dysentery.
▪ Bloody diarrhea is usually a sign of invasive enteric
infection that carries a substantial risk of serious morbidity
and death, especially in children in developing countries.
▪ Overcrowded areas with unsafe drinking water and poor
sanitation are the most common risk factors for ABD.
▪ The disease is characterized by acute fever and bloody
diarrhea, and can also present with systemic symptoms
and signs as well as dehydration especially in young
children.
▪ Shigella dysenteriae is most frequently isolated from the
stools of affected children and is transmitted from person-
to-person through the fecal-oral route.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CASE DEFINITIONS FOR THE FOOD AND WATER-BORNE
DISEASES (FWBD) SURVEILLANCE CLUSTER
1. ACUTE BLOODY DIARRHEA (ABD)
Case Classification:
Suspect: A person with diarrhea with visible blood in the stool.
Confirmed Case: A suspect with stool positive for bacterial and parasitic pathogens(i.e Shigella
dysenteriae type 1, Entamoeba histolytica or Escherichia coli) thru bacterial culture or any molecular
diagnostic test
Laboratory test:
Stool/rectal swab: for Bacteriology culture; Clinical microscopy
(Salmonella ssp., Shigella dysenteriae , Campylobacter jejuni. Aeromonas, Entamoeba
histolytica, E. coli)
Cases to look out for:
Increasing number of bloody diarrhea from one barangay/municipality over a short period of time
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CHOLERA
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CASE DEFINITIONS FOR THE FOOD AND WATER-BORNE
DISEASES (FWBD) SURVEILLANCE CLUSTER
2. CHOLERA
Case Classification
• Suspected Case:
A suspected case is any patient aged ≥ 2 years who has acute watery diarrhoea and severe
dehydration or died from acute watery diarrhoea.
(Acute watery diarrhoea is characterized by three or more loose or watery, non-bloody stools
within a 24-hour period.)
● Probable Case:
A suspected case that is cholera RDT positive.
● Confirmed Case:
A suspected case that is laboratory-confirmed.
(Isolation of Vibrio cholerae 01 or 0139 from stools in any patient with diarrhea by culture or
Any molecular diagnostic test)
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
ACUTE VIRAL HEPATITIS
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
ACUTE VIRAL HEPATITIS
∙ Viral hepatitis is an infection that causes liver
inflammation and damage. Inflammation is swelling
that occurs when tissues of the body become
injured or infected.
∙ Heavy alcohol use, toxins, some medications, and
certain medical conditions can cause hepatitis.
∙ Common in many countries, especially those
without modern sanitation.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
ACUTE VIRAL HEPATITIS A
∙ Hepatitis A is a liver disease caused by the
hepatitis A virus (HAV).
∙ The hepatitis A virus is transmitted primarily
through oral fecal route.
∙ Symptoms of hepatitis A range from mild to
severe, and can include fever, malaise, loss
of appetite, diarrhea, nausea, abdominal
discomfort, dark-coloured urine and jaundice.
∙ The incubation period of hepatitis A is usually
14–28 days.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CASE DEFINITIONS FOR THE FOOD AND WATER-BORNE
DISEASES (FWBD) SURVEILLANCE CLUSTER
3. ACUTE VIRAL HEPATITIS A
Case Classification
Suspected case – a person with acute illness characterized by acute jaundice, dark urine, loss of
appetite, body weakness, extreme fatigue and right upper quadrant tenderness.
Confirmed case – a suspected case that is laboratory confirmed for IgM or anti-HAV.
Laboratory test -serum: for serology
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Rotavirus Surveillance
Case Definition and Filling out of
Forms
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Epidemiology Bureau
ROTAVIRUS
• According to WHO Rotavirus is the leading cause of severe
diarrheal disease and dehydration in infants and young
children throughout the world.
• Rotavirus is common, accounting for 35–60% of acute
severe diarrhoea in children < 5 years of age in countries
without rotavirus vaccine, with the highest attributable
percentage in infants.
• Rotavirus is highly communicable; it is shed in the stool at
high concentration, and transmission is through faecal-oral
route, either person-to-person or through fomites in the
environment. Photo source: WHO website, Regional of Africa
• The incubation period is one to three days.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CASE DEFINITIONS FOR THE FOOD AND WATER-BORNE
DISEASES (FWBD) SURVEILLANCE CLUSTER
4. ROTAVIRUS
Case Classification
• Suspected Case:
• Any child who is <5 years of age and is currently undergoing treatment for acute
diarrhea*
• Confirmed Case:
• A suspected case that has been laboratory-confirmed as Rotavirus.
Notes:
• A child <5 years of age includes children aged 0 to 4 years, 11 months and 29 days;
• ‘Undergoes treatment’ means that the child has received intravenous (IV) rehydration therapy while
undergoing observation in the Emergency Room (ER) or was admitted in the hospital ward for acute diarrhea;
• ‘Acute diarrhea’ is defined as the passage of three or more loose or watery stools within a 24-hour period for
≤14 days;
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Rotavirus CIF
PARTS I and II (DRU INFO AND PATIENT INFO)
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Rotavirus CIF
PARTS III, IV, V and VI (CLINICAL, EPIDEMIOLOGIC, IMMUNIZATION
HISTORY and DETAILS OF INVESTIGATOR)
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Rotavirus CIF
PARTS VII, VIII (LAB DATA AND CLASSIFICATION)
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
TYPHOID FEVER
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
TYPHOID
• Typhoid fever and paratyphoid fever are life-threatening illnesses
caused by Salmonella serotype Typhi and Salmonella serotype
Paratyphi, respectively.
• Typhoid fever and paratyphoid fever have similar symptoms.
People usually have a sustained fever (one that doesn’t come
and go) that can be as high as 103–104°F (39–40°C)
• Other symptoms of typhoid fever include weakness, stomach
Photo source: CDC website
pain, headache, diarrhea or constipation, cough, loss of appetite.
• The disease is transmitted via oral-fecal route.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
CASE DEFINITIONS FOR THE FOOD AND WATER-BORNE
DISEASES (FWBD) SURVEILLANCE CLUSTER
5. TYPHOID
Case Classification
• Suspected Case: A person with an illness characterized by insidious onset of sustained fever,
headache, malaise, anorexia, relative bradycardia, constipation or diarrhea, and non-productive cough.
• Probable Case: A suspected case that is epidemiologically linked to a confirmed case in an outbreak.
• Confirmed Case: A suspected or probable case that is laboratory confirmed.
• Laboratory test:
- Blood – 1st week Urine / stool – 2nd-3rd week : Bacteriology culture
(Salmonella typhi, salmonella paratyphi)
Note: Serological tests for typhoid fever (e.g. Widal test and Typhidot) may be used only for
presumptive diagnosis. It should not be used as a confirmatory diagnostic tool for typhoid. Hence,
cases diagnosed using such method will remain classified as suspect cases.
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
Thank you for listening ! ☺
Republic of the Philippines
Boosting
Department of Health
Universal Health Coverage Office of the Secretary
