98 Public Health Impact of the Canadian Paediatric Surveillance Program (CPSP)

To describe public health actions arising from CPSP studies.

Clinicians reported specific uncommon diseases/conditions with high morbidity and mortality monthly to the CPSP. For case reports, treating physicians were sent standardized questionnaires requesting clinical data. Over 2400 paediatricians, including paediatric specialists, participated with a response rate of 83% for initial reports and 95% for detailed questionnaires showing that the CPSP is a timely, purposeful and action-oriented surveillance tool.

Implications of study results are two-fold: first, demonstrating the impact of vaccines on diseases, the importance of genetic screening, and the astuteness of specific guidelines; and second, identifying the need for such targeted public health strategies as:

• Implementation of universal varicella immunization – 61% of confirmed necrotizing fasciitis cases were preceded by varicella;

• Herpes vaccine development – neonatal herpes infection study established pre-vaccine baseline incidence data, demonstrated that 63% of cases were HSV-1 and 40% of mothers were unaware of their infections;

• Improved educational interventions for vitamin D dietary supplementation – identified vitamin D deficiency rickets at risk population as darker-skinned, breast-fed infants (58);

• Timely detection and close follow-up of termed jaundiced newborns, often discharged early – neonatal hyperbilirubinemia study confirmed 145 cases;

• Mandatory ban of baby walkers – survey documented at least 132 current injuries;

• Development and mandatory use of weight-size appropriate car restraints and booster seats – survey identified 47 lap-belt syndrome injuries.

Systematic analyses, interpretation and dissemination of CPSP study findings has identified important public health actions which benefit Canadian children and their families.