Division of Public Health, Surveillance and Response

The Public Health Surveillance and Response Division was established incorporating GERMS-SA,Outbreak Response and Travel Health

The Division facilitates communication and data sharing between the national and provincial health departments and the NICD and provide epidemiological input to other NICD units through collaborative projects and support of surveillance and epidemiological activities and outbreak responses.

Working Groups:

  • GERMS-SA:  GERMS-SA is a laboratory-based surveillance programme for fungal and bacterial causes of pneumonia, meningitis and diarrhoeal diseases. Approximately 200 laboratories (public and private) report cases and send isolates to the NICD according to specific GERMS case definitions. At 25 sentinel sites across the country, surveillance officers collect clinical information on patients relating to these specific pathogens. The objectives of the programme are to:
    • Estimate the burden of infectious diseases under surveillance
    • Monitor antimicrobial susceptibility trends
    • Monitor the impact of the HIV/AIDS Comprehensive Care, Management and Treatment Programme in SA on HIV-associated opportunistic infections
    • Evaluate the impact of vaccines included in the Expanded Programme on Immunisation (EPI)
    • Monitor hospital-acquired infections

Special studies currently being undertaken include a case control study to measure the effectiveness of a conjugate vaccine against invasive pneumococcal disease. The work carried out by the GERMS team has significantly contributed to the development of clinical guidelines for pneumonia, meningococcal disease, cholera, cryptococcosis, typhoid fever, etc., and the introduction of pneumococcal conjugate vaccine and Hib bosster dose into the EPI. For more information and reports, access the GERMS-SA website.

  • Outbreak Response: The Outbreak Response Team is tasked with providing technical support for all aspects of communicable disease outbreak investigation and control in the nine provinces of South Africa, with special emphasis on optimising the role of laboratory services during these events. The team aims to be a source of intelligence during outbreaks, and through working in close collaboration with the provincial and national Departments of Health, ensures a comprehensive outbreak response, as well as the development of systems for early detection and improved reporting. Through close partnerships with the NHLS diagnostic laboratories and reference units of the NICD, the team aims to facilitate appropriate laboratory diagnostic services during outbreaks and specialised diagnostics as required.

The Outbreak Response Team plays a crucial role in communications with stakeholders such as the Department of Health, medical practitioners, media and the general public. We publish a monthly Communicable Diseases Communiqué for providing up-to-date information on communicable disease events in South Africa, as well as regularly produce various healthcare worker guidelines, handbooks, fact-sheets, etc. for outbreak-prone communicable diseases of high public health importance. The Team also plays a central role in capacity development by providing in-service training to SA-FELTP residents, public health specialist registrars and secondees from international partner organisations, and routinely provides Epidemic Preparedness and Response Training to staff of the Department of Health.

  • Travel Health: Travel Health was established in 2008 with the aim of being a centre for travel health-related activities and consulting on international health matters. This working group provides pre- and post-travel health advice and consultations for travel health practitioners, as well as for staff of the NHLS and NICD for work related field activities. Regular expert consultations are provided both locally and internationally to international focal points, institutes and health practitioners for South African travellers presenting with infectious diseases after travel within southern Africa and further abroad. These include diseases in travellers such as trypanosomiasis, severe malaria and rickettsial disease (tick bite fever). Consultation is also provided for the elimination of malaria in South Africa and other countries within southern Africa.

PROVINCIAL EPIDEMIOLOGY TEAM (PET)

NICD has historically supported the National Department of Health (NDOH) in its roles of responding to priority diseases such as HIV and TB and to outbreaks of infectious diseases. Support to provincial DOH has primarily been from teams based at the NICD until 2014 when the NICD set up a provincial epidemiology team (PET) comprising 1 senior epidemiologist based at the NICD and 9 provincial field epidemiologists; one in each of the 9 provincial DOH offices.

Currently there are 5 provincial epidemiologists in KwaZulu-Natal, Mpumalanga, Free State, Eastern Cape and North West provinces. The process of filling the vacant positions is underway. Having an NICD epidemiologist in each province ensures that epidemiology, public health, diagnostic and clinical expertise within the NICD is available to provinces in a timely manner to effectively support communicable disease surveillance, prevention and control, epidemiology research, training and outbreak response at provincial and district level.

The main focus for the next few years is on HIV/TB and CDC (notifiable disease surveillance) and outbreak response. The PET provides expert technical advice and assistance on the design, maintenance, analysis and interpretation of surveillance databases. Additionally they support synthesis and analysis of surveillance and routine clinical and DHIS data collected at provincial, district and sub-district levels by both NICD and DoH to determine populations at risk, monitor disease trends and distribution, detect outbreaks and subsequently advise on interventions required to curb morbidity and address public health needs and resource allocation. To highlight one example;  provincial epidemiologists analyse data generated via the NICD centre for TB to describe and report on trends and numbers of patients diagnosed with drug susceptible and drug resistant TB. These reports analysed together with provincial data from electronic TB registers showing the actual number of patients’ initiating TB therapy, are used to identify and address gaps in the TB treatment cascade. The PET is also responsible for the implementation and management of the clinic based surveillance of HIV/TB drug resistance and STIs and provides some supervision to the GERMS surveillance.

NICD COMMUNICATIONS UNIT

The National Institute for Communicable Diseases (NICD) Communication Unit continues to expand its role in conveying important public health messages and outbreak alerts to both the medical and allied professionals through guidelines and information sheets, as well as to the general public through media releases, interviews on TV, radio and the print media and through the introduction of social media. The NICD has over the past year set up a Twitter account, which is an effective tool for public health messaging.

The NICD website is proving to an invaluable resource for information regarding outbreak response, diseases surveillance and infectious diseases information.  A case in point would be the setting up of a portal on the NICD website dedicated to updating information on a daily basis during the Ebola Virus Disease Outbreak in West Africa.

The information of the NICD Centres is updated monthly; the Alerts and News sections are updated twice weekly.  Over the past year, the NICD website has continued to grow in attracting the general public, the media and health professionals.  To meet the increasing demands for this, media training for senior staff was undertaken. A general review of the NICD website is planned for the coming year with an interim updating of all Centre information.

A new electronic format has been successfully developed for disseminating the NICD publications with stakeholders in the public and private sector and national and provincial Departments of Health. These include the monthly Communicable Disease Communiqué which highlights current communicable disease events and outbreaks, the monthly NICD Surveillance Bulleting which collates data from the NICD surveillance programmes, and the quarterly bulletin which documents more formally outbreaks and surveillance programmers.

The Unit continues to collate internal publications :The  NICD Science Focus, a quarterly compilation of abstracts of scientific publications by NICD staff members published in peer- reviewed journals; NICD newsletter which has a more informal focus on events and happening at the NICD, and staff awards and profiles individual staff members and their work.

Over the past year a good partnership was forged with the National Department of Health’s Communications team – there are now collaborations in media relations during high profile events such as outbreaks with international and local significance.

Division Leadership and Contact Details:

Irma Latsky 
Assistant to Prof Lucille Blumberg
Office: 011 555-0395  /  Fax:  0867 583 326
E-mail: irmal@nicd.ac.za

Prof. Lucille Blumberg,
Deputy-Director, Head of Division, and Head of Travel Health
Tel: +27-11-386-6337
Email: lucilleb@nicd.ac.za

Dr. Vanessa Quan
Head of GERMS-SA
Tel: +27-11-386-6012 / 6234
Email: vanessaq@nicd.ac.za

Dr. Kerrigan McCarthy
Head of Outbreak Response
Tel: +27-11-555-0392
Email: kerriganm@nicd.ac.za

Dr Portia Mutevedzi
Senior Public Health Epidemiologist
portiamu@nicd.ac.za
Cell: 082 6580140

Nombuso Shabalala
Manager: Communications
Tel: 011 555 0545
Email: nombusos@nicd.ac.za

Send alerts and requests to: outbreak@nicd.ac.za