Public health surveillance

Blood Safety Contribution Program

The Blood Safety Contribution Program (BSCP) supports the development and/or enhancement of provincial and territorial systems to monitor errors and adverse events associated with the transfusion of blood components and blood products and the transplantation of cells, tissues and organs; namely:

Transfusion Error Surveillance System (TESS).
Transfusion Transmitted Injuries Surveillance System (TTISS); and
Cells, Tissues and Organs Surveillance System (CTOSS).

The recipients of BSCP funding include provincial and territorial governments, transfusion and/or transplantation centres and agencies and/or groups designated by provincial and territorial Ministries of Health to undertake surveillance for blood/tissue/organ associated adverse events, and Canadian not-for profit organizations that support transfusion adverse event surveillance activities in the provinces and territories.

Recipients transfer information to the Public Health Agency of Canada. This information is cleansed, validated, analyzed and reported at a national-level and made available to recipients and other stakeholders. This information is used to identify trends in transfusion-associated errors, adverse reactions and injuries in Canadian hospitals at the national level that are used as benchmarks for national and even international stakeholders. Overall, these surveillance systems are aimed at improving transfusion processes and maximizing patient safety.

Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS)

Surveillance of acute flaccid paralysis (AFP) in Canada is a collaborative effort between the Public Health Agency of Canada and the Canadian Paediatric Society. The purpose of national AFP surveillance is to monitor Canada's polio-free status by ensuring a sensitive, active surveillance system and prompt, appropriate investigation of AFP cases to rule out the possibility of poliovirus infection. AFP is defined as the acute onset of focal paralysis or weakness characterized as flaccid (reduced tone) without other obvious cause (e.g., trauma) in children less than 15 years old and excludes transient weakness (e.g., post-ictal weakness). All reported AFP cases are reviewed to determine compatibility with national surveillance definitions for paralytic poliomyelitis. The information provided by participating physicians and nurse monitors in the detailed questionnaire is essential for this adjudication process. CAFPSS was initiated in 1991 through the Canadian Immunization Program Monitoring Active (IMPACT) network of paediatric hospitals, and in 1996 was expanded to include data collection from a network of over 2500 paediatricians across Canada.

Canadian Chronic Disease Surveillance System

The Canadian Chronic Disease Surveillance System (CCDSS) uses linked administrative data sources from every province and territory to estimate the incidence and prevalence of chronic conditions, as well as all-cause mortality among Canadians with and without these conditions and use of health services. Data can be disaggregated by age, sex, age groups and province or territory. The CCDSS aims to foster the collection of surveillance data in a consistent and comparable way across jurisdictions. Patient privacy is protected since only aggregated data are shared by the provinces and territories. Tracking chronic conditions through this approach complements other surveillance data sources, such as surveys and registries, and allows for timely reporting to support the planning and evaluation of policies and programs.

Data from the CCDSS are available on the Public Health Infobase.

Learn more about the CCDSS: 'The Canadian Chronic Disease Surveillance System - An Overview'.

Canadian Congenital Anomalies Surveillance Network

The Canadian Congenital Anomalies Surveillance Network CCASN was established in 2002, under the umbrella of the Canadian Perinatal Surveillance System (CPSS). It is a national framework to support interdisciplinary collaboration and networking, bringing together research, surveillance and clinical and public health practices, with the ultimate goal of enhancing the quality of surveillance data and expanding our understanding of congenital anomalies.

Canadian Hospitals Injury Reporting and Prevention Program

The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system that collects and analyzes data on injuries to people who are seen at the emergency rooms of 11 pediatric hospitals and 8 general hospitals in Canada. The CHIRPP has unique, richly detailed data of "pre-event" injury information obtained by asking:

What was the injured person doing when the injury happened?
What went wrong?
Where did the injury occur?

Staff in the emergency department also collect information on the nature of the injury, injured body part and treatment received.

The CHIRPP's information is provided to interested parties, such as injury prevention workers, researchers, healthcare providers, and public health practitioners who are striving to reduce injuries and make Canada safer. They use the data to set priorities, and to develop and evaluate injury prevention strategies. CHIRPP data are used to increase awareness and provide information for parents and caregivers, to better understand risks and hazards, to help tailor prevention programs, to focus efforts on hazardous situations or people who are at high risk of injury, and to help governments develop policy and legislation that improves safety.

Read more information about the CHIRPP's electronic database (eCHIRPP) in the Health Promotion and Chronic Disease Prevention Journal.

Canadian Integrated Program for Antimicrobial Resistance Surveillance

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) collects, analyzes, integrates and communicates trends in antimicrobial use and antimicrobial resistance for select enteric bacteria from humans, animals, and retail meats across Canada. It is coordinated by the Public Health Agency of Canada’s Centre for Food-borne, Environmental and Zoonotic Infectious Diseases and the National Microbiology Laboratory in collaboration with federal, provincial, academic and private industry partners.

The representative and methodologically unified surveillance components can be linked to examine relationships between antimicrobials used in food-animals and humans, and the associated health impacts. This information supports: (i) the creation of evidence-based policies to control antimicrobial use in hospital, community, and agricultural settings, and thus prolong the effectiveness of these drugs, and (ii) the identification of appropriate measures to contain the emergence and spread of resistant bacteria between animals, food, and people in Canada.

Canadian Measles/Rubella Surveillance System

National enhanced surveillance of measles, rubella, congenital rubella syndrome (CRS) and congenital rubella infection (CRI) is conducted through CMRSS. The system was created in 1998 in order to enhance existing national surveillance for measles following its elimination in Canada. Joint national surveillance of measles and rubella commenced with the addition of rubella and CRS/CRI to the measles surveillance system in 2006 and 2007, respectively. Integrated surveillance of measles and rubella is recommended by the Pan American Health Organization (PAHO) as they are both under elimination in the Region of the Americas, and they share similar clinical presentation, methods of epidemiologic investigation and laboratory diagnostics.

The purpose of CMRSS is to conduct timely, ongoing, national monitoring of the circulation of measles and rubella virus in Canada. The system is coordinated by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) of the Public Health Agency of Canada (the Agency) and involves weekly reporting by all provinces and territories, including zero-reporting, to the Agency and subsequent weekly reporting by the Agency to PAHO. All reported cases are assessed against the national case definitions, and only those that meet the definition of a confirmed case are added to the database. The National Microbiology Laboratory (NML) performs genotyping for all suitable samples received. Probabilistic matching on province/territory, date of birth (or age), and gender is conducted by CIRID to link the laboratory and epidemiological data, which are then entered into the CMRSS database.

Canadian Nosocomial Infection Surveillance Program (CNISP)

The Canadian Nosocomial Infection Surveillance Program (CNISP) collects national epidemiologic and laboratory (molecular and resistance) data on:

various healthcare-associated infections (HAI)
antimicrobial resistant organisms (ARO)
hospital-level antimicrobial utilization

CNISP was established in 1995 as a partnership between:

the Public Health Agency of Canada's Centre for Communicable Diseases and Infection Control (CCDIC) and the National Microbiology Laboratory (NML)
the Association of Medical Microbiology and Infectious Disease (AMMI) Canada
sentinel hospitals across Canada

The goal of CNISP is to help facilitate the prevention, control and reduction of HAIs and AROs in Canadian acute care hospitals through active surveillance and reporting. Data collected:

measures the burden of HAIs, including AROs
establishes benchmark rates for internal and external comparison
identifies potential risk factors
allows for the assessment of specific interventions to improve the quality of patient care in Canadian acute care hospitals

At present, 90 sentinel hospitals from 10 provinces and 2 territories participate in the CNISP network with continued efforts to further recruitment.

CNISP conducts surveillance on:

Candida auris
antimicrobial use (AMU)
point prevalence studies
Clostridioides difficile infections (CDI)
surgical site infections (SSI), including:
- pediatric cardiac surgery
- cerebrospinal fluid shunts
- hip and knee arthroplasty
carbapenemase-producing organisms (CPA and CPE)
central line-associated bloodstream infections (CLABSI)
vancomycin-resistant Enterococci (VRE) bloodstream infections
methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections
hospital-level antibiograms for Escherichia coli (E. coli), S. aureus (MRSA and MSSA), Klebsiella pneumoniae, Pseudomonas and Acinetobacter
viral respiratory infection (VRI): COVID-19

Contact CNISP

Public Health Agency of Canada
130 Colonnade Rd
Ottawa ON K2E 1B6
Email: cnisp-pcsin@phac-aspc.gc.ca

Publications and related links

Canadian Paediatric Surveillance Program

The Canadian Paediatric Surveillance Program (CPSP) was established in 1996 to monitor diseases and conditions in Canadian children that are relatively low in frequency but are of public health importance, with high disability, morbidity, mortality and economic cost to society. The program is a joint project of PHAC and the Canadian Paediatric Society (CPS) and is the responsibility of Surveillance and Applied Research.

A Scientific Steering Committee oversees the Program and reviews new study proposals. Preference is given to studies that have strong public health importance and could not be undertaken any other way. Upon initiation of a new study, practicing Canadian paediatricians, paediatric sub-specialists and other participating specialists (e.g. geneticists) receive a summary of the protocol, including the case definition and a brief description of the condition. This serves to educate and increase awareness of conditions under surveillance while providing a uniform basis for reporting.

For additional information on the Canadian Paediatric Surveillance Program, please view the CPSP's poster titled What is the Canadian Paediatric Surveillance Program?

Canadian Perinatal Surveillance System

The Canadian Perinatal Surveillance System (CPSS) is part of the Public Health Agency of Canada's (PHAC) initiative to strengthen national health surveillance capacity. The CPSS is an ongoing national health surveillance program delivered through the Maternal and Infant Health Section. Its mission is to contribute to improved health for pregnant women, mothers and infants in Canada.

Creutzfeldt-Jakob Disease Surveillance System

Creutzfeldt-Jakob Disease Surveillance System Report

Enhanced National Invasive Pneumococcal Disease Surveillance System (eIPD) pilot

Currently, nationally representative data for invasive pneumococcal disease (IPD) collected through the Canadian Notifiable Diseases Surveillance System (CNDSS), and the National Microbiology Laboratory, Streptococcus Unit. The epidemiologic and laboratory data is not linked, limiting the ability to interpret IPD trends in Canada. The establishment of a national surveillance system, combining both epidemiologic and laboratory data, would provide for a better representation of IPD incidence across the country, greater confidence into regional variation in serotype distribution and antimicrobial susceptibility, and an opportunity to detect unusual clusters. Each of these enhancements in data quality will allow for better informed immunization and treatment guidelines.

The eIPD is an enhanced case-based surveillance system that is currently being piloted jointly by the Centre for Immunization and Respiratory Infectious Diseases and the NML. The pilot was launched on April 4, 2011 in one province in Canada, and will be expanding to a two more provinces in the near future. The primary objectives of the eIPD are to:

track, at a national level, any shift in IPD serotypes as a result of the implementation of vaccine programs;
to track, at a national level, any changes in antimicrobial susceptibility of Streptococcus pneumoniae; and to detect geographic and temporal changes in the incidence of IPD.

Epidemiologic and laboratory data for each case are linked at the P/T level through a web-based CNPHI application. Quarterly surveillance summaries and annual reports will be produced by PHAC.

National level IPD surveillance information is available at:

National Laboratory Surveillance of Invasive Streptococcal Disease in Canada - Annual Summary 2015

FluWatch - Influenza Surveillance

The Centre for Immunization and Respiratory Infectious Diseases (CIRID) produces the weekly FluWatch reports summarizing influenza surveillance activities in Canada. Weekly reports are produced during the influenza season (October - May) and biweekly reports are produced during the off-season (June - September). Influenza surveillance is a collaborative effort between provincial and territorial ministries of health, public health and hospital laboratories, national surveillance networks, sentinel physicians, and CIRID.

FoodNet Canada

FoodNet Canada is a multi-partner initiative facilitated by the Public Health Agency of Canada (PHAC). Agriculture and Agri-Food Canada (AAFC) and the Public Health Agency of Canada (PHAC) are major funding partners for the pilot phase of FoodNet Canada. It is meant to support activities that will reduce the burden of enteric disease, by comprehensive sentinel site surveillance implemented through local public health units. This initiative will result in effective evaluation and development of policies related to the safety of food and water. Its approach is in line with leading-edge work in public health, as called for in Canada by the recent Haines (meat safety), Naylor (SARS outbreak) and O'Connor (water safety) reports, the Auditor General and the Pan-Canadian Public Health Network; in the United States, by the Centers for Disease Control and Prevention (CDC); in Australia, by the Department of Health and Ageing; and in the European Union, by the Integrated Approach to Food Safety. Such work focuses on the necessity of collaboration among jurisdictions and of integration of efforts, new communication networks, rigorous systematization, and involvement of local public health units to inform policy at the local, regional and national levels.

HIV and AIDS Surveillance

Surveillance of HIV and AIDS

Data on 2012 HIV/AIDS Attitudinal Tracking Survey is now available on open data.

Human Emerging Respiratory Pathogens Bulletin

Monthly situational analysis of emerging respiratory diseases affecting humans

IMPACT

IMPACT, Canada's Immunization Monitoring Program ACTive, is a paediatric hospital-based national active surveillance network for adverse events following immunization, vaccine failures and selected infectious diseases that are, or will be, vaccine-preventable.

IMPACT is administered by the Canadian Paediatric Society with funding from the Public Health Agency of Canada.

Injury Surveillance On-Line

Injury Surveillance On-Line provides a centralized source of current data on injury deaths and hospitalizations in Canada. Interactive queries offer a choice of geography, age groups, sex, injuries and morbidity or mortality data. A variety of presentation methods such as maps, charts, graphs and tables can be produced. This timely and unique on-line data source provides easy access to, and promotes the use of, Canadian injury information and statistics.

Data on Unintentional injuries in Canada 2010 is available on open data.

International Circumpolar Surveillance System of Invasive Bacterial Diseases

The International Circumpolar Surveillance (ICS) initiative is a population-based surveillance network of countries with circumpolar regions. Within Canada, 6 regions (Yukon, Northwest Territories, Nunavut, northern Labrador, Québec Cree and Québec Nunavik) participate in the surveillance of invasive bacterial diseases. Surveillance of invasive pneumococcal disease began in 1999. Surveillance expanded in 2000 to include:

invasive meningococcal disease
invasive group A streptococcal disease
invasive group B streptococcal disease
invasive Haemophilus influenzae disease

More information about the International Circumpolar Surveillance (ICS) program

Lyme Disease Enhanced Surveillance System

The Lyme Disease Enhanced Surveillance (LDES) System was established in 2011 by a working group of the Pan-Canadian Public Health Network. Data collection is conducted by the Public Health Agency of Canada in partnership with provincial health authorities. Through the LDES, the Agency monitors the incidence rates of Lyme disease and identifies Canadian populations at risk by geographical location, age and gender. The LDES is also able to identify environmental risks and new geographical risk areas before human cases are reported. Tracking Lyme disease cases through enhanced surveillance supports early diagnosis and treatment. The LDES system helps guide targeted communications and planning of public health interventions at different levels of government.

For additional information on Lyme disease surveillance, please visit Surveillance of Lyme disease.

Measles and Rubella Surveillance Pilot

The Measles and Rubella Surveillance (MARS) pilot is a surveillance initiative which seeks to augment national surveillance of measles, rubella, congenital rubella syndrome and congenital rubella infection by supporting real-time, centralized web-based collection of non-nominal case investigation data. The MARS system incorporates a real-time electronic notification system which simultaneously alerts laboratory and epidemiology stakeholders within the Public Health Agency of Canada (the Agency) and the reporting province at the outset of each investigation. MARS also supports periodic data collection, including weekly zero reporting by provincial public health (as conducted by the Canadian Measles/Rubella Surveillance System) and monthly reporting of aggregate measles and rubella IgM test data by provincial public health laboratories. The MARS pilot was collaboratively developed and implemented by the National Microbiology Laboratory and the Centre for Immunization and Respiratory Infectious Diseases of the Public Health Agency of Canada using the Canadian Network for Public Health Intelligence platform. MARS data collection was launched in June 2011 at participating provincial laboratory and public health pilot sites in British Columbia, Alberta and Newfoundland.

National Enhanced Invasive Meningococcal Disease Surveillance System

IMD has been nationally reportable in Canada since 1924, with national enhanced surveillance introduced in 1992. Enhanced surveillance was established to capture bacteriologic information on IMD cases for the purpose of describing annual trends, in particular serogroup trends. Enhanced surveillance provides important information for immunization recommendations, vaccine programs and health policies in Canada. Data from 1985 to 1991 was collected retrospectively and included in the system.

Provincial and territorial departments of health submit line-listed, non-nominal epidemiologic data on all cases of invasive meningoccoccal disease (IMD) that meet the national case definition through an annual data request to the Agency. Provincial and territorial public health and/or hospital laboratories send all Neisseria meningitidis isolates to the National Microbiology Laboratory (NML) for confirmation of serogroup and further bacteriologic testing, including serotyping and subtyping of all isolates and multilocus enzyme electrophoresis of all serogroup C isolates. Probabilistic matching on province/territory, date of birth (or age), sex, onset date, and serogroup (when available) is conducted to link epidemiologic and laboratory data for cases with missing information.

National Enteric Surveillance Program

The National Enteric Surveillance Program (NESP) is a national surveillance program designed to provide timely analysis and reporting of laboratory confirmed enteric disease cases in Canada. The NESP has been in operation since April 1997 and provides weekly reports to stakeholders across the country.

Notifiable Diseases Online

Notifiable Diseases Online is an interactive website that enables users to explore annual data from the Canadian Notifiable Disease Surveillance System (CNDSS). It provides data on nationally notifiable diseases including the counts and rates of reported cases, data limitations and disease descriptions. Users have the option to view simple pre-built charts, custom charts, or perform large data extracts. The CNDSS monitors trends in nationally notifiable diseases, infectious diseases that have been identified collectively by the federal, provincial and territorial governments as priorities for monitoring and control.

Opioid- and stimulant-related harms surveillance system

The Government of Canada works closely with the provinces and territories to share data and monitor fatal and non-fatal harms related to opioids and stimulants across the country. The opioid- and stimulant related harms surveillance system was initially established as one component of the response to the opioid overdose epidemic in Canada. The purpose of the system is to develop a national picture of the public health impact of opioid- and stimulant-related harms, inform decision makers, and help guide response efforts. The system includes:

data on apparent opioid and stimulant toxicity deaths, provided by provincial and territorial offices of Chief Coroners and Chief Medical Examiners;
data on opioid- and stimulant-related poisoning hospitalizations from the Canadian Institute for Health Information (CIHI); and
data on suspected opioid-related overdoses, provided by provincial and territorial Emergency Medical Services. Data from these three sources are updated on a quarterly basis. Where possible, the data may be stratified by time (year/quarter), province or territory, manner (intent), sex, age group, as well as the type of substance(s) involved.

Data from the opioid- and stimulant-related harms surveillance system are available on the Public Health Infobase.

Respiratory Virus Detection Surveillance System

The Respiratory Virus Detection Surveillance System reports on respiratory viruses in Canada.

Sexually Transmitted Infections Surveillance and Epidemiology

Tuberculosis Prevention and Control Surveillance Reports

Surveillance of tuberculosis (TB)

West Nile Virus Surveillance Information

Surveillance of West Nile virus is hosted by the Infectious Disease Prevention and Control Branch, and the National Microbiology Laboratory of the Public Health Agency of Canada.

The Parliamentarian Observer L' Obseratoire parlementaire

Tuesday, May 31, 2022