History
The Canadian Paediatric Surveillance Program (CPSP) was established in 1996 under the visionary joint leadership of the late Dr. Victor Marchessault, former Executive Director of the Canadian Paediatric Society, and Dr. Philippe Duclos, former Chief of the Division of Immunization at the Laboratory Centre for Disease Control at Health Canada.
Modelled after the British Paediatric Surveillance Unit, a pilot program to conduct public health surveillance on rare paediatric diseases was launched in Canada in January 1996. Three conditions were initially selected for surveillance: Acute flaccid paralysis was selected to support the World Health Organization’s polio eradication efforts; congenital rubella syndrome was selected to monitor progress towards the goal of eliminating rubella infection during pregnancy by the year 2000; and group B streptococcal infection was chosen because no Canadian data existed on the incidence of the infection at that time.
After a successful pilot, the Program was expanded and new conditions were selected for surveillance. A Scientific Steering Committee comprised of experts in paediatrics, public health, epidemiology, and related disciplines was established to guide the development of the Program and to oversee all surveillance projects.
By the late 1990s, the positive impact of voluntary, physician-led public health surveillance was clear. Participating paediatricians and paediatric subspecialists were engaged and reporting cases of rare conditions to the monthly active surveillance system. Most importantly, results from concluded studies emphasized the importance of undertaking timely epidemiological data collection to affect and confirm public health policy decisions.
By 2001, the CPSP had established a variety of ways to share knowledge and information generated by the Program. Many study teams published their findings in peer-reviewed journals. Other knowledge translation mechanisms include the annual CPSP Results, Surveillance Highlights in Paediatrics & Child Health, and presentations at national and international conferences. The Program also provides monthly Adverse Drug Reaction Tips to all participants, offering prompt information related to paediatric medication safety issues.
In 2002, the CPSP was expanded to include one-time surveys, designed as a cost-effective tool to identify an emerging public health issue or measure the epidemiologic “pulse” of a specific paediatric condition. In collaboration with Health Canada, the initial one-time survey on injuries associated with baby walkers contributed data to support the 2004 total sales ban on such products in Canada. Subsequent one-time surveys have explored a range of important topics including paediatric palliative care, international adoption, and the use of cannabis for medical purposes.
Importantly, in the face of emerging public health threats, the established infrastructure of the CPSP can be rapidly mobilized to gather near real-time data to quickly inform public health authorities on the scope of these concerns. For example, in 2008, the CPSP conducted rapid surveillance following an outbreak of renal stones and renal failure in very young children in China, associated with the consumption of powdered milk products contaminated with melamine. Government authorities, as well as families, were concerned that children in Canada may be at risk. Within three weeks, the CPSP provided the Public Health Agency of Canada the necessary assurances that no similar cases had been identified in Canada.
In 2011, the CPSP celebrated its 15th anniversary and launched eCPSP, an online reporting system that moved the Program from monthly paper-based reporting to a more efficient and cost-effective online system. Response times improved significantly while maintaining the desired response rates.
In 2020, the CPSP quickly mobilized once again to provide real-time data and analysis to national and provincial public health officials on the effects of COVID-19 and multisystem inflammatory syndrome in children. The Program was able to gather data on a weekly basis and report results to inform public health actions needed to keep children and youth safe during the global pandemic. This type of emergency response exemplifies the added-value of a national network for active surveillance that is well connected with paediatricians and public health officials.
Today, the CPSP is a successful partnership between the Canadian Paediatric Society and the Public Health Agency of Canada that provides valuable data on rare and emerging childhood diseases and conditions as well as on public health issues affecting children and youth. After more than two decades of surveillance, the CPSP’s findings continue to positively impact child health and guide paediatricians, researchers, and public health policy makers.
