Computerised Infectious Disease Reporting (CIDR) system
Health Protection Surveillance Centre (HPSC).
CIDR was established in 2004, however, historical data on the notifiable infectious diseases was also included in the system i.e.
1988-June 2000 (historical aggregate data on notifiable diseases collected by the Department of Health)
July 2000 onwards (case-based information on notifiable diseases reported by Departments of Public Health to HPSC)
2004 (Outbreak data included)
2004 - 2010 (current format implemented in Departments of Public Health and Microbiology laboratories. While awaiting CIDR implementation, Departments of Public Health continued to report to HPSC using the system established in July 2000 and these data were imported to CIDR)
2013: (Case-based reporting of STIs implemented on CIDR).
CIDR is used for the statutory surveillance of notifiable infectious diseases in Ireland (including COVID-19) in order to provide the best possible information for the control and prevention of infectious diseases.
The objectives of CIDR include:
1. To monitor trends
2. To detect changes in disease occurrence e.g. identify outbreaks and new pathogens
3. To describe the current burden and epidemiology of disease
4. To determine risk factors for the disease and populations at greatest risk
5. To guide public health actions and inform policy
6. To evaluate control measures / interventions
7. To generate hypotheses and stimulate research.
In scope: Infectious Disease Notifications on 80 of 89 notifiable diseases.
Out of scope: Nine notifiable diseases whereby data collected through separate surveillance systems. These include some of the pathogens (n=5) under antimicrobial resistance surveillance (AMR), namely Enterococcal bacteraemia, Escherichia coli infection (invasive), Klebsiella pneumoniae infection (invasive), mcr-positive Enterobacteriaceae infection or colonisation, Novel or Rare Antimicrobial-resistant Organism (NRAO), Pseudomonas aeruginosa infection (invasive), Staphylococcus aureus bacteraemia and two sexually transmitted infections i.e. Ano-genital warts and Non-specific urethritis.
National.
1988-present
(varies depending on when the disease became notifiable and case-base reporting implemented).
1988-July 2000 – aggregate data
July 2000 onwards – case-based reporting implemented in Ireland
2004 - Outbreak data included
2004-2010 – CIDR pilot and go-live implementation (excluding STIs). Historical data and data from regions awaiting implementation on CIDR imported to the system.
2013 – Case-based reporting of STIs commenced and included on CIDR.
CIDR is the information system developed to manage the surveillance and control of notifiable infectious diseases in Ireland. Case-based data on laboratory and clinical notifications are collected on CIDR, which includes:
- Vaccine-preventable diseases,
- Respiratory (including COVID-19) and direct contact diseases,
- Infectious intestinal diseases,
- Vector borne and zoonotic diseases,
- Blood borne and sexually transmitted infections and
- Healthcare associated infections.
Enhanced surveillance data (additional detailed data) are also collected on many of the infectious diseases.
Summary data on infectious disease outbreaks are also collected in CIDR and individual cases notified on CIDR and associated with an outbreak are linked to the outbreak.
The full list of notifiable diseases can be found at www.hpsc.ie.
The current list is also specified in S.I. No. 258/2022 - Infectious Diseases (Amendment) Regulations 2022, available at https://www.irishstatutebook.ie/eli/2022/si/258/
Departments of Public Health, HPSC, HSE Senior Management and healthcare workers, Department of Health and other policy makers, researchers, European Centre for Disease Control (ECDC) and World Health Organisation (WHO).
- Patient demographics (name, address, age, gender, ethnicity, country of birth, occupation)
- Positive laboratory results (organism, type, specimen and test details)
- Onset and diagnosis dates
- Hospitalisation status
- Outcome.
Additional epidemiological information (enhanced surveillance) are collected on certain diseases and depending on the disease can include:
- Symptoms
- Underlying medical conditions
- Other risk factors
- Exposures
- Severity indicators including detailed information on
o ICU admission
o Outcomes
- Vaccination status
- Typing and whole genome sequencing (WGS) results.
Information on outbreaks are also collected on CIDR (HSE area, disease, outbreak type, location and cases associated with it are linked.
No
(Core data elements were based on a National General Practice Information Technology (GPIT) demographic data set developed in 1999).
No, IHI or PPSN are not included on CIDR.
Some equity stratifiers are included i.e.
- Place of residence
- Ethnicity
- Country of birth
- Gender
- Occupation
CIDR is a web-based information system with the data collected held in a single shared national information repository.
Data from laboratories are uploaded electronically or entered manually to CIDR by public and some private laboratories.
Staff in Departments of Public Health (or in HPSC on behalf of Public Health) process laboratory notifications on CIDR and also input clinical notifications, outbreak data, data from private laboratories and enhanced /epidemiological data collected by Public Health professionals or other healthcare professionals. Thereby laboratory, clinical, epidemiological and outbreak data are linked on CIDR.
During the COVID-19 pandemic, a Robotic Process Automation (RPA) solution was implemented on CIDR to assist with the processing of laboratory records and the entering of enhanced data.
Once these data are processed on CIDR they are available through the CIDR SAP Business Objects Reporting repository to the relevant Department of Public Health and HPSC (national view) to review, analyse, interpret and report on.
Data are collected and processed on CIDR on a daily basis (Monday-Friday) and during the COVID-19 pandemic, seven days per week (Sunday-Saturday).
No clinical coding or international classification of disease (ICD) system is in use.
However, surveillance case definitions are applied (i.e. the set of clinical and microbiological criteria by which a case of infectious disease is defined. The case definitions used in Ireland are predominantly based on EC case definitions. For details see: http://www.hpsc.ie/NotifiableDiseases/CaseDefinitions/ )
On average 33,394 cases were reported annually between 2013-2019, range 25,814 – 46,065. As a result of the COVID-19 pandemic the annual number of notifications increased exponentially with 134,775 and 698,627 cases notified in 2020 and 2021, respectively and almost 900,000 to date in 2022 (as of 8th August).
On average 550 outbreaks were reported annually between 2013-2019. As a result of the COVID-19 pandemic the annual number of outbreaks notified, increased exponentially to approx. 11,000 in both 2020 and 2021 and just over 3,000 to date in 2022 (as of 8th August).
Weekly and annual reports are produced and published on HPSC public website at http://www.hpsc.ie/hpsc/NotifiableDiseases
The HPSC hub on the Epidemiology of COVID-19 in Ireland is updated weekly and available at
https://epi-covid-19-hpscireland.hub.arcgis.com/
Quarterly or biannual reports are also produced for some disease areas and published on the HPSC website at http://www.hpsc.ie
CIDR users can access data according to their role and location as laid out in the CIDR National Business Rules policy (v4). On-demand reports are provided to CIDR users through the CIDR SAS Business Objects Reporting repository.
Data requests can be submitted via hpsc@hse.ie and will be assessed on a case-by-case basis. Depending on the level of detail requested, some requests undergo a formal review process, conducted by the CIDR National Peer Review Group.
The CIDR National Peer Review Group is a sub-group of the National CIDR National Business Rules Committee and was established to facilitate the collaborative use of CIDR data for research and other purposes, whilst ensuring confidentiality and data protection issues are appropriately addressed.
Enquiries from researchers to access CIDR data cam be submitted to cidrdatarequests@hpsc.ie
No.