# Surveillance > Surveillance for FMGE Community Medicine: types, IDSP S P L forms, zero reporting, IHIP and milestones like polio-free India 2014 and smallpox eradication. - Canonical URL: https://prepelephant.com/topics/fmge/community-medicine/surveillance-fmge - Exam / course: FMGE · Subject: Community Medicine - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Surveillance", PrepElephant, https://prepelephant.com/topics/fmge/community-medicine/surveillance-fmge ## Direct answer Surveillance, as WHO defines it, is the continuous, systematic collection, analysis and interpretation of health data, followed by dissemination to those who need to act — done not for research but for public health action. In India the flagship is the Integrated Disease Surveillance Programme (IDSP), launched in 2004, which collects weekly syndromic, presumptive and laboratory-confirmed reports from health facilities and has now been upgraded into the digital Integrated Health Information Platform (IHIP). FMGE expects the types of surveillance, the mechanics of IDSP reporting, and the vocabulary of control, elimination and eradication. ## What you must remember - Types: passive surveillance uses routine routine reports (cheap, complete coverage, but insensitive); active surveillance reaches out to find cases (sensitive, expensive, used for polio acute flaccid paralysis); sentinel surveillance uses selected reporting sites, as for HIV at antenatal clinics; syndromic surveillance reports clinical patterns before laboratory confirmation. - IDSP (2004) reporting is weekly through three forms: the S form (syndromic, by health workers), the P form (presumptive, by doctors) and the L form (laboratory-confirmed). - Zero reporting means "no cases this week" is recorded and sent — silence is itself data, and a missing report is treated as a system failure, not absence of disease. - IDSP watch-list conditions include acute diarrhoeal disease, typhoid, malaria, dengue, Japanese encephalitis or acute encephalitis syndrome, measles and respiratory illness; unusual clustering triggers early warning signals. - Attributes of a good surveillance system: sensitivity, timeliness, representativeness, positive predictive value, simplicity, flexibility and acceptability. - Milestones to memorise: smallpox's last natural case was in Somalia in 1977 and WHO declared eradication in 1980; India's last wild poliovirus case was 13 January 2011 and the WHO South-East Asia Region certified India polio-free on 27 March 2014; maternal and neonatal tetanus elimination was validated in 2015. - Control reduces incidence to an acceptable level; elimination interrupts transmission in a defined geography; eradication is worldwide and permanent (smallpox alone so far); extinction means the agent no longer exists even in laboratories. ## How a fever cluster moves through IDSP A sub-centre health worker logs 12 cases of fever with rash in her village this week on the S form. Through the weekly cycle the data reach the block and district surveillance officer, who sees that the same week last year had one case. Presumptive measles is notified; the P form is filled by the medical officer and samples — blood for ELISA and a throat swab where relevant — feed the L form. The district reacts within days rather than weeks: case isolation advice, vitamin A to cases, a search for unimmunised children, and a mop-up immunisation session. This is the entire point of surveillance compressed into one village: detection, verification, analysis, response. With IHIP since 2021 the pipeline has become case-based, real-time and geotagged rather than aggregate and weekly, but the logic is unchanged. ## Terms that decide the one-markers Three confusions dominate. First, surveillance versus monitoring: surveillance watches for disease trends and outbreaks in populations, monitoring tracks the progress of an activity or programme (immunisation session held, children covered). Second, passive versus active: polio's acute flaccid paralysis surveillance is the standard active example because every reporting unit must send a weekly report even when zero AFP cases exist, and search activities actively hunt for cases. Third, elimination versus eradication: yaws and neonatal tetanus are eliminations (zero transmission in India, agent still elsewhere); smallpox is the only human eradication. An examiner favourite is asking which vaccine-preventable disease India has eradicated — the answer remains smallpox, since polio is a regional certification of interruption of wild virus, not global eradication. ## Frequently asked questions ### What are the S, P and L forms of IDSP? The S (syndromic) form is filled by health workers from clinical pictures, the P (presumptive) form by treating physicians adding a working diagnosis, and the L (laboratory-confirmed) form by laboratories; all three flow weekly up the system. ### What is zero reporting? The practice of explicitly reporting "zero cases" for the week, so that a blank return can be distinguished from a missing one; it keeps the surveillance loop closed and flags reporting-unit failure immediately. ### What is sentinel surveillance with an example? Surveillance through selected facilities or populations that give quality data, such as the HIV sentinel surveillance conducted at antenatal clinics and sexually transmitted infection centres to track the epidemic's trend. ### Which is the only human disease eradicated so far, and when? Smallpox — the last natural case occurred in Somalia in 1977 and WHO declared eradication in 1980, after an intensified campaign built on surveillance and containment vaccination. ### When was India certified polio-free? 27 March 2014, when the WHO South-East Asia Region was certified after three years without any wild poliovirus; India's last wild poliovirus case was on 13 January 2011 in Howrah. ### What is the difference between elimination and eradication? Elimination reduces cases of a disease to zero in a defined geographic area with continued measures required (measles elimination goals); eradication is permanent, worldwide reduction to zero, so control measures can stop — achieved only for smallpox.