Since 1993, the importance of bacterial pneumonia and meningitis prompted the Pan American Health Organization to implement a regional surveillance program based on a network of sentinel hospitals and laboratories, SIREVA (Regional Vaccine System) and then, SIREVA II (Surveillance Network System of Agents Responsible for Bacterial Pneumonia and Meningitis), to provide prospective information on the distribution data of serotypes and susceptibility of S. pneumoniae to antibiotics, as well as epidemiological information for estimating the burden of these diseases and the formulation of increasingly efficient vaccines.

Specific objectives

Generate quality information accepted by the international scientific community.
Create an intra- and interregional network that would serve as a model platform in accordance with the principles of quality management.
Create a biological material bank that, associated with the corresponding epidemiological information on a demographic basis, would allow to estimate disease burden, guide national decision-making authorities, assist in determining the ideal composition of conjugated vaccines to be used in the region and facilitate the measurement of the impact of vaccine interventions.
Create and maintain in the long term a relationship between public health laboratories in the region in the exchange of information and technology transfer.
Create and maintain within countries a close relationship between epidemiology departments and laboratory for the surveillance of vaccine preventable invasive bacterial diseases.

To achieve these objectives, a multicenter network was initiated in six countries in the region in 1993: Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. Countries were selected based on epidemiological criteria, high prevalence, geographical distribution, population size and operational possibilities. The National Centre for Streptococcus (NCS) in Alberta, Canada, and the Laboratory Center for Disease Control in Ottawa, Canada, provided laboratory and epidemiological support, respectively. A common protocol was established, which was refined in places to respond to the specific situations of each country. The selection of hospitals was based on the pediatric population served and the manifest desire of clinicians and laboratory staff to participate in the project.