prevention and control of zoonoses zoonoses in mainland china

Prevention and Control of Prevention and Control of ZoonosesZoonoses in Mainland Chinain Mainland China

Disease Prevention & Control Bureau, Ministry of Health // Department of Health of Tibet

Dr. Qing Hua HE

October 2010 Veterinary Public Health Workshop in HK

Epidemiological trend of communicable diseases

Major zoonotic diseases

Surveillance and control strategies

ContentsContents

A plague, cholera

B26

influenza A H1N1, atypical pheumonia, avian- human influenza, anthrax, scarlet fever, bacillary and amebic dysentery, typhoid and paratyphoid, rabies, haemorrhagic fever, dengue fever, brucellosis, leptospirosis, AIDS, viral hepatitis, poliomyelitis, measles, cerebrospinal meningitis, pertussis, diphtheria, encephalitis B, tetanus neonatorum, gonorrhoea, syphilis, schistosomiasis, malaria, tuberculosis,

C11

influenza, conjunctivitis, infectious diarrhea, hand-foot-mouth disease, epidemic and endemic typhus, parotitis, rubella, leprosy, kala-azar, echinococcosis, filariasis

StatutoryStatutory NotifiableNotifiable Communicable DiseasesCommunicable Diseases

Report on Statutory Notifiable Communicable Diseases for 2009

5,898,415 cases15,267 persons diedThe incidence rate is 444.15 per

100,000 personsThe mortality rate is 1.15 per

100,000 persons

Epidemic trend of Communicable diseasesEpidemic trend of Communicable diseases

Group A and Group B Communicable Diseases

3,499,485 cases incidence rate is 263.52 per 100,000 persons

14,848 persons died mortality rate is 1.12 per 100,000 persons

Incidence or death from these communicable diseases (except infectious atypical pneumonia, poliomyelitis and diphtheria) have been reported

Group C Communicable Diseases

2,398,833 cases incidence rate is 180.63 per 100,000 persons

416 persons died mortality rate is 0.03 per 100,000 persons


2009 vs. 2008

The number of blood-borne and sexually transmitted diseases has increased by 3.92%.

The number of communicable respiratory diseases has decreased by 13.83%.

The number of communicable intestinal diseases has decreased by 12.64%

The number of natural foci and vector-borne diseases has decreased by 5.17%.

The number of Group C communicable diseases has increased by 38.63%, mainly due to the growing number of hand-foot-mouth disease

cases (480 000 - 1.15 million cases)

EpidemicEpidemic trend of Communicable diseasestrend of Communicable diseases

A decreasing proportion of deaths caused by communicable diseases

5.45%

0.89%1.44%1.77%

2.18%

2.76%

10.1%

14.82%

15.81%

22.32%

22.45%

cerebrovasculardisease

malignancy

respiratory disease

heart disease

injury andpoisoning

digestive system

communicablediseasesendocrine diseases

genitor-urinarydiseases

perinatal death

others


8

0

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2004 2005 2006 2007 2008

万例

年

肠道传染病呼吸道传染病虫媒及自然疫源性传染病血源及性传播传染病

Year

Cases (10000)

intestinal respiratory

vector-borne and natural foci blood-borne and sexually transmitted

Morbidity Curve of Group A and Group B Morbidity Curve of Group A and Group B Communicable diseases by Transmission RouteCommunicable diseases by Transmission Route

Announcement No. 1149 of the Ministry of Agriculture, 19 January 2009 (26 Types)

Highly Pathogenic Avian Influenza, Rabies, Anthrax, Brucellosis, Leptospirosis, Bovine Tuberculosis, Japanese Schistosomiasis, Japanese Encephalitis, Streptococcus Suis Type II, Filariasis, Bovine Spongiform Encephalopathy, Toxoplasmosis, Echinococcosis, Salmonellosis, Trichinosis, Cysticercosis Cellulosae, Glanders, Tularemia, E. Coli (O157:H7), Listeriosis, Q Fever, Melioidosis, Actinomycosis, Clonorchiasis, Avian Tuberculosis, Leishmaniasis

List of List of ZoonoticZoonotic DiseasesDiseases

Rabies( Cases )

List of Major List of Major ZoonoticZoonotic DiseasesDiseases

122010-10-70

100

200

0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85- 年龄组

报告发病数(例)

男女

Number of reported Rabies Cases by Age Group in 2009

(Cases)

Male Female

Age Group

0

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300

1 2 3 4 5 6 7 8 9 10 11 12

月份

报

告

发

病

数

2008年

2009年

2010年

Number of reported Rabies Cases in China by Month 2008 - July 2010

( Cases )

month

Rabies, countries or areas at risk in 2008 (from WHO website)

0

5000

10000

15000

20000

25000

30000

1950

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2.5发病数发病率

Brucellosis

No. of reported cases and incidence rates, 1950-2009

No. of cases Incidence rate

Major Major ZoonoticZoonotic DiseasesDiseases

No. of cases(male)

No. of cases(female)

Incidence rate(male)

Incidence rate(female)

age group

Rep

orte

d in

cide

nce

rate

(1/1

0000

0)

( cases )

Number of Reported Brucellosis casesNumber of Reported Brucellosis cases by age group and gender in 2008by age group and gender in 2008

0

1000

2000

3000

4000

5000

6000

7000

1 2 3 4 5 6 7 8 9 10 11 12

月份

报

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病

数

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Number of reported brucellosis cases in China by month, 2008-July 2010

2008

2009

2010

month

( cases )

Global distribution of brucellosis cases

annual incidence rate (1/1000000)————

cases reported without concrete data

Anthrax

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1 2 3 4 5 6 7 8 9 10 11 12月份

报告发病数

2008年

2009年

2010年

2008

20092010

month


( cases )

Human infection by Streptococcus suis

In July 2010, only one case has been reported in China. As at the end of July, totally 9 cases have been reported in 2010, with zero mortality.

Human avian influenza

7 cases of human infection by highly pathogenic avian influenza were reported in 2009, with 4 deaths. As compared with 2008, there were 3 more reported cases and the same number of death cases in 2009.

As at the end of July 2010, only 1 case of human avian influenza was reported in China, with 1 death case.


Lawful and scientific approach for prevention and control

Enforcement of the Law of Infectious Diseases Control

Step up surveillance by establishing surveillance points and networks to gather information on the dynamic change of communicable diseases

Roles of departments and regions

Set up collaborative prevention and control mechanism between departments

Set up collaborative prevention and control mechanism between departments and provinces

Surveillance and Control StrategiesSurveillance and Control Strategies

Enhancement on systems, organization and capacity

Implement the following three measures –

Funding: to keep the basic public health service funding per capita at $ 15 or above and secure funds for launching communicable disease prevention and control work

County: to enhance the capacity of centers for disease prevention and control at the county level in investigating and handling zoonotic disease cases

System：to improve policies, directives, regimes, standards, parameters and guidelines.

Perfect the working mechanism, protection mechanism and operation mechanism


Classified Management:

Mandatory management: For group A diseases, mandatory isolation for treatment and mandatory quarantine will be enforced to control the epidemic.

Stringent management: For group B diseases, prevention and control measures will be implemented to bring down the incident rates.

SurveillanceSurveillance: For group C diseases, we will monitor the epidemic trends to prevent outbreak of diseases.

Goals:

Routine goal：Prevention, Control and Mitigation

Ultimate goal: Eradication and Abatement


Specific Measures

1、Responsibilities of relevant departments

Health departments at various levels shall duly identify,

report and treat zoonotic disease cases.

Agricultural departments at various levels shall implement

comprehensive prevention and control measures on

immunization and quarantine of livestock and culling of test-

positive livestock; strengthen quarantine at slaughterhouses;

keep a close watch of livestock circulation; and prohibit

uninspected livestock and poultry products or products

failed the quarantine inspection from entering the food

market.


2、Strengthen epidemic notification and cooperation

in investigation

Regional health and agricultural departments shall seriously implement the zoonotic disease notification system to ensure timely, proactive notification of epidemic situation and dissemination of information on prevention and control efforts.

After receiving notification, relevant departments shall organize personnel to jointly conduct investigations and prevent the spread of epidemics.

3、Step up supervision and inspection

Health and agricultural departments at various levels shall strengthen enforcement of the Law on Prevention and Treatment of Infectious Diseases and the Animal Epidemic Prevention Law. Any unit or individual who fails to take prompt preventive and control measures in accordance with the laws shall be subject to administrative sanctions or legal liabilities.


4、Launching health education and publicity programmes to promote the prevention and control of zoonotic diseases

5、Direct Network Report on Communicable Diseases must be timely and accurate

Direct Network Report System

Bureau of Public Health at county (district) level

Bureau of Public Health at municipal (city) level

Department of Public Health at provincial (district) level

case investigation form

communicable disease report card

Centre for disease control and prevention at county (district) level

Centre for disease control and prevention at municipal (city) level

Centre for disease control and prevention at provincial (district) level

Chinese Centre for Disease Control and Prevention

Ministry of Healthinformation dissemination

Hospital

clinical diagnosis of (suspected) cases

case found, diagnosis

epidemiological investigation

tracking, correction, analysis, application

confirmation, analysis, application

analysis and application

analysis and application

result analysis

report on epidemic situation

work report feedback tracking, correction, investigation

Remark: Relevant units are authorised to access and use the information maintained by the national data centre

report

national data centre

Thank you very much！

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prevention and control of zoonoses zoonoses in mainland china

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