Topic 5: Information Assurance and Security

Disease Surveillance in China

Dan RuISYM-540-P08/06/2009

Disease Surveillance

• Monitor spread of disease• Establish patterns of progression• Predict, observe and minimize harm caused by

outbreak, epidemic, and pandemic situations• Key: Disease Case Reporting• 1969 WHO mandatory reporting

System in China

• National Disease Reporting System (NDRS)• Cover over 1.3 billion people• 35 notifiable infectious disease – Class A,B, & C

• National Disease Surveillance Points (DSPs)• Stratified cluster random sampling• Select 145 reporting sites in 30 provinces• Cover 1% of China’s population

• Surveillance System for Specific Disease• Infections disease• Occupational disease• Food poisoning, etc.

National Disease Reporting System

• 1959: system established• Analog Telephone Linevillage → township → county → province → nation

• 1986: new system began • Digital Communication Network

• 1987: start operating• Nationwide Antiepidemic Computer

Telecommunication Network (NATCN)

NACTN

Existing Databases• National report on:

– Infectious disease– Occupational disease– Outbreaks of food poisoning

• National disease surveillance• National survey data bases:

– Drinking water quality– Human-parasite infections– Nutritional surveys– Nutrition for the elderly

Future Developments• Accumulate information• Update techniques• Establish subnetworks

within provinces

– Smoking and health– Child-nutrition surveillance– Diarrheal disease of children

National Disease Surveillance Points

• 1980-1989: Voluntary Participation• 10 million people: upper middle class• Biased data collection

• 1989-now: Stratified Cluster Radom • 145 DSPs in 30 provinces • Cover 1% of China’s population• Characterize risk factors and patterns of death among adults• Identify factors that influence the quality of data collected• Develop methods to monitor Chronic disease• Devise approaches to promote use of data from DSPs by

policymakers

DSPs

Household• Number of members• Income• Health-care situation• Water supply• Toilet facilities

Individual• Occupation• Education• Birth/Death• Episodes of infectious disease• Pregnancy/Lactation/Feeding• Vaccination

2003 SARS Outbreak

• Investing over $9 billions • 5,300 road projects• Reported cases: 7,492• Death toll: 685• Late report, fail to ask international help• Outbreak is 10 times worse than admitted

Policies/advises to People

• Ensure strict hygiene, well-balanced meals, seasonal clothing, physical exercise, adequate rest and reduced stress, and avoid smoking

• Ensure adequate indoor ventilation and avoid crowded public places

• Go to hospital immediately if symptoms appear• Do not visit atypical pneumonia patients• Tell children prevention methods

2009 Swine Flu

• Reported cases: 1,930• No reported death

Thermal scanner shows the heat signature of passengers

China's Aggressive Stance on Swine Flu