China Diseases Surveillance

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1 Disease Surveillance Practice on Zoonosis with Focus on Vectors and Reservoirs in China Liu Qiyong Director Assistant National Institute for Communicable Disease Control and Prevention WHO Collaborating Center for Research and Training in Zoonoses Chinese Center for Disease Control and Prevention Chairman Society for Vector Biology & Control, CPMA Add: P.O. Box5, Changping, Beijing,102206, P.R. China Tel:

2 If we neglect this threat, we will pay a heavy price for it. Zoonoses

3 Outline Zoonoses: Communicable Diseases Legislation Surveillance Systems Examples Other Information

4 Legislation Regulation on the Control of Communicable Diseases, 1956? Regulation on the Control of Acute Communicable Disease, 1959 Law for Control and Prevention of Communicable Diseases, 1989 Amended Law for Control and Prevention of Communicable Diseases Approved by National People s s Congress in Aug , Implementing in Dec.1, 2004 Diseases for notification (3 groups- 37 diseases) Punishment for delinquent reporting

5 National Statutory Notifiable Communicable Diseases Group A: A Plague,, Cholera Group B: B SARS, AIDS, Viral hepatitis, Poliomyelitis, HPAI, Measles, HFRS, Rabies, Japanese encephalitis, Dengue fever, Anthrax,, Bacillary & amebic dysentery, TB, Typhoid fever/paratyphoid fever, Meningococcal Meningitis, Pertussis,, Diphtheria, Neonatal Tetanus, Scarlet fever, Brucellosis,, Gonorrhea, Syphilis, Leptospirosis, Schistosomiasis, Malaria Group C: C Influenza, Mumps, Rubella, Acute hemorrhagic Conjunctivitis, Leprosy, Epidemic typhus/endemic typhus, kala-azar azar, Echinococcosis, Filariasis,, Infectious diarrhea

6 Public Health Service Agencies in China Ministry of Health Provincial health departments Prefectural health bureaus County health bureaus China CDC Provincial Disease Control Agencies Prefectural/City Disease Control Agencies County Disease Control Agencies Township hospitals Village clinics

7 Infrastructures for Communi. Dis. Surveillance Central: CCDC Office of Dis. Control & Emer.Res. Center for Public Health Surveillance & Infor. Ser. NIP, TB Center, HIV/AIDS Center Institute for Communi. Dis. Contr. & Prev. Institute for Viral Dis. Cont. & Prev. Institute for Food Safety and Public Nutrition Provincial CDCs/TB Centers Prefecture/Municipal CDCs/TB Centers County/District CDCs/TB Centers Hospitals, Clinics, Community Health Centers, Blood Banks, Quarantine Agencies

8 Communicable Disease Surveillance Systems -Old System National Notifiable Communicable Diseases Report System Aggregative data reporting monthly level by level too late for Identifying of outbreak too roughly Information for CDCs above County level Diseases Surveillance Points (DSPs) System Since points selected randomly nationwide Coverage 10 million of Population Birth and death registry and reporting, vital statistics Class A, B and C statutory notifiable infectious dis. Reporting Class C reporting only in the DSPs Conducting health surveys Specific Diseases Surveillance System: TB, HIV/AIDS, STD, plague,, VPD,

9 Communicable Disease Surveillance Systems -New Structure Statutory Notifiable Diseases Reporting System (3 group,37 diseases) Enhanced Communicable Disease Surveillance Plaque, Cholera, Rabies, HRFS, Dengue, TB, AIDS/HIV, VPD, Brucellosis, etc.. Case Investigation and/or Lab. Diagnosis Sentinel Surveillance - Influenza/ILI, STIs/HIV in Population at High Risk SARS and Avian Flu. Early Alert Surveillance - Cause-unknown pneumonia surveillance based on all levels hospitals. - Infect. dis. related death reporting based on county and above levels hospitals Laboratory or environmental surveillance -Pulse-net, Food-net Disaster related health condition and public health emergency reporting System -Disaster related public health and sanitary condition - Dis outbreak, chemical leaking, environmental pollution, food poisoning, etc.

10 Reporting System of Statutory Notifiable Communicable Diseases (3 groups-37 dis.) Launched since January 2004 Internet-based real-time (quasi real-time ) case reporting system Timing of reporting (new guideline will be issued next month) - Group A and SARS, HPAI, Polio, pulmonary anthrax : within 2 hours - Group B and C: within 24 hours Method of reporting Online reporting if Internet available For Clinic and hospital which internet unavailable: Fax, mailing cards or telephone reporting to County CDC and input through Internet by County CDC

11 Reporting System of Statutory Notifiable Communicable Diseases Enabling early Detection of outbreak/epidemic Detailed case data at each level CDC and HD. Real-time online or offline analysis/statistics and table/graph making Feedback and dissemination of surveillance information (DRNCDA) Daily Report of Notifiable Communicable Disease and Adverse Health Events: to MoH and CCDC subcenter (WRNCDA) Weekly Report of Notifiable Communicable Disease and Adverse Health Events: to MoH, CCDC subcenter, Provincial HD and CDC (MRNCDA) Monthly Report of Notifiable Communicable Disease and Adverse Health Events: to MoH, CCDC Subcenter, HD and CDC at Each level (ARNCDA) Annually Report of Notifiable Communicable Disease and Adverse Health Events: to MoH, CCDC Subcenter, HD and CDC at Each level

13 Topology of Reporting System of Statutory Notifiable Communicable DiseasesD 移动 / 联通短信网推送的信息 OL TP 数据国家 CDC系统 OL AP 数据发布的信息 ME M 公众手机查询统计查询统计本省数据个案报告检验报告个案报卡监测个案报卡统计报表 VPN 查询统计检验报告查询统计本省 OL AP数据其它信息系统省 CDC系统 ME M 各级医疗机构乡镇报告人市县 CDC 研究机构管理员卫生部应急指挥系统

14 Main feature If If need, add add notifiable diseases at at any any time time Browse Cases variable at at all all level level CDC Web-GIS Auto alert alert

Main function CASE CASE query query Real Real time time online online or or offline offline analysis/statistics analysis/statistics and and table/graph

15 Main function CASE CASE query query Real Real time time online online or or offline offline analysis/statistics analysis/statistics and and table/graph table/graphmaking Analysis Analysis on on daily, daily, weekly, weekly, monthly monthly and and yearly yearly basis basis Dictionary Dictionary management management

16 Web-GIS Platform -Display Case Incidence from National to Township Level 专题图分析专题图叠加

17 Weekly Report Report of of Notifiable Communicable Disease and and Adverse Health Health Events Events Disseminated to to MOH, MOH, CCDC CCDC institutes and and subcenters/, Provincial HD&CDC Summary Disease outbreak/epidemic Other aberration detected Adverse Health Events International outbreak news important implication

18 图年第 46 周全国甲乙类传染病报告发病数与前五周中位数比较 (%) 鼠疫下降上升钩端螺旋体病流行性乙型脑炎疟疾霍乱百日咳甲肝戊肝未分型痢疾伤寒和副伤寒艾滋病狂犬病布鲁氏菌病斑疹伤寒白喉新生儿破伤风肺结核合计登革热传染性非典型肺炎乙肝淋病梅毒丙肝麻疹流行性脑脊髓膜炎猩红热流行性出血热炭疽黑热病 Enteric diseases 例肠道传染病周例血源及性传播疾病周 Hematic & STD 35000例 3500 例 Respiratory Diseases 虫媒及自然疫源性疾病 VBD 呼吸道传染病周周

19 Enhanced Disease Surveillance Plague, Cholera, Rabies, HRFS, Dengue, etc. EPI-target diseases Character and feature Based on statutory reporting of cases Case investigation and sample collection Lab diagnosis Active surveillance for some diseases Environmental and risk factor surveillance for some diseases

20 Disease with Related Animal Surveillance Plague: Rabies HRFS Dengue Malaria Japanese encephalitis Anthrax Leptospirosis kala-azar Echinococcosis Filariasis Schistosomiasis SARS HPAI Brucellosis TB Epidemic typhus/endemic typhus

21 Plague Surveillance and Alert System Reservoirs, Rodents Vectors, Fleas Animal & Human Surveillance Control activities/process management and monitoring Real time analysis/statistics and table/graph making Analysis on daily, weekly, monthly and yearly basis Real-time Alert

22 Plaque 病例数 ( 例 ) 年 2003 年 2004 年 10 By Nov 25, 2004, 22 palque cases were reported fromqinghai(20), 年全国鼠疫报告病例月分布月份 Gansu(1) and Neimenggu(1)

23 Hemorrhagic Fever with Renal Syndrome (HFRS) Jan,1 Nov,14, cases, and 183 deaths. Number of cases in 5 Provinces take 70% of total cases (LN, SD, HeB,HLJ, JL) Animals: Rodents 病例数 ( 例 ) 年 2003 年 2004 年月 ( 终审 ) 年全国流行性出血热报告病例月分布

24 A New Comprehensive Vector Surveillance System in China Launched in 2005 New protocols Program management The targeted vectors: mosquitoes, flies, cockroaches, rodents The pilot provinces: 17 provinces The scenarios: 40 cities

26 Challenge Weak designing and evaluation of surveillance system Analysis, interpretation of surveillance data need being improved Lack of methodology and technique to use information to facilitate decision-making Low capability to detecting and identifying emerging infection Laboratory surveillance very weak

27 媒介生物可持续控制国际论坛 International Forum For Sustainable Management Of Disease Vectors 21 st -23 rd April, 2006, Beijing Central Garden Hotel 中苑宾馆

for Vector Biology & Control, CPMA 协办 : 中华预防医学会医学寄生虫学分会 Co-sponsor:

28 媒介生物可持续控制国际论坛组织机构 Organization 主办 : 中华预防医学会 Organizer:Chinese Preventive Medicine Association 承办 : 中华预防医学会媒介生物及控制分会 Sponsor:Society for Vector Biology & Control, CPMA 协办 : 中华预防医学会医学寄生虫学分会 Co-sponsor: Society for Medical Parasitology, CPMA 中华预防医学会铁路分会 Society for Railway Health, CPMA

29 组织机构 Organization 国际顾问委员会 :Duane J. Gubler,Brian Herbert Kay 等名誉主席 : 韩启德 HAN Qide 王陇德 WANG Longde 主席 : 汪诚信 WANG Chengxin 副主席 : 蔡纪明汤林华陆文德杨维中徐建国李德新王宝麟孙贤理刘起勇等秘书长 : 刘起勇 LIU Qiyong( 兼 )

30 会议主题及议题会议主题 : 媒介生物可持续控制主要议题 : 1. 新发和再度爆发的媒介生物性疾病 2. 媒介生物监测及控制方法和策略 3. 媒介生物抗药性的治理 4. 媒介生物入侵的防御和管理 5. 媒介生物及媒介生物性疾病的风险评估 6. 大型活动媒介生物控制保障会议期间同时进行国际媒介生物控制技术及产品展示

31 The Theme: Sustainable Management of Disease Vectors Topic Themes: Emerging and re-emerging vector-borne diseases. Updates for techniques and strategies on vector surveillance and control. Management of resistance of disease vectors to pesticides. Strategy and technique for managing disease vector invasions. Risk assessment on vector and vector borne diseases for civil engineering Pest management for wellbeing of big events Exhibitions of Techniques and Products for Vector Management During the Forum

32 论坛网址 website:

35 Hotel Location 中苑宾馆地理位置优越, 依傍著名的古刹五塔寺大钟寺, 以及体现首都现代文明的动物园紫竹院公园首都体育馆北京展览馆中央民族学院北京交通大学西侧的白颐路直达颐和园圆明园香山, 门前的高粱桥斜街直通西直门桥联想桥, 径入二三环四环线

36 中苑宾馆环境外部环境内部环境

37 insect1 中苑宾馆大堂

38 Slide 37 insect1 中苑宾馆大堂采用透明屋顶的设计, 阳光充足, 大堂多采用朱红明黄的黑色金色的装修主色调, 由显最高贵典雅金碧辉煌在中苑大堂中各个服务设施分布其中, 总台会议报道台大堂吧商务中心商场邮局航空公司保险室等, 随时为您提供方便快捷的服务设在大堂西侧的总台率先采用坐式服务, 使客人更加轻松的办理各项手续, 体现了以人为本的管理方式 meijie, 10/26/2005

39 会议住宿豪华单人间标准双人间

40 ICDC

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