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Topic 5: Information Assurance and Security
Disease Surveillance in China
Dan Ru
ISYM-540-P
08/06/2009
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 Line
village → 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:
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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
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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
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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