Topic 5: Information Assurance and Security Disease Surveillance in China

1. Topic 5: Information Assurance and SecurityDisease Surveillance in China Dan Ru ISYM-540-P 08/06/2009

2. 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

3. 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.

4. 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)

5. NACTN Existing Databases Future Developments Accumulate information Update techniques Establish subnetworks within provinces Smoking and health Child-nutrition surveillance Diarrheal disease of children • 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

6. 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

7. DSPs Household Individual Occupation Education Birth/Death Episodes of infectious disease Pregnancy/Lactation/Feeding Vaccination • Number of members • Income • Health-care situation • Water supply • Toilet facilities

8. 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

10. 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

11. 2009 Swine Flu • Reported cases: 1,930 • No reported death

12. Thermal scanner shows the heat signature of passengers

13. China's Aggressive Stance on Swine Flu