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Dr. Zhen XUBranch of Respiratory Disease Prevention and ControlDivision for Disease Control and Emergency Response
Chinese Center for Disease Control and PreventionJune, 2011
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Integration of ILI sentinel surveillance system and ILI outbreak event report system
Data input, query and auto analysis Lab info management Surveillance quality monitoring
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Epidemiology SurveillanceDiagnosis and Registry: daily
Reporting of ILI case: weekly
Collect and analyze the surveillance data
Laboratory SurveillanceSpecimen collection: 5-15 nose & throat swabs
from ILI cases per week per hospital
Lab detection: PCR test or virus isolation, antigenic and genetic analysis, antiviral resistance
5
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Specimens info & results
Specimens info & results
Re-identification
Re-identification
Network laboratories
Specimens collectionSpecimens collection
Send specimens to labsSend specimens to labs
ILI sentinel hospitals
CCDC
DetectionDetection
Isolates to CCDCIsolates to CCDC
ILI reportingILI reporting
ILI surveillance information reporting
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Input data of ILI counts and ILI% by week
and age group; Data query by date, by week, by age group,
by hospital and by area ;
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Input data of PCR and virus isolation results by specimen within 48h; Data query by patient, by date, by week, by hospital and by area ;
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event-based report basic info of ILI outbreak: major symptoms, case number, lab results, duration and location of the outbreak progress report of outbreak response;
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0
50
100
150
200
250
300
15 21 27 33 39 45 51 4 10 16 22 28 34 40 46 52 5 11 17 23 29 35 41 47 1 7 13 19
报告暴发疫情起数
周次
甲型H1N1流感暴发疫情
无实验室结果的ILI暴发疫情
季节性流感暴发疫情
2010-20112009-20102008-2009
0
2
4
6
8
10
14 19 24 29 34 39 44 49 2 7 12 17
暴发起数
周次2010-2011
0
10
20
30
40
50
60
70
0
500
1000
1500
2000
2500
3000
3500
4000
14 21 28 35 42 49 3 10 17 24 31 38 45 52 7 14 21 28 35 42 49
阳性率(
%)
阳性数
周次
UntypedYamagataVictoriaB(lineage not determined)A(unsubtyped)A(unsubtyped excluded H1N1pdm)H1N1H3N2H1N1pdmInfluenza Positive(%)
2009 2010 2011
ILI analysis
Virus typingSurveillance quality monitoring
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environment surveillance data
Serological surveillance
data
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Influenza Weekly Report
www.cnic.org.cn
www.cnic.org.cn/eng
Information dissemination: Weekly Report
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Information Sharing
FluID
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To monitor the severity of Pandemic H1N1 and understand the characteristics of SARI cases caused by pdm H1N1
Following WHO case definition Support by MOH and EID program Data source:◦ Epi data by case: Respiratory, Internal ICU, and Infectious
Departments from 10 hospitals◦ Lab data: 10 network Labs where the hospitals located
Data report: EPI Database weekly sent from hospitals and labs by email
Data sharing: Brief report sent to hospitals and labs regularly
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•Most are clinical cases;•No virological info;•Limited use for flu surveillance
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Case patients hospitalized with 2009 pandemic influenza A (H1N1) virus infection, by date of
onset, China, Sep 2009–Feb 2010. ICU,
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Still lack of a comprehensive surveillance system to oversee the virus and diseases caused by flu virus◦ Characteristics and burden of mild, severe and fatal case
Maintain the current giant ILI network—cost, willingness and enthusiasm
Translating data into practice is much more important than collecting data◦ Surveillance data, research data
Risk assessment of surveillance data Quality monitoring didn’t followed by in time quality
improvement action SARI surveillance info is independent from ILI system. Mild
and severe case caused by flu virus cannot be linked well
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Vaccine gap◦Supply: 30m doses VS 570m population◦Capacity: 126m doses VS 570m population
Vaccination strategy◦Annual technical recommendations for target population only◦Flu vaccination not covered by national government or
medical insurance◦Beijing is the only city to provide the free vaccination service
to local population: 65yrs, primary and middle school ﹥students
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Improve the sentinel SARI surveillance◦ Internet-based reporting of epi and lab data◦ Integration with HIS and LIS in hospitals◦Publication and sharing of SARI findings
Modeling the ILI seasonal pattern Application of early warning based on long-term
and good-quality flu data in pilot areas Describe the burden of severe and fatal cases
caused by flu virus◦Population-based inpatients surveillance ◦DSP site: ICD code-based deaths analysis
Use the data for vaccination policy making
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Information Information Platform Platform
SequenceDatabase
Lab Data Management
WebsiteWebsite
Surveillance Information System
Security check
Security check
Public propaganda
New
Technical support
Data Entry
Analysis&Report
Result feedback
Submission
Share
Search
Download
Take&Return
Result Entry
Receipt
Integrated information system
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