1. Topic 5: Information Assurance and Security Disease 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 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

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

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