Dr. Zhen XUBranch of Respiratory Disease Prevention and ControlDivision for Disease Control and Emergency Response

Chinese Center for Disease Control and PreventionJune, 2011

Integration of ILI sentinel surveillance system and ILI outbreak event report system

Data input, query and auto analysis Lab info management Surveillance quality monitoring

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

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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

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 ;

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 ;

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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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

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暴发起数

周次2010-2011

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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

environment surveillance data

Serological surveillance

data

Influenza Weekly Report

www.cnic.org.cn

www.cnic.org.cn/eng

Information dissemination: Weekly Report

Information Sharing

FluID

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

•Most are clinical cases;•No virological info;•Limited use for flu surveillance

Case patients hospitalized with 2009 pandemic influenza A (H1N1) virus infection, by date of

onset, China, Sep 2009–Feb 2010. ICU,

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

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

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

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