[A discussion on the strategy of evaluating the communicable disease surveillance systems in US Center for Disease Control and Prevention and World Health Organization].

OBJECTIVE: To compare the different surveillance system evaluation guidelines proposed by US Center for Disease Control and Prevention (CDC) and WHO, so as to develop an evaluation strategy suitable for communicable disease surveillance systems in China. METHODS: Systematic collection and review on the guidelines that were proposed by US CDC and WHO. Situation analysis together with feasibility analysis were linked to the analysis of evaluation strategy used in China. RESULTS: US CDC guidelines were more appropriate for evaluating those single or simple systems that focusing on those 'system characteristics' while the. WHO protocols were more appropriate for evaluating the multi-system or complicated system which focusing on data related to 'system functions'. The US CDC guidelines had been widely used in China and it was the right moment to start to evaluate the functions. CONCLUSION: More flexible and comprehensive strategy based on national conditions is needed when constitute the national communicable disease surveillance evaluation guidelines. The multi-step strategy described in this article could be used as reference.

[Study on the timeliness of detection and reporting on public health emergency events in China].

OBJECTIVE: To analyze the timeliness of detection and reporting on public health emergency events, and to explore the effective strategies for improving the relative capacity on those issues. METHODS: We conducted a retrospective survey on 3275 emergency events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Developed by county Centers for Disease Control and Prevention, a uniformed self-administrated questionnaire was used to collect data, which would include information on the detection, reporting of the events. RESULTS: For communicable diseases events, the median of time interval between the occurrence of first case and the detection of event was 6 days (P25 = 2, P75 = 13). For food poisoning events and clusters of disease with unknown origin, the medians were 3 hours (P25, P75 = 16) and 1 days (P25 = 0, P75 = 5). 71.54% of the events were reported by the discoverers within 2 hours after the detection. CONCLUSION: In general, the ranges of time intervals between the occurrence, detection or reporting of the events were different, according to the categories of events. The timeliness of detection and reporting of events could have been improved dramatically if the definition of events, according to their characteristics, had been more reasonable and accessible, as well as the improvement of training program for healthcare staff and teachers.

Tahyna virus and human infection, China.

In 2006, Tahyna virus was isolated from Culex spp. mosquitoes collected in Xinjiang, People's Republic of China. In 2007, to determine whether this virus was infecting humans, we tested serum from febrile patients. We found immunoglobulin (Ig) M and IgG against the virus, which suggests human infection in this region.

[Study on the occupational distribution of discoverers and reporters of public health emergency events reported through Internet-based surveillance system].

OBJECTIVE: To describe the occupational distribution of staff who worked on detection and reporting on public health emergency events, and to explore the effective strategies for identification and reporting on emergency events. METHODS: We conducted a retrospective survey on 3275 emergent events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Data were collected by uniform self-administrated questionnaires by county Centers for Disease Control and Prevention, including information on events detection and reporting, etc. RESULTS: Among event discoverers, 56.40% (1847/3275) were healthcare staff, 20.58% (674/3275) were teachers, and 15.15% (496/3275) were staff from the disease control systems. Among those event reporters, 56.82% (1861/3275) were healthcare staff, 21.77% (713/3275) from disease control system and 10.75% (352/ 3275) were teachers. CONCLUSION: Healthcare staff and teachers played the most important role in detection and reporting on events. It would be favorable to improve the ability of events detection and reporting if we could enhance the training program to the relative staff in medical facilities and school settings especially at the grass root level.

[Etiology of aseptic meningitis prevalent in Xuzhou].

BACKGROUND: To find the pathogenic agents of aseptic meningitis prevalent in Xuzhou of Jiangsu province in 2001. METHODS: The enterovirus (EV) was cultured from CSF of the patients and identified with anti-serum by neutralization test. Neutralization titer of antibody in paired sera from meningitis children was determined. EV RNA was detected by RT-PCR. RESULTS: Four strains of Coxsackievirus B5, 2 strains of Coxsackievirus B3 and 1 strain of Echovirus 7 were isolated from 22 CSF specimens. The isolation rate of virus was 31.8% (7/22), 21 CSF were tested by RT-PCR, the positive rate of EV RNA was 52.4% (11/21); 57.9% (11/19) of patients paired-sera had over 4 folds antibody rise or became seroconverted. CONCLUSION: Enterovirus was the pathogenic agent of aseptic meningitis prevalent in Xuzhou of Jiangsu province, the main serotype of the virus was Coxsackievirus B5.

[Epidemiological study on an outbreak caused by E. coli O157:H7 in Jiangsu province].

OBJECTIVE: To carry out epidemiological study on an outbreak caused by E. coli O157:H7 infection in Jiangsu province in 1999. METHODS: Epidemiological, microbiological and moleculebiological methods were used to find out the source, route of transmission and risk factors. RESULTS: 95 severe O157:H7 infected patients with acute renal failure in 9 counties and districts of 2 municipalities were reported in Jiangsu province, 1999 while 83 of the patients died with a death rate of 87.37%. Most patients were seen in mid or late June. The ratio of male to female was 1 to 1.44 and 88.42% of the patients were over 50 years old. 38 patients occurred in 2000 with 34 deaths. Major factors contributing to the outbreak would include without drinking tap water, eating leftover food, poor sanitary status in kitchen, not washing hands before meal and after bowl movement. 2 strain of O157:H7 was isolated from severe patients and 3 from diarrhea cases. Carrier rate among animals was up to 9.62% and 99.41% of the strains carried toxic gene. Strains isolated from feces of patients and animals belonged to the same colonies. CONCLUSION: This outbreak was severe which caused by O157:H7 and was first seen in China, which was closely related to the high carrier rate of O157:H7 in animals and to the positive rate of high toxic gene of the strains. There were various routes of transmission and the main factors of infection would include poor personal health habits and poor sanitation of the household.

[Rapid assessment of safety injection in one county, north rural area in China].

OBJECTIVE: To estimate the frequency of injections and proportion of unsafe injections and to analyses the critical determinants of poor injection practices in general population in China. Also, to study knowledge, attitudes, practice research in providers and general population. METHODS: A random sample consisting residents and health care providers in a rural county was elected and interview about the frequency of received injection, as well as knowledge, attitudes and practices regarding injections were studied. RESULTS: Overall, 1 004 village residents, and 94 providers were interviewed. Among residents, 145 persons (14.4%), with 457 times (0.46 times per person) had received at least one injection during the previous 3 months. The frequency of injection was 1.84 per year. The proportion of received injections on treatment and immunizations was significantly different among > 12 years age group and < or = 12 years age group. Ninety-four point four percent of disposable syringes/needles were used for injections. Knowledge among the population and providers regarding injection safety was limited. CONCLUSION: Injections were moderately frequent in this rural area and the proportions of disposable syringes/needles used for injections was very high. Knowledge of safe injection and reasonable injection as well as consciousness of self-protection in the providers and residents need to be improved.