Biology Reference
In-Depth Information
During the third and current stage (2004-present), the SARS outbreak
occurred in early 2003. This event stressed the disease surveillance system
and exposed weaknesses with the prior disease reporting processes, par-
ticularly in data collection and transfer. The major problems identified were
(Jin 2004)
1. Delays in disease reporting: Because the prior system had collected
data on a monthly basis, it was difficult to effect early detection and
warnings for infectious disease outbreaks.
2. Incomplete reports due to aggregate data: With data being first
aggregated by county for reports to upper level CDCs (or EPSs), it
was quite challenging to trace back outbreaks and investigate risk
factors in clusters.
3. Lack of feedback and transparency: With no routine feedback mech-
anism from the upper to the lower levels, local authorities did not
receive actionable information on disease activity in the region.
From the lessons learned from SARS, the Chinese government made the
decision to enhance the public health system and place development of a
new infectious disease surveillance system as one of its highest priorities.
10.2 System Development
The development of China's infectious disease surveillance system, the
China Information System for Disease Control and Prevention (CISDCP),
was led by China National Center for Disease Control and Prevention (CDC)
in 2003 with nationwide support. This section summarizes its architecture
and major features.
The main goals of the new surveillance system were as follows (Ma 2006,
Wang 2004, Wang 2006):
1. To establish a five-level disease control and prevention network
with a vertical top-down infrastructure (Figure 10.3) and to create a
Regional Public Health Information Network (Figure 10.4).
The five-level network consisted of levels extending from the
centralized national level to the township. In the upper levels
(national, provincial, and prefecture/city), an intranet was estab-
lished, while on the bottom levels (county and township), PC sta-
tions were deployed.
