Abstract
ObjectiveTo evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease.MethodsWe estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff.FindingsThe alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days.ConclusionThe automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China.
Highlights
To improve control of infectious disease outbreaks, it is critical to establish early detection and warning systems
The response system was based on surveillance data on dozens of notifiable diseases and on several statistical algorithms for the automated and routine detection of aberrations in such data, at county level, that might indicate the early stages of potential outbreaks
We aimed to evaluate the performance of the response system by analysing the sensitivity, specificity and timeliness in the detection of HFM disease outbreaks
Summary
To improve control of infectious disease outbreaks, it is critical to establish early detection and warning systems. In April 2008, a web-based automated system for the early detection of – and rapid response to – outbreaks of infectious disease was implemented across China.[13] This system – the China infectious disease automated alert and response system (hereafter referred to as the response system) – was developed by the Chinese Centre for Disease Control and Prevention, with the support of the Chinese Ministry of Health and the World Health Organization. The response system was based on surveillance data on dozens of notifiable diseases and on several statistical algorithms for the automated and routine detection of aberrations in such data, at county level, that might indicate the early stages of potential outbreaks
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