不同监测系统在甲型H1N1流感爆发疫情发现与控制中的效果评价

Effects of different surveillance systems on detection and control for 2009 H1N1 flu outbreak

目的评价不同传染病监测系统甲型H1N1流感爆发疫情发现与控制效果,为进一步完善甲型H1N1流感爆发疫情防控策略提供科学依据。方法通过比较症状监测系统和传染病网络直报系统发现的甲型H1N1流感爆发疫情首发病例发病时间和被监测系统发现的时间差等指标来评价疫情发现的及时性;通过比较两系统发现的爆发疫情持续时间和爆发疫情的罹患率来评价疫情控制的有效性。结果共发生7起甲型H1N1流感爆发疫情,症状监测系统发现3起,传染病网络直报系统发现4起。症状监测系统发现的疫情定性为甲型H1N1流感爆发疫情的时间平均为首发病例发病后109.00h,直报系统为201.50h,二者差异有统计学意义(P<0.05)。症状监测系统发现的疫情结束时间平均为首发病例发病后323.67h,直报系统为603.75h,二者差异有统计学意义(P<0.05);症状监测系统发现的爆发疫情罹患率为11.8%,直报系统为17.9%,二者差异有统计学意义(P<0.05)。结论症状监测系统在甲型H1N1流感爆发疫情发现的及时性和疫情控制效果方面明显优于传染病直报系统,但症状监测系统并不能发现所有的爆发疫情,应充分发挥症状监测系统和传染病网络直报系统的各自优点,及时发现和控制甲型H1N1流感爆发疫情。

Objective To evaluate effects of varied surveillance systems of infectious diseases on detection and control for 2009 influenza A/H1N1 outbreak to provide scientific evidence for perfecting strategies in its control and prevention. Methods Timeliness in detection of outbreak of A/H1N1 flu was evaluated by comparing time interval of onset of its initial case and outbreak onset detected by syndromic surveillance system （SSS） and web-based disease report information system （DRIS） in China, as well as effectiveness of its control was evaluated by comparing length of outbreak lasting and attack rate of H1N1 flu between them. Results There were seven outbreaks of HIN1 flu in 2009 in Shunyi district, Beijing, three detected by SSS and four by DRIS in China. Time interval between onset of initial case and onset of outbreak detected and confirmed by SSS averaged 109.00 hours, and that between onset of initial case and onset of outbreak detected by web-based DRIS in China averaged 201.50 hours （ P 〈 0.05 ）. Time interval between onset of initial case and end of outbreak spanned 323.67 hours in average detected by SSS, and that spanned 603.75 hours by DRIS in China （P 〈 0. 05）. Attack rate of H1N1 flu in outbreaks detected by SSS averaged 11. 8 percent and that by DRIS averaged 17.9 percent （P 〈 0.05）. Conclusions Timeliness in detection of H1N1 flu outbreak by SSS and effectiveness of its control are significantly better than that detected by DRIS in China, but not all the outbreaks of H1N1 flu can be detected by the former, therefore, it is necessary to bring advantages of both SSS and DRIS into full play to detect and control it timely.