上海市腹泻病综合监测的创新探索、构建及应用

The innovative exploration,establishment and application of Shanghai diarrhea comprehensive surveillance

为满足肠道传染病防控需要,2012年起上海市创新探索腹泻病综合监测模式,监测科学布点、系统采样、多病原集合、联通医院信息系统,实现了"一个监测、多个病种;一份样本,多种病原"的监测模式,对全年龄段人群进行持续的主动监测,监测内容包括人口学、临床医学、流行病学、病原检测、药敏监测等病例信息。监测取得了如下初步成效:掌握真实世界的腹泻疾病特征及周期变化规律,发现本市腹泻的最主要病原体为诺如病毒;发现了少见病原体或病原体血清型,提供疫情溯源线索;促进了公共卫生机构和临床医疗机构的信息共享,为临床诊疗提供科学依据。未来腹泻病综合监测将朝扩展监测广度和监测深度、智能化辅助诊疗、暴发疫情预警、流行趋势预测、应用检测新技术等方向提升。

In order to meet the needs of prevention and control of intestinal infectious diseases,a comprehensive surveillance for diarrheal diseases has been innovated and explored in Shanghai since 2012.The surveillance has extensive distribution of sentinel hospitals,systematic sampling,multi-pathogen collection,and hospital information system(HIS)as the basis,which has achieved"One system for surveillance of multiple diseases and one sample for detection of multiple pathogens".Continual active surveillance for the whole population has been conducted,covering demography,clinical information,epidemiology,pathogen detection,and drug sensitivity test for diarrhea cases.The surveillance has obtained preliminary achievements as follows.First,diarrheal diseases and their periodic changes have been characterized,in which the most prevalent pathogen of diarrhea is determined to be norovirus in Shanghai.Second,some rare pathogens and serotypes have been identified that may provide clues to the sources of outbreaks.Third,it facilitates the information sharing between public health institutions and clinical institutions,and provides scientific evidence for clinical diagnosis and treatment.In the future,Shanghai diarrhea comprehensive surveillance will be improved for expanding range and depth of surveillance,artificial intelligence assisted diagnosis and treatment,early warning of outbreaks,prediction of epidemic trends,and application of new detection technologies.