prevention and control of zoonoses zoonoses in mainland china
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Prevention and Control of Prevention and Control of ZoonosesZoonoses in Mainland Chinain Mainland China
Disease Prevention & Control Bureau, Ministry of Health // Department of Health of Tibet
Dr. Qing Hua HE
October 2010 Veterinary Public Health Workshop in HK
Epidemiological trend of communicable diseases
Major zoonotic diseases
Surveillance and control strategies
ContentsContents
A plague, cholera
B26
influenza A H1N1, atypical pheumonia, avian- human influenza, anthrax, scarlet fever, bacillary and amebic dysentery, typhoid and paratyphoid, rabies, haemorrhagic fever, dengue fever, brucellosis, leptospirosis, AIDS, viral hepatitis, poliomyelitis, measles, cerebrospinal meningitis, pertussis, diphtheria, encephalitis B, tetanus neonatorum, gonorrhoea, syphilis, schistosomiasis, malaria, tuberculosis,
C11
influenza, conjunctivitis, infectious diarrhea, hand-foot-mouth disease, epidemic and endemic typhus, parotitis, rubella, leprosy, kala-azar, echinococcosis, filariasis
StatutoryStatutory NotifiableNotifiable Communicable DiseasesCommunicable Diseases
Report on Statutory Notifiable Communicable Diseases for 2009
5,898,415 cases15,267 persons diedThe incidence rate is 444.15 per
100,000 personsThe mortality rate is 1.15 per
100,000 persons
Epidemic trend of Communicable diseasesEpidemic trend of Communicable diseases
Group A and Group B Communicable Diseases
3,499,485 cases incidence rate is 263.52 per 100,000 persons
14,848 persons died mortality rate is 1.12 per 100,000 persons
Incidence or death from these communicable diseases (except infectious atypical pneumonia, poliomyelitis and diphtheria) have been reported
Group C Communicable Diseases
2,398,833 cases incidence rate is 180.63 per 100,000 persons
416 persons died mortality rate is 0.03 per 100,000 persons
Epidemic trend of Communicable diseasesEpidemic trend of Communicable diseases
2009 vs. 2008
The number of blood-borne and sexually transmitted diseases has increased by 3.92%.
The number of communicable respiratory diseases has decreased by 13.83%.
The number of communicable intestinal diseases has decreased by 12.64%
The number of natural foci and vector-borne diseases has decreased by 5.17%.
The number of Group C communicable diseases has increased by 38.63%, mainly due to the growing number of hand-foot-mouth disease
cases (480 000 - 1.15 million cases)
EpidemicEpidemic trend of Communicable diseasestrend of Communicable diseases
A decreasing proportion of deaths caused by communicable diseases
5.45%
0.89%1.44%1.77%
2.18%
2.76%
10.1%
14.82%
15.81%
22.32%
22.45%
cerebrovasculardisease
malignancy
respiratory disease
heart disease
injury andpoisoning
digestive system
communicablediseasesendocrine diseases
genitor-urinarydiseases
perinatal death
others
Epidemic trend of Communicable diseasesEpidemic trend of Communicable diseases
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0
20
40
60
80
100
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2004 2005 2006 2007 2008
万例
年
肠道传染病 呼吸道传染病虫媒及自然疫源性传染病 血源及性传播传染病
Year
Cases (10000)
intestinal respiratory
vector-borne and natural foci blood-borne and sexually transmitted
Morbidity Curve of Group A and Group B Morbidity Curve of Group A and Group B Communicable diseases by Transmission RouteCommunicable diseases by Transmission Route
Announcement No. 1149 of the Ministry of Agriculture, 19 January 2009 (26 Types)
Highly Pathogenic Avian Influenza, Rabies, Anthrax, Brucellosis, Leptospirosis, Bovine Tuberculosis, Japanese Schistosomiasis, Japanese Encephalitis, Streptococcus Suis Type II, Filariasis, Bovine Spongiform Encephalopathy, Toxoplasmosis, Echinococcosis, Salmonellosis, Trichinosis, Cysticercosis Cellulosae, Glanders, Tularemia, E. Coli (O157:H7), Listeriosis, Q Fever, Melioidosis, Actinomycosis, Clonorchiasis, Avian Tuberculosis, Leishmaniasis
List of List of ZoonoticZoonotic DiseasesDiseases
122010-10-70
100
200
0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80- 85- 年龄组
报告发病数(例)
男 女
Number of reported Rabies Cases by Age Group in 2009
(Cases)
Male Female
Age Group
0
50
100
150
200
250
300
1 2 3 4 5 6 7 8 9 10 11 12
月份
报
告
发
病
数
2008年
2009年
2010年
Number of reported Rabies Cases in China by Month 2008 - July 2010
( Cases )
month
0
5000
10000
15000
20000
25000
30000
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
2008
0
0.5
1
1.5
2
2.5发病数 发病率
Brucellosis
No. of reported cases and incidence rates, 1950-2009
No. of cases Incidence rate
Major Major ZoonoticZoonotic DiseasesDiseases
No. of cases(male)
No. of cases(female)
Incidence rate(male)
Incidence rate(female)
age group
Rep
orte
d in
cide
nce
rate
(1/1
0000
0)
( cases )
Number of Reported Brucellosis casesNumber of Reported Brucellosis cases by age group and gender in 2008by age group and gender in 2008
0
1000
2000
3000
4000
5000
6000
7000
1 2 3 4 5 6 7 8 9 10 11 12
月份
报
告
发
病
数
2008年
2009年
2010年
Number of reported brucellosis cases in China by month, 2008-July 2010
2008
2009
2010
month
( cases )
Global distribution of brucellosis cases
annual incidence rate (1/1000000)————
cases reported without concrete data
Anthrax
0
10
20
30
40
50
60
70
80
1 2 3 4 5 6 7 8 9 10 11 12月份
报告发病数
2008年
2009年
2010年
2008
20092010
month
Major Major ZoonoticZoonotic DiseasesDiseases
( cases )
Human infection by Streptococcus suis
In July 2010, only one case has been reported in China. As at the end of July, totally 9 cases have been reported in 2010, with zero mortality.
Human avian influenza
7 cases of human infection by highly pathogenic avian influenza were reported in 2009, with 4 deaths. As compared with 2008, there were 3 more reported cases and the same number of death cases in 2009.
As at the end of July 2010, only 1 case of human avian influenza was reported in China, with 1 death case.
Major Major ZoonoticZoonotic DiseasesDiseases
Lawful and scientific approach for prevention and control
Enforcement of the Law of Infectious Diseases Control
Step up surveillance by establishing surveillance points and networks to gather information on the dynamic change of communicable diseases
Roles of departments and regions
Set up collaborative prevention and control mechanism between departments
Set up collaborative prevention and control mechanism between departments and provinces
Surveillance and Control StrategiesSurveillance and Control Strategies
Enhancement on systems, organization and capacity
Implement the following three measures –
Funding: to keep the basic public health service funding per capita at $ 15 or above and secure funds for launching communicable disease prevention and control work
County: to enhance the capacity of centers for disease prevention and control at the county level in investigating and handling zoonotic disease cases
System:to improve policies, directives, regimes, standards, parameters and guidelines.
Perfect the working mechanism, protection mechanism and operation mechanism
Surveillance and Control StrategiesSurveillance and Control Strategies
Classified Management:
Mandatory management: For group A diseases, mandatory isolation for treatment and mandatory quarantine will be enforced to control the epidemic.
Stringent management: For group B diseases, prevention and control measures will be implemented to bring down the incident rates.
SurveillanceSurveillance: For group C diseases, we will monitor the epidemic trends to prevent outbreak of diseases.
Goals:
Routine goal:Prevention, Control and Mitigation
Ultimate goal: Eradication and Abatement
Surveillance and Control StrategiesSurveillance and Control Strategies
Specific Measures
1、Responsibilities of relevant departments
Health departments at various levels shall duly identify,
report and treat zoonotic disease cases.
Agricultural departments at various levels shall implement
comprehensive prevention and control measures on
immunization and quarantine of livestock and culling of test-
positive livestock; strengthen quarantine at slaughterhouses;
keep a close watch of livestock circulation; and prohibit
uninspected livestock and poultry products or products
failed the quarantine inspection from entering the food
market.
Surveillance and Control StrategiesSurveillance and Control Strategies
2、Strengthen epidemic notification and cooperation
in investigation
Regional health and agricultural departments shall seriously implement the zoonotic disease notification system to ensure timely, proactive notification of epidemic situation and dissemination of information on prevention and control efforts.
After receiving notification, relevant departments shall organize personnel to jointly conduct investigations and prevent the spread of epidemics.
3、Step up supervision and inspection
Health and agricultural departments at various levels shall strengthen enforcement of the Law on Prevention and Treatment of Infectious Diseases and the Animal Epidemic Prevention Law. Any unit or individual who fails to take prompt preventive and control measures in accordance with the laws shall be subject to administrative sanctions or legal liabilities.
Surveillance and Control StrategiesSurveillance and Control Strategies
4、Launching health education and publicity programmes to promote the prevention and control of zoonotic diseases
5、Direct Network Report on Communicable Diseases must be timely and accurate
Direct Network Report System
Bureau of Public Health at county (district) level
Bureau of Public Health at municipal (city) level
Department of Public Health at provincial (district) level
case investigation form
communicable disease report card
Centre for disease control and prevention at county (district) level
Centre for disease control and prevention at municipal (city) level
Centre for disease control and prevention at provincial (district) level
Chinese Centre for Disease Control and Prevention
Ministry of Healthinformation dissemination
Hospital
clinical diagnosis of (suspected) cases
case found, diagnosis
epidemiological investigation
tracking, correction, analysis, application
confirmation, analysis, application
analysis and application
analysis and application
result analysis
report on epidemic situation
work report feedback tracking, correction, investigation
Remark: Relevant units are authorised to access and use the information maintained by the national data centre
report
national data centre
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