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A community-level Communicable Disease Surveillance System in a Metropolitan city.
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Sun Seog Kweon, Hyung Cheol Park, Hyun Nam, Jin Su Choi
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Korean J Epidemiol. 2008;30(2):294-300. Published online December 31, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.2.294
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Abstract
OBJECTIVES
The surveillance of infectious diseases, which is crucial in public health, may also suffer from poor community support. In South Korea, the government operates several national surveillance system for the National notifiable infectious diseases(NNID). Some programs work satisfactorily but other programs may not be fully accepted at the community level which result in low participation and delayed report.
METHODS May 2003, to improve the blind side of the National Surveillance System, a district health agency initiated a community based surveillance system for infectious diseases called as Communicable Disease Information Sharing System (CDISS) to complement the national program. As the name suggests, it underscores the mutual benefit of surveillance for public and private health sectors through partnership.
With collaboration of participating private clinics and hospitals around the district, the health agency collects data and provides the health practitioners more up-to-dated information on the trend of infectious diseases than National level information. Total population of study area, Dong-gu which locate in the center of Gwangju-metropolitan city, is about 120,000 in 2005. Reporting facilities consist of 6 daycare clinics, 3 hospitals, and 1 university hospital, 2 local public health organizations.
RESULTS CDISS was introduced in May 2003, and full system has been successfully operated since March 2004 with 10 participating facilities. Each reporting facility regularly sends the weekly reporting form, filled with the number of patients in last week, to Dong-gu District Health Center in every Wednesday. All data were organized in tables and graphs by weekly summarizing the reporting data and interpreted information. Feedback is done to reporting facilities until Friday through faxes, email, website (http://kjdisweb.richis.org) ?at least a week earlier than National Surveillance System.If reported data exceeded epidemic alert level, the community warnings are issued through mass-media and other means of public communication.During the period of CDISS operation, some epidemic events and sporadic outbreak occurred in Dong-gu were detected well-earlier than the notification at national level, such as chickenpox, viral enteritis, and epidemic keratoconjunctivitis(EKC).
CONCLUSIONS The program has been functioning successfully with active community participation and revealed to be economic and effective way of disease surveillance in the community. Several episodes of disease epidemic were reported by the program well before the recognition of the epidemic at the national level. We suggest that the community surveillance program may well complement national surveillance system.
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Measles Outbreak among Institutional Infants after Hospital Infection.
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Hyung Cheol Park, Eun Young Park, Sun Hee Cho, Young Jun Choi, Hyun Kyun Ki, Young Hwa Jung, Kyung Rye Moon, So Yeon Ryu, Ki Soon Kim
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Korean J Epidemiol. 2001;23(1):50-58.
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PURPOSE
S: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000.METHODS The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route.RESULTS Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution.
Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant.CONCLUSIONS This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children.
Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.
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