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Surveillance Systems for Infectious Diseases in Korea Ok Park, Medical Officer, KCDC Trilateral Seminar on R & D Policies to Emerging And Re-emerging Infectious Diseases, December 14-16, 2005, Boston Overall Incidence of Notifiable Infectious Diseases in Korea

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Surveillance systems for infectious diseases in korea l.jpg

Surveillance Systems for Infectious Diseases in Korea

Ok Park, Medical Officer, KCDC

Trilateral Seminar on R & D Policies to Emerging

And Re-emerging Infectious Diseases,

December 14-16, 2005, Boston


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Overall Incidence of Notifiable Infectious Diseases in Korea

* The cases of Tuberculosis, Hansen’s disease, and HIV/AIDS were excluded


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Emerging Infectious Diseases in Korea

  • Leptospirosis, Legionellosis outbreak (1984)

  • HIV Infection (1985)

  • Entero-hemorrhagic E-coli (O157) infection (1998)

  • Vancomycin intermediate susceptible Staphylococcus

    aureus infection (1999)

  • Brucellosis (2002)

  • Botulism (2003)


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Reemerging / Increasing Infectious Diseases in Korea

  • Reemergence of vivax Malaria (1993)

  • Reemergence of Rabies (1998)

  • Increase in Food-borne diseases

    • Shigellosis : caused by Shigella sonnei

    • Food poisoning

    • EHEC infection : increasing since first outbreak in 2003

  • Increase in Hantavirus hemorrhagic fever syndrome, Scrub typhus, Leptospirosis (since 1998)

  • Increase of HIV/AIDS



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Reported Cases of Measles by Year

Adapted measles elimination

strategy and conducted mass

immunization campaign, 2001


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Reported Cases of Malaria by Year

Adapted malaria elimination

strategy in 1999 and launched

DPRK project in 2001


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Enhancement of Infectious Disease Surveillance and Response

Increase of Emerging and Re-emerging Infectious Disease

  • Adopt Proactive Strategy for Communicable Disease (Control→ Elimination)

  • Build Infrastructure to Respond Communicable Disease

Organization

  • Revision of

  • CDPL

  • Sentinel

  • surveillance

  • Immuni-

  • zation

  • Registry

Legislation

Human

resources

IT

Stockpiling

R & D

  • FETP

  • FMTP

  • Onsite

  • supervision

  • Cyber

  • education

  • Training

  • courses

  • Vaccine

  • Antibiotics

  • Antiseptics

  • PPE

  • Ventilators

  • Vaccine

  • Diagnosis

  • Therapy

  • Serum

  • bank

  • EDI

  • DB

  • Modeling

  • Info

  • sharing

  • KCDC

  • Formation

  • of Task

  • Forces


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Reporting System of Notifiable Diseases

Physicians

Report

(Tel/Fax)

Feedback

Health Center

(District level)

Specimen

Referral

Feedback

Feedback

Report

(EDI)

Prov. Inst. of Health

& Environment

  • Dept. of Health

  • (Provincial level)

Report

(EDI)

Feedback

Specimen

Referral

Feedback

KCDC


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Enhancement of Legal Framework

  • Revision of Communicable Disease Prevention Law

    • Enacted in 1953

    • Revised in 2000 to strengthen legal basis for EID- Extend diseases for notification (3 groups 29

      diseases to 5 groups 64 diseases)

      - Change notification criteria

      - Shorten the reporting time

      - Stipulate Notification form,

      Notification process,

      Scope of notification of each disease

      Punishment for delinquent reporting


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Classification and Reporting Time of Notifiable Infectious Diseases


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Adapt IT for surveillance and Enhance analysis and Feedback

  • Adapt IT for surveillance

    • Electronic data interchange system for reporting

    • Data management program

    • Statistical program

    • Develop Disweb as a portal site for sharing information on communicable diseases

  • Enhance Data Analysis and Feedback

    • CDWR(Communicable Disease Weekly report)

    • CDMR(Communicable Disease Monthly Report)

    • Statistical Year Book

    • Press releases


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Information Flow

Management

program

Management

program

Management

program

Management

program

Management

program

Prov.

DB

PHC

DB

Management

program

Doctor

Health

center

TEL,FAX

Province

Database

EDI

EDI

KCDC

Sentinel

site

Feedback

Statistic DB

Statistical

Program




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Statistical Program

of Communicable Diseases



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English version of Diswebhttp://dis.mohw.go.kr/english/index.htm


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Establishment of

Various Surveillance Systems

  • Sentinel Surveillance by the CDPL

    • Influenza, Viral hepatitis A, B, C, STDs

    • Imported Parasitic Diseases, VRSA infection, CJD

  • Sentinel surveillance on the voluntary basis

    • Pediatric Sentinel Surveillance, Viral conjunctivitis

  • Network for information sharing and surveillance

    • Infection specialists network (2002)

    • EpiNet (2003)

  • Syndromic Surveillance and Rumor Surveillance System

    • Emergency room based syndromic surveillance (2002)

    • Enhanced syndromic surveillance during major international events (2003)

    • K- ProMed


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Website for sentinel or syndromic surveillance


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Website for Influenza Surveillance

(Korean/English version)


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Human Resources Development and Collaboration with Private Sector

  • Development of Human Resources

    • Field Epidemiology Training Program (1999)

    • Field Management Training Program (2002)

    • Training program by each Div.

      - Training for communicable disease surveillance : 3 to 4 times a year

  • Enhancement of Collaboration with Private Sector

    • Development and operation of sentinel surveillance in the collaboration with private sector

    • Co-hosting of seminar, conferences

    • Research Project


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Gaps for Infectious Disease Surveillance Sector

  • Insufficient capacity at local government

    • Lack of human resources at local government to respond to emerging infectious diseases

    • Frequent rotation of health care workers

  • Insufficient operation of various surveillance system

    • Development of various surveillance systems which can serve as an early warning system

    • Lack of experts to operate each surveillance system


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Gaps for ID Surveillance Sector

  • Insufficient integration among surveillance systems

    • Insufficient integration between Notifiable Disease Surveillance & laboratory surveillance

  • Low participation rate for notification from physicians

    • Low notification rate of notifiable diseases

      - Shin et al, 1994, notification rates of group 1 and group 2 diseases are respectively: 71.0% (95% PI, 96.2 - 75.3), 20.0% (95% PI, 18.9 – 21.3)

      - Shin et al, 2003, small scale survey result, notification rates of group 1, 2, & 3 are 76.4%, 50.5% & 43% respectively

      - Survey in one city, 2002, report always (28%) ; report generally (37%), report sometimes (18%) ; report rarely (9%) ; no experience of infectious disease (8%), N=727


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Future Plans Sector

  • Development of web-based reporting system

    • Convenience of data management

    • Real-time analysis

  • Integration of Notifiable Disease Surveillance and Laboratory Surveillance

    • Comprehensive surveillance

    • Increase notification rate


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Future Plans Sector

  • Extension of electronic reporting system to private sector

    • Convenience of notification from the private sector

    • Enhance notification rate automatically

    • Decreasing duplicated work in public health sector

  • Development of human resources

    • Continuous training to develop human resources

  • Collaboration with private sector to enhance participation in disease surveillance

    • Enhance R & D

    • Operation of various surveillance system


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Thank You Sector


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