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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


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surveillance systems for infectious diseases in korea

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
Overall Incidence of Notifiable Infectious Diseases in Korea

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

emerging infectious diseases in korea
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)
reemerging increasing infectious diseases in korea
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
reported cases of measles by year
Reported Cases of Measles by Year

Adapted measles elimination

strategy and conducted mass

immunization campaign, 2001

reported cases of malaria by year
Reported Cases of Malaria by Year

Adapted malaria elimination

strategy in 1999 and launched

DPRK project in 2001

enhancement of infectious disease surveillance and response
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
reporting system of notifiable diseases
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

enhancement of legal framework
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

slide12

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
information flow
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

slide16

Statistical Program

of Communicable Diseases

english version of disweb http dis mohw go kr english index htm
English version of Diswebhttp://dis.mohw.go.kr/english/index.htm
slide19

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
slide21

Website for Influenza Surveillance

(Korean/English version)

slide22

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
slide23

Gaps for Infectious Disease Surveillance

  • 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
slide24

Gaps for ID Surveillance

  • 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

slide25

Future Plans

  • 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
slide26

Future Plans

  • 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