Asia-Pacific Economic Cooperation
Chinese Taipei
Health Information Technology for Disease Surveillance & Response:
H7N9 as an Example
Jen-Hsiang Chuang, MD, PhD
Director, Epidemic Intelligence Center
Centers for Disease Control, Chinese Taipei
Email: [email protected]
Asia-Pacific Economic Cooperation
Chinese Taipei
Approach of Emerging Infectious Disease Surveillance & Response in Chinese Taipei
Paquet C, et al. Euro Surveill. 2006;11(12):pii=665.
where IT be able to facilitate
Asia-Pacific Economic Cooperation
Chinese Taipei
Detection of Human Cases of a Novel H7N9 Virus in China on Mar. 31 (SUN)
1:08 pm - Xinhua news reported 3 human cases of H7N9 in China
1:25 pm - a SMS describing the outbreak sent from media watch room to all of the directors at CDC, Chinese Taipei
Media Watch Room
This outbreak was detected by Google News with keyword search for “avian flu (in Chinese)”
Asia-Pacific Economic Cooperation
Chinese Taipei
CDC’s Response on March 31
Several emails & phone calls for initial risk assessment of H7N9 outbreak by 2pm
Teleconference activated at 4pm to discuss implications
A press release and a letter to doctors issued at 7pm
Asia-Pacific Economic Cooperation
Chinese Taipei
Three Days Later (Apr. 3)
Listed H7N9 influenza a notifiable disease after convening an expert meeting (videoconference among 50 people)
Developed an in-house real-time RT-PCR for diagnosis
Activated Central Epidemic Command Center (CECC) for interdepartmental coordination (videoconference among 100 people)
Asia-Pacific Economic Cooperation
Chinese Taipei
Centralized Web-based Reporting System
for Communicable Diseases
Asia-Pacific Economic Cooperation
Chinese Taipei
Data Warehousing Server
Notifiable
Disease Surveillance System
Laboratory Surveillance
ODSData Warehousing
Systems of CDC, Chinese Taipei
ETL Server
• SAS Analytics Platforml• Web-based applications (GIS,
Epidemic curves)
Data Analytical Server
On-line Analytical Server
On-line Analytical System • Business Objects for ad
hoc reporting
Syndromic Surveillance System
P&I Mortality Surveillance System
School-base Surveillance System
Surveillance System for Populous Institutions
. .
. . .
Infectious Disease Data Warehouse
. . .
Asia-Pacific Economic Cooperation
Chinese Taipei
Web-based Query for H7N9 Reporting Cases
Reporting clinicians, local DOH staff & CDC staff can access the system to get real-time test results.
ID Name Onset dateReport
dateDisease
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-
-
-
-
-
-
County
Asia-Pacific Economic Cooperation
Chinese Taipei
0
5
10
15
20
25
30
35
23-Mar 2-Apr 12-Apr 22-Apr 2-May 12-May 22-May 1-Jun 11-Jun 21-Jun
Nu
mb
er
of
Ca
ses
onset date
H7N9 H1N1 H3N2
B negative
Epidemic Curve of H7N9 Suspected Cases in Chinese Taipei, 2013
Updated July 3, 2013
Change case definition on June 1st
Asia-Pacific Economic Cooperation
Chinese Taipei
Web-based Query for Epidemic Curve of H7N9 in Chinese Taipei
URL: http://nidss.cdc.gov.tw/
• Updated at 7am each day
• Free access by the public
One imported case from China announced on Apr. 24
Asia-Pacific Economic Cooperation
Chinese Taipei
Sina: http://roll.news.sina.com.cn/s_qlg2013_all/index.shtml Baidu: http://news.baidu.com/z/twdz/zhuanti.html Xinhua: http://www.xinhuanet.com/health/zt/2013qlg/index.htm National Health and Family Planning Commission of the People's Republic of China:
http://www.moh.gov.cn/ Shanghai Municipal Health Bureau: http://wsj.sh.gov.cn/ Official weibo of the Information Office of the Shanghai Municipal Government:
http://e.weibo.com/shanghaicity Beijing Municipal Health Bureau: http://www.bjhb.gov.cn/ Jiangsu Provincial Department of Health: http://www.jswst.gov.cn/gb/jsswst/index.html Anhui Provincial Health Department: http://www.ahwst.gov.cn/ Health Bureau of Zhejiang Province: http://www.zjwst.gov.cn/ The Health Department of Shandong Province: http://www.sdws.gov.cn/default/ Henan Provincial Health Bureau: http://www.hnwst.gov.cn/ Department of Health of Jiangxi Province: http://www.jxwst.gov.cn/ Fujian Provincial Health Bureau: http://www.fjphb.gov.cn/ Health Department of Hunan Province: http://www.21hospital.com/ Ministry of Agriculture of the People's Republic of China :http://www.moa.gov.cn/
News Surveillance for H7N9 Outbreaks in China
Asia-Pacific Economic Cooperation
Chinese Taipei
Comparison of Sources’ Timeliness for Reporting H7N9 Outbreaks in China
1
3
2
4
5
5
4
Asia-Pacific Economic Cooperation
Chinese Taipei
Some Statistics
As of June 3013 CECC meetings 51 press conferences78 press releases5 letters to doctors
8,000 doctors thru e-newsletters58 medical associations22 local DOHs
Asia-Pacific Economic Cooperation
Chinese Taipei
Access of CDC Web Site
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
China’s 1st family cluster
Imported case confirmed
Asia-Pacific Economic Cooperation
Chinese Taipei
Interactions with Facebook Users (1)
31 posts
426,000 people read posts
Asia-Pacific Economic Cooperation
Chinese Taipei
Interactions with Facebook Users (2)
25,200 people clicked images or videos
15,600 people liked posts or left messages
Asia-Pacific Economic Cooperation
Chinese Taipei
Sharing Genomic Sequencing Data of Imported H7N9 Case
Asia-Pacific Economic Cooperation
Chinese Taipei
H7N9 Publications in Chinese Taipei
Chang SY, Lin PH, Tsai JC, Hung CC, Chang SC. The first case of H7N9 influenza in
Taiwan. Lancet. 2013;381(9878):1621.
Tang RB, Chen HL. An overview of the recent outbreaks of the avian-origin influenza A
(H7N9) virus in the human. J Chin Med Assoc. 2013;76(5):245-8.
Lo YC, Chen WC, Huang WT, et al. Surveillance of avian influenza A(H7N9) virus
infection in humans and detection of the first imported human case in Taiwan, 3 April to
10 May 2013. Euro Surveill. 2013;18(20).pii:20479.
Wu HS, Chuang JH, Chang FY. Taiwan faces challenges on the emerging avian
influenza A (H7N9) virus in China. J Formos Med Assoc. 2013;112(6):299-301.
Chen GW, Lai MM, Wu SC, Chang SC, Huang LM, Shih SR. Is avian influenza A
(H7N9) virus staggering its way to humans? J Formos Med Assoc. 2013;112(6):312-8.
Chang FY, Lin TY, Chiu WT. Taiwan’s response to human infection with H7N9 in
China. N Engl J Med. 2013 (Accepted).
Asia-Pacific Economic Cooperation
Chinese Taipei
Conclusions
Information technology plays a key role in the
surveillance & response of emerging infectious diseases
in Chinese Taipei
Systematic collection of significant data
Analyses of these data
Timely dissemination of results to guide interventions