Design And Implementation Of The Monitoring And Warning System For Food Borne Diseases Of Key Population

Currently,infectious diseases,either new or old,have posed an unprecedented threat to public health,making prevention and control of infectious diseases increasingly hard.Monitoring and pre-warning of infectious diseases are a linchpin to controlling,lowering or reducing hazards of emergencies caused by infectious diseases.And it is the basicguarantee to manage the hazards from the source.Construction of an efficient infectious disease and foodborne disease monitoring and pre-warning system,which can quickly respond to emergencies,has become necessary for infectious disease prevention and control.In recent years,catering service spots,schools,nurseries and kindergartens have become major places where infectious diseases and foodborne diseases occurred.It is important to discover the epidemic trajectory of infectious diseases and food-borne diseases and control them in an early stage by firmly controlling people who engaged in the food processing,sales,catering service and child-care.This research made use of modern information and technology for a survey of epidemiology,clinical diagnosis and other factors which might influence the human health based on the patient information from the municipal health information platform,key group physical examination data and the hospital intelligent system?HIS?,and to monitor occurrence,development and epidemic rules of infectious diseases and foodborne diseases.Objective:To enhance the health status of people engaging in food processing,marketing,catering service and child-caremonitoring of,and to explore a monitoring and pre-warning system which can contribute to early discovery and early handling of infectious diseases and foodborne diseases among food processing,sales,catering service,and child-care service personnel.Method:According to the pathogenic characteristics of infectious diseases and foodborne diseases in Changshu,Jiangsuprovince over the past few years,gastrointestinal diseases was selectedas the target diseases for monitoring.Monitoring points were set up in three comprehensive hospitals and 35 community health clinics in Changshu to test effects of the monitoring and pre-warning system.The system was targeted at occurrence of gastrointestinal diseases found among personnel engaging in food processing,sales,catering service,and child-care service.The basic databases of the key groups from the municipal health information platform and the information from different data platforms in the urban and rural hospital intelligent system?HIS?were captured.The ID card number was adopted as the only source recognition.The preliminary diagnosis results based on symptoms of patients and the ICD?International Classification of Diseases?code of the infection disease and foodborne disease types are compared.Through comparison,patients and suspects with infectious diseases and foodborne diseases were confirmed.Then,the pre-warning system sent the pre-warning information to the local medical institutions and prevention and healthcare institutions according to the setting rules.The information was surveyed by professionals.A questionnaire was designed for every disease type.The corresponding control measures were adopted according to the survey results.Pre-warning regulations were established in advance to realize automatic collection,analysis and pre-warning of data information.The system can automatically calculate the immediate response rate within 2h,the daily response rate within 24h,the untimely response rate above 24h,and response completeness were adopted as indexes for evaluation and assessment.The rank sum test wasusedtocomparedifferent response ratesamongdifferent monthgroups since operation of the monitoring and pre-warning system.The response rate of different months was compared among groups using the?² test.Results:1.The system mainly adoptedthe MVC framework and B/S?Browser/Sever?framework.According to the computer module design style and flow,functional moduleswere designed,which included the personnel database,automatic pre-warning,and search statistics,pre-warning management,system management and homepage setting.Various modules could automatically realize their corresponding functions,and the system normal operation and response time was?5s.2.The system monitored 72,566 personnel from the food-related industries,of total people31,172 were males and 41,394 were females.Their age averaged 37.59 years old.The system collected 29,715 items of monitoring results from August 1,2017 to October 31,2017.At last,430 records in line with pre-warning ruleswere generated.The pre-warning information was distributed among 33 medical institutions.The top three disease types of the monitoring information system were acute gastroenteritis?180items?,intestinal infection?80 items?and acute enteritis?66 items?.3.Of 430 records,129 records were confirmed to be valid after checking,and the information valid rate was 30.00%.Among the successful interventions,there were 37restaurant attendants,followed by 11 chefs?including folk chefs,chefs in collective units and schools?,and 7 supermarkets workersand2 canteen workers.The remaining239 personnel were not effectively intervened because of not working in the food-related industries,or not being themselves,or failing to be contacted.4.The response rate and completeness rate of 430 information items,after verification,were both 100%.Over the past three months after operation of the system,the median response time was 25.92hours.The timely response rate and the daily response rate were 46.48%and 69.70%,respectively.The median response time of different months decreased month by month,while the timely response rate of different months increased on a monthly basis.The differenceamongthree months was statistical significant.Conclusion:Infectious disease and foodborne disease monitoring and pre-warning system among the key populationis in line with laws and regulations,the 13^th Five-Year Planning of Disease Prevention and Control in Changshu City,and the emergent public health incident monitoring and pre-warning system construction demands.AS a branch in the monitoring and early warning system of public health emergencies,this system has scientific and reasonable research methods and technical routes.The application results suggested that the infectious disease and foodborne disease monitoring and pre-warning system of thekey group is generally stable,and can timely use the valid information in theexisting health information database,and automatically compare the key group's diagnosis information and send disease pre-warning information.