ABSTRACT
Objective:To develop an early warning index system to identify the outbreak of respiratory infectious diseases and to assess the epidemic risk of these diseases in Shanghai. Methods:A two-round Delphi survey with a panel of 31 experts was used to select the modifying indicators. All indicators were evaluated for necessity，feasibility，stability， and sensitivity through online questionnaires. Results:The consultation recovery rates of both rounds were 100%. The authority coefficient was 0.88， and the Kendall's W of the second-round consultation was 0.138 （P<0.001）， suggesting a good coordination among experts’ opinion. Our early warning index system was developed after the two-round Delphi survey and included two sets of indicators， one for rapid risk assessment and another for monitoring and tracing risk. Both sets of the indicators involved three aspects： transmissibility， clinical severity and potential influence of emerging diseases. The rapid risk assessment system part covered 10 indicators while the risk monitor system part covered 23 indicators. In the rapid risk assessment system part， the weight value of the top three indicators were greater than 0.10， with the highest weight value of 0.171 for titled visiting rate of influenza-like illness patients in the Emergency Department or other outpatient visits. In the risk monitor system part， the weight value of the top eight indicators were greater than 0.05， and the greatest was 0.087 for R0 （basic reproductive number）. Conclusion:The developed scientific and reliable evaluation indicator system can be used to forecast the outbreak and epidemic risk of respiratory infectious diseases. However， sensitivity and stability of the indicators need further validation and evaluation.
ABSTRACT
Objective To study current situation and existed problems in the public health emergency alert and response system so as to formulate more advices to consummate it and help to establish a more reasonable system adapting to our country. Methods A qualitative study was carried out among CDC working staff including two focus group discussions(FGD). Results Although government had put more emphasis on public health,increasing its devotion and strengthening the alert and response capability after SARS outbreak, some problems still existed, such as ① absence of correlative laws and rules; ② lack of government devotion; ③ insufficient utilization of surveillance information; ④ lack of the canonical response guidance. Conclusions With regard to the building up of the public health emergency alert and response system, the following proposals are put forward: increasing payout on public health; consummating the construction of disease surveillance network; affording more education and training to correlative staff engaged in the disease control to improve their abilities.