Objective:To analyze COVID-19 infection incidence and risk factors among Chinese national team members during overseas training and competitions (April-October 2022) to inform prevention for international events. Methods:A nationwide cross-sectional survey used electronic questionnaires distributed to 69 national teams. A total of 1,020 valid questionnaires were included for analysis, covering athletes, coaches, medical staff, team leaders, and other support personnel. The χ2 test was used to analyse the relationships between infection rates and variables, including individual factors, travel modes, accommodation conditions, and protective behaviors. Results:The overall infection rate was 35.5%. Infection rates differed significantly across occupational groups: athletes had the highest rate (37.9%), followed by coaches (29.8%) and team leaders (21.7%). Personnel who participated in both overseas training and competitions presented a significantly higher infection rate (47.9%) than did those who only participated in competitions (19.0%) (p < 0.001). Individuals vaccinated with 2 doses had the highest infection rate (48.6%), whereas those receiving ≥4 doses had the lowest infection rate (22.4%). χ2 analysis revealed significant risk factors for infection: sharing accommodation floors with foreign personnel, inadequate room ventilation, irregular room disinfection during training periods, taking nondirect flights, and inconsistent mask wearing. Conclusion:Infection risk among national team members abroad clustered by role, assignment type, and behaviors. Elevated risk was linked to intensive training schedules, suboptimal implementation of prevention protocols, and frequent contact with foreign personnel. Multifaceted interventions-source control, rigorous process management, and strict adherence to personal protective measures-should be strengthened to reduce infection risk.

ObjectiveTo explore the application of the prevention, preparation, response, and recovery (PPRR) theory in the cross-departmental collaboration in the prevention and control of infectious diseases in the China International Import Expos (CIIEs) held in every November in Shanghai from 2018 to 2024, thus providing an empirical basis and theoretical reference for optimizing the cross-departmental collaboration mechanism under regular prevention and control. MethodsWe collected the epidemic prevention and control work plans, emergency response plans, technical guidelines, summary reports, and relevant epidemic cases handled by Shanghai Center for Disease Control and Prevention during the CIIEs from 2018 to 2024. The case analysis method was used to analyze the practices and achievements of cross-departmental collaboration in the prevention, preparation, response, and recovery phases based on the PPRR model. ResultsAn efficient information collaboration mechanism was established based on an innovative "1+6+N" cross-departmental command architecture. The work in the prevention phase encompassed establishing a cross-departmental and multi-dimensional risk assessment model, adopting a layered monitoring strategy, and strengthening health monitoring. In the preparation phase, a modular prevention and control plan library was established, consisting of work plans, emergency plans, and technical guidance or operation manuals. In addition, cross-departmental joint training and exercises were conducted, and emergency material reserves were reasonably allocated to improve the response speed. In the response phase, a "4 h plus 12 h" disposal requirement was strictly implemented. Public health, security and CIIE bureau teams were mixed as an emergency response group and divided into several units. The interval between risk identification and risk confirmation as well as between risk confirmation and risk management was strictly controlled through risk hierarchical management. During the recovery phase, full-process post evaluation was conducted to solidify experience and promote optimization of resource allocation and disposal processes while assessing the effectiveness of the response. Upon evaluation, the above measures are expected to be effective to increase the risk warning time to within 30 minutes and reduce the overall emergency decision-making and response time to 10% of that under the conventional model. Therefore, Shanghai achieved "zero infection" of epidemics and "zero transmission" of imported diseases. ConclusionsThe collaborative mechanism architecture constructed based on the PPRR model can be used for the research of cross-departmental collaborative mechanisms in mass gatherings. In the future, cross-departmental collaboration on infectious disease prevention and control in mass gatherings can be further promoted in three dimensions: mechanism innovation, technological empowerment, and collaborative governance.

What is already known about this topic?:Since May 2022, a global outbreak of mpox has emerged in more than 100 non-endemic countries. As of December 2023, over 90,000 cases had been reported. The outbreak has predominantly affected men who have sex with men (MSM), with sexual contact identified as the principal mode of transmission. What is added by this report?:Since June 2023, China has faced an occurrence of mpox, predominantly affecting the MSM population. Approximately 90% of those affected reported engaging in homosexual behavior within 21 days prior to symptom onset, a trend that aligns with the global outbreak pattern. The prompt identification of cases, diligent tracing of close contacts, and the implementation of appropriate management strategies have successfully mitigated the spread of mpox virus in China. What are the implications for public health practice?:We propose that mpox is transmitted locally within China. Drawing from our experiences in controlling the virus spread, it is crucial to investigate and formulate effective surveillance and educational strategies. Importantly, we must encourage high-risk populations to promptly seek medical care upon the onset of symptoms.

Background: Emergency Operations Center (EOC) is a place to provide response to public health emergencies. Chinese Center for Disease Control and Prevention (China CDC)’s EOC was officially established in 2016, which has been the core department for the public health emergencies and risk response. In recent years, we have been continuously improving the function of EOC through many incidents. In the study, we hope to share the construction status, operation management experience of China CDC’s EOC and the response process in the human avian influenza A (H7N9) outbreak.Main text: The China CDC’s EOC mainly focus on building the five core elements including sites/places and facilities, information and data, plans and procedures, training and exercises, and logistics. Based on summarizing previous emergency response, the China CDC’s EOC established its own incident management and the standardized response procedures. The event-specific data, context-specific data and event management data could be obtained through various source. The logistics department of the EOC also provides comprehensive support. The well-trained staff is another necessary conditions for its operation. Through sharing the response process of H7N9 outbreak, it further explains the EOC’s functions in the five phases of outbreak response, such as the formulation of the incident response framework, monitoring, personnel dispatch and resource mobilization.Conclusions: The EOC contributes to faster and more efficient responses during emergencies which enable a greater reduction in morbidity and mortality. Compared with the traditional incident response process, under the command and coordination of China CDC’s EOC, each group involved in the response has a clearer goal, responsibilities and tasks at each stage. Meanwhile, each group also gave full play to its own expertise and advantages. As a whole, incident response tended to be more specialized and precise, which generally improves the efficiency of incident response. However, different countries and regions have different response processes to the events. We still suggested that appropriate emergency operation plan should be made according to the complexity of incident response in the region when constructing response mechanism, through our experience. And the China CDC’s EOC is still at growing and groping phase.

目的 了解2014-2018年江苏省苏州市乙型肝炎(乙肝)重复报告情况,为今后研究提供数据支持.方法 利用传染病报告信息管理系统收集的2014-2018年苏州市乙肝报告病例进行个案查重,计算乙肝重复报告率,并进行统计学分析.结果 共累计报告乙肝病例12 823例,其中有731例重复报告病例,重复报告率为5.70％,年度间重复报告率(4.32％)高于年度内重复报告率(1.44％).报告地区的重复报告构成比为0.55％～32.42％,重复报告率为1.46％～11.20％.各年龄组的重复报告率为3.59％～6.40％(x2=21.518,P=0.001),高年龄组的重复报告率高于低年龄组;省、市、县、乡级医疗机构均有重复报告病例,重复报告率为3.23％～7.69％ (x2 =62.272,P＜0.001).结论 苏州市乙肝报告存在重复上报情况,可能原因为国家传染病报告信息系统无法实现跨年度重复报卡查询以及病例基本信息缺失、变更、错误导致系统无法识别.昆山市、姑苏区、外地机构上报对全市重复报告影响较大,应强化对该地区医疗机构乙肝报告查重工作;省、县级医疗机构重复报告率高于地市级、乡级医疗机构.

ObjectiveTo understand the hospital preference in terms of area and grade for treatment in hepatitis B cases in Suzhou from 2014 to 2018 and provide evidence for the rational allocation of medical resources in the prevention and treatment of hepatitis B in Suzhou. MethodsThe data of the confirmed hepatitis B cases with current address in Suzhou from 2014 to 2018 were collected from the National Notifiable Infectious Disease Reporting Information system (NNDRS), and the data were collated and analyzed by Excel 2013. The medical care seeking flow of the hepatitis B cases in Suzhou was drawn by using the circlize package of R software (version 3.6.1). The Sankey diagram of the medical care seeking flow and hospital grade was generated with the networkD3 package of software R, and the extra-area medical care seeking map of the hepatitis B cases was produced with software ArcGIS 10.3. ResultsIn hepatitis B cases in Suzhou, 9.74% sought medical cares in hospitals in other cities. 64.24% sought medical cares in local hospitals of the districts or counties. The hospitals in Gusu district were the preference of hepatitis B cases in urban area of Suzhou. The hepatitis B cases in 4 outer counties of Suzhou were more likely to see doctors in hospitals in Shanghai. Up to 73.48% (3 370/4 586) of the hospitals for extra-area medical care seeking belonged to grade Ⅲ (A), while the proportion of grade Ⅲ (A) hospitals for local medical care seeking was 15.67% (1 291/8 237) (OR＝14.91, 95% CI: 13.65–16.29). ConclusionHepatitis B patients in Suzhou were mainly treated by local hospitals of districts or counties where they lived, while the patients seeking extra-area treatment mainly went to the grade Ⅲ (A) hospitals in Gusu district of Suzhou and in Shanghai.

目的 了解我国省、市、县三级疾病预防控制机构(简称疾控机构)在应对突发事件应急处置过程中的公共卫生风险沟通需求,评估各级疾控机构的公共卫生风险沟通能力. 方法 采用描述性流行病学调查方法设计本次调查及问卷,普查和抽样调查结合的方式开展调查.并编制了卫生应急风险沟通能力测评问卷,评估疾控机构专业人员的风险沟通能力. 结果 调查省份其疾控机构均未设置独立的风险沟通专职科室,且风险沟通职能多设在应急部门.县(区)级机构的风险沟通制度或预案制定情况(46.6％)好于地市(州)级(28.6％).仅38.6％的单位开展过风险沟通培训,县(区)级开展演练率为17.0％.77.8％的单位开展过舆情监测,且模式以专业人员网络收集和电话热线收集为主.专业人员风险沟通能力评分不高,调查对象平均得分为8.7分(总分34分). 结论 各级疾控机构需要重视风险沟通的重要性,拓展渠道收集信息,提高专业人员的风险沟通能力,设置专业化制度来保障风险沟通工作的顺利进行.

Background: The EOC of Chinese Center for disease Control and Prevention (China CDC) was officially established in 2016, which has become the core department for the public health emergencies and risk response. In recent years, we have continued to improve and summarize the EOC's role and functions in different events. And we also want to share the construction status and operation management experience of the EOC of China CDC. It is also to promote the construction of global emergency operation management system. Main text: We searched the websites of WHO, USCDC and ECDC for the EOC-related concepts. And through expert interviews and personal communication with experts, we collected relevant opinions and identify additional published literature, then described the current situation of construction of China CDC’s EOC. For EOC, different organizations / agencies have different definitions. In China, the EOC is a place where CDC organizes and conducts the related emergency response work. And it is also an important part of public health emergency system construction. The China CDC’s EOC had developed a series of incident action plan (IAP) and the standardized forms for each incident. The event-specific data, context-specific data and event management data are usually obtained by different system and channel. The China CDC’s EOC would improve the staff’s abilities through an ongoing series of training and exercises. Comparing with before, the efficiency of incident response has been greatly increased after the establishment of EOC. Conclusions: The China CDC’s EOC is still growing and groping phase. It is necessary to continue theoretical learning and practice to continuously improve the capacity of the construction and operations of the EOC system. We need continued close collaboration and partnership with international organizations to enable more to be accomplished through leveraging individual institutional strengths. The standardize approach to respond to public health emergencies meet global standards needs.

Objectives To Share the construction status and operation management experience of the EOC of China CDC. It is also to promote the construction of global emergency operation management system. Methods We searched the websites of WHO, USCDC and EU CDC for the EOC-related concepts. And through expert interviews and personal communication with experts, we collected relevant opinions and identify additional published literature, then described the current situation of construction of China CDC’s EOC. Results For EOC, different organizations / agencies have different definitions. In China, the EOC is a place where CDC organizes and conducts the related emergency response work. And it is also an important part of public health emergency system construction. The China CDC’s EOC had developed a series of incident action plan (IAP) and the standardized forms for each incident. The event-specific data, context-specific data and event management data are usually obtained by different system and channel. The China CDC’s EOC would improve the staff’s abilities through an ongoing series of training and exercises. Comparing with before, the efficiency of incident response has been greatly increased after the establishment of EOC. Conclusions The China CDC’s EOC is still growing and groping phase. It is necessary to continue theoretical learning and practice to continuously improve the capacity of the construction and operations of the EOC system. We need continued close collaboration and partnership with international organizations to enable more to be accomplished through leveraging individual institutional strengths. The standardize approach to respond to public health emergencies meet global standards needs.

BackgroundThe initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. MethodsWe collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. ResultsAmong the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). ConclusionsOn the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.) The authors provide an epidemiologic analysis of the first 425 confirmed cases of infection with the novel coronavirus in Wuhan, China. This analysis provides estimates of the epidemic doubling time and the basic reproductive number and shows clear evidence of sustained human-to-human transmission.

目的 评估2017年1月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,预计2017年1月全国总报告事件数和病例数将较2016年12月有所下降,事件类别主要以发生在学校的水痘、流行性感冒、流行性腮腺炎、其他感染性腹泻等传染病事件为主.近期我国内地将继续出现人感染H7 N9禽流感散发病例,不排除出现H7N9禽流感聚集性病例以及人感染其他亚型动物流感病毒病例的可能.流行性感冒、水痘、流行性腮腺炎等呼吸道传染病将出现季节性升高.病毒性腹泻暴发疫情将持续发生,且诺如病毒仍将为主要致病原.寨卡病毒病输入我国的风险持续存在,输入后在南方蚊媒条件适宜的地区仍有引发本地传播的风险,但导致大规模本地传播的风险极低.中东呼吸综合征从沙特等中东国家输入我国的风险持续存在,但导致大规模疫情的风险低.因燃煤取暖导致的非职业性一氧化碳中毒事件正处于高发时段.结论 2017年1月我国的突发公共卫生事件及传染病疫情发生态势与往年相似,将是全年突发公共卫生事件报告数较少的月份之一;需关注人感染禽流感、流行性感冒、病毒性腹泻、寨卡病毒病、中东呼吸综合征等传染病疫情引发的公共卫生风险.

This chapter introduces the history, design, technical elements, and functional framework of China Infectious Diseases Automated-alert and Response System (CIDARS). The targeted diseases, early warning methods, and response steps are also described. Based on the running data of the system from 2011 to 2013, the performance of CIDARS is analyzed and evaluated, and further direction of CIDARS is also discussed.

On the Internet, there is a lot of open access information related to infectious diseases, e.g., official announcement, media news, bulletin boards, blogs, and other social media. If proper data retrieval and screening methods were applied on these Internet-based data, it would be very useful to improve the timeliness of early detection for infectious diseases. In China, we practice early warning using Internet-based data with routine intelligence screening assessment every day, and respond to any unusual event in a timely manner. Through this mechanism, the surveillance and early warning of Internet-based data for infectious disease and public health emergency plays an important supplemental role to the traditional surveillance systems.

Modern information technology developments provide the necessary foundation for the establishment of infectious disease surveillance and early warning systems. Multiple diseases information systems provide more comprehensive and reliable information sources for early warnings. This chapter introduces methods of the development and construction of early warning of infectious diseases, including the fundamental principles of investigation, system design, system framework and essential functions, system implementation, and system evaluation.

This chapter introduces the definition, the key elements, the contents, and the roles of surveillance in infectious disease prevention and control. Several major infectious disease surveillance systems in China are then generally introduced one by one.

This chapter describes how the surveillance department conducts investigation and verification, risk assessment, and takes necessary public health actions after the early warning system detects or produces a warning signal. We need to verify the reliability and validity of the warning signal, to conduct a risk assessment to see how it may affect public health, and to advise what kind of actions are required to prevent and control a communicable disease.

目的 评估2016年11月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据既往传染病和突发公共卫生事件监测数据,预计11月全国总报告事件数和病例数将较10月有所上升,主要以发生在学校的水痘、季节性流感、流行性腮腺炎、手足口病、其他感染性腹泻病等传染病暴发事件为主.人感染禽流感散发疫情将会逐渐上升.寨卡病毒病输入我国的风险持续存在,输入后在南方蚊媒条件适宜的地区仍有引发本地传播的风险.在东北和华北等燃煤自采暖家庭中发生非职业性一氧化碳中毒风险将明显上升.结论 2016年11月我国的突发公共卫生事件将有所上升;需重点关注人感染禽流感,一般关注季节性流感、寨卡病毒病、非职业性一氧化碳中毒所引发的公共卫生风险.

目的 评估2016年4月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,预计4月全国报告事件数和病例数较3月将有所增加.近期我国仍有可能出现黄热病、寨卡病毒病、登革热、基孔肯雅热等蚊媒传播传染病的输入性病例,广东、云南、海南、福建、广西和浙江等重点省(自治区)存在输入后发生本地传播或小规模聚集性病例的可能,应加强蚊媒监测和控制.近期流感活动仍将处于高水平,但随着气温升高,暴发疫情数量会逐步回落.人感染H7N9禽流感疫情仍将呈散发态势,不排除继续出现其他亚型动物流感病例的可能.全国手足口病流行强度将逐渐增强,重症和死亡病例将陆续增多.我国持续存在埃博拉出血热和中东呼吸综合征等的输入风险,但输入后导致大规模疫情的可能性极低.结论 2016年4月我国的突发公共卫生事件及传染病疫情发生态势与往年相似,较3月将有所增加;需关注寨卡病毒病、黄热病、流行性感冒、人禽流感、手足口病等传染病疫情引发的公共卫生风险.

目的 评估2016年12月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,预计12月主要以发生在学校的水痘、流行性感冒、流行性腮腺炎、手足口病、其他感染性腹泻病等传染病暴发事件为主.人感染禽流感散发疫情将逐渐上升;流行性感冒发病水平将继续上升;寨卡病毒病输入我国的风险持续存在,输入后在南方蚊媒条件适宜的地区仍有引发本地传播的风险;病毒性腹泻暴发疫情将持续发生,且诺如病毒仍将为主要致病原.结论 预计全国2016年12月全国总报告事件数和病例数将较11月有所下降.需重点关注人感染禽流感、季节性流感、寨卡病毒病和病毒性腹泻等传染病的公共卫生风险.

目的 评估2016年1月国内外突发公共卫生事件及需要关注传染病的风险.方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省(直辖市、自治区)疾病预防控制中心专家参与评估.结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,1月将是全年突发公共卫生事件报告数较少的月份之一,预计全国总报告事件数和病例数将较2015年12月有所下降.近期我国内地将继续出现人感染H7N9禽流感散发病例,不排除出现人感染其他亚型动物流感病毒病例的可能.流行性感冒、水痘、流行性腮腺炎等呼吸道传染病将出现季节性升高.近期,中东呼吸综合征在沙特仍持续有散发病例报告,我国仍存在输入风险,但进一步播散的风险极低.因燃煤取暖导致的非职业性一氧化碳中毒事件将持续高发.结论 2016年1月我国的突发公共卫生事件及传染病疫情发生态势与往年相似,处于全年较低水平;需关注人禽流感、流行性感冒、中东呼吸综合征等传染病疫情以及非职业性一氧化碳中毒引发的公共卫生风险.