早期异常报告系统在北京市朝阳区流行性感冒预警中的应用

目的探索早期异常报告系统在北京市朝阳区流行性感冒(流感)预警中的应用效果,为流感防控提供科学依据。方法选择2015年3月30日-2018年4月1日北京市朝阳区流感样病例(influenza-like illness,ILI)和流感病原学监测数据,用流感病原学监测数据确定朝阳区流感流行期的"金标准",用早期异常报告系统(early aberration reporting system, EARS)对ILI进行预警,将预警结果与"金标准"进行对比并评价预警效果。结果 2015-2018年北京市朝阳区共有26所哨点医院开展了ILI监测,3所哨点医院开展了流感病原学监测。使用EARS预警方法的灵敏度、特异度、阳性预测值、约登指数、kappa值和及时性中位数分别为0.60、0.88、0.70、0.48、0.50和0.68。利用北京朝阳医院发热门诊与中日友好医院发热门诊的ILI合并数据进行预警的效果较好,灵敏度、特异度、阳性预测值、约登指数、kappa值和及时性分别为0.70、0.89、0.74、0.59、0.60、0.80。结论 EARS方法可以及时探测北京市朝阳区的流感暴发,北京朝阳医院和中日友好医院2个发热门诊的ILI数据结合EARS方法具有良好的预警效果。

Application of early aberration reporting system in influenza early warning in Chaoyang district of Beijing,China

Objective To evaluate effect of early aberration reporting system under the condition of different classifications of influenza-like-illness cases in Chaoyang District of Beijing, China,and to provide scientific basis for prevention and control of influenza. Methods Influenza-like-illness cases and the virologic data between March 30 th 2015 and April 1 st 2018 were collected from Beijing Monitoring and Early Warning System for Infectious Diseases.Weekly virologic data were used as the "Golden standard" to measure the onset of influenza epidemic.We compared the early warning signals of Early Aberration Reporting System(EARS) under conditions of different classifications of influenza-like-illness to the signals generated by the "Golden standard".Results The surveillance was launched in 26 hospitals in Chaoyang district of Beijing during the 2015 to 2018 influenza seasons while the influenza etiology surveillance was 1 aunched in only 3 hospitals.The sensitivity, specificity, positive predictive value, Youden index, kappa value and timeliness of EARS were 0.60, 0.88, 0.70, 0.48, 0.50 and 0.68, respectively.The combined data of influenza-like cases from the fever clinic of Beijing Chaoyang Hospital and the fever clinic of China-Japan Friendship Hospital were effective for early warning.The sensitivity, specificity, positive predictive value, Yorden index, kappa value and timeliness are 0.70, 0.89, 0.74, 0.59, 0.60, 0.80, respectively. Conclusions The EARS can detect influenza outbreaks in time.Judging from multiple indicator data, the influenza-like case data of the two fever clinics of Beijing Chaoyang Hospital and China-Japan Friendship Hospital combined with the EARS method show a good early warning effect.