Broadly speaking, it not only refers to clinical symptoms, but also includes many diseases-related phenomena, mainly including: (1) patient visits in the emergency room (ed) of the hospital (including visits, patients' complaints and doctors' initial visits); (2) pharmacies sell OTC drugs; (3) Sales of medical related articles (including medical masks and toilet paper). ); (4) Absence rate of school or unit; (five) the animal is sick or dead; (6) Test results of public health laboratory; (7) the results of forensic identification of unexplained death; (8) Emergency medical assistance 120 telephone records. The classification and diagnosis of symptoms are the basic components of symptom monitoring system. Although most researchers have made extensive choices about symptoms, the unification of the definition of symptoms has just begun. Respiratory symptoms, gastrointestinal symptoms, skin symptoms and nervous system symptoms have been continuously used for symptom monitoring.
fundamental principle
The traditional disease monitoring system is based on hospital diagnosis and laboratory examination, and there is usually a time interval from symptom report or sample collection to the final diagnosis of the disease. However, the response to bioterrorism or other public health emergencies needs to be determined and responded quickly. The application of symptom monitoring can track the scale and speed of disease outbreaks, monitor disease trends, and give early warning of public health emergencies through suspicious diseases (or symptoms), reminding people to take effective measures in time to reduce morbidity and mortality and reduce economic losses. The early symptom epidemic curve and the disease outbreak epidemic curve can be graphically represented (Figure 1). Symptom monitoring aims to identify diseases with early symptoms.
The threshold of the number of cases, which will be td earlier than the threshold determined by traditional monitoring methods. The ability of symptom monitoring and early warning depends on the scale of disease outbreak, the range of people affected, the definition of symptoms and various data resources, the standard of starting early warning investigation and the ability of medical institutions to find and report special cases. At the same time, the disease prevention and control institutions must have corresponding procedures and programs to check and evaluate the operation of symptom monitoring.
Analysis and early warning application
Symptom monitoring has been widely used in recent years, which has promoted the early warning ability of diseases and related events to a certain extent and reduced losses. 1995, Milwaukee, USA was hit by a heat wave, which led to an increase in high temperature-related mortality compared with the same period. Later, an early warning scheme for dealing with high temperature was put forward, which required that as long as environmental signals or weather forecasts suggested that a heat wave was coming ahead of schedule, corresponding measures should be taken and the scheme should be continuously improved every year. 1999 When the heat wave struck again, the ratio of heat-related morbidity or mortality decreased by 50%. In response to possible bioterrorism attacks, during the World Cup in Korea and Japan in 2002, both Japan and South Korea established symptom monitoring systems based on the data of emergency rooms in hospitals. In order to understand the scope of anthrax spore bioterrorism attacks, the United States began to monitor the sale of OTC drugs through the Internet. In 2003, Hogan WR and others monitored the outbreak of respiratory and digestive tract infectious diseases in children by selling over-the-counter electrolytes. In the summer of 2003, a shepherd dog with fever and blisters was found in Wisconsin, USA. They immediately linked the case with similar cases in other States, tracked the sales network of these dogs, and diagnosed them in the laboratory.
Prior to this, measures have been taken to control the further spread of the disease. During the 2002 Winter Olympics in the United States, Utah used hospital outpatient and emergency data for bioterrorism monitoring. The above reports show that symptom monitoring has played a certain role in dealing with various public health emergencies, and with the deepening of research in this field, it will have better application prospects.
Wang Zhan
More and more attention has been paid to symptom monitoring, but it cannot replace traditional public health monitoring or doctor's diagnosis. At the same time, due to the limitations of signal detection methods, unnecessary economic losses caused by hazards may be overestimated, and because of the relatively low frequency of infectious diseases, various symptom monitoring methods cannot be tested and evaluated in practice in time. In view of this, the author thinks that the research and application should be strengthened in the following aspects: (1) Learn from the experience of traditional disease surveillance and use the obtained data to establish a joint system integrating traditional disease surveillance and symptom surveillance, learn from each other's strong points and make up for each other's shortcomings, so as to achieve long-term coordinated development. (2) Make full use of today's advanced network information technology, develop more advanced online direct reporting and information processing systems, and improve the response speed to early information. (3) Strengthen the close cooperation between disease prevention and control institutions and other relevant departments (such as drug retail departments, hospital emergency rooms, public health laboratories, schools, etc.). ), establish a unified data collection and analysis system and strengthen information sharing. (4) Strengthen the research on statistical analysis methods of data analysis and extraction, improve early warning ability while ensuring the reliability of analysis results as much as possible, and strengthen the research on evaluation of monitoring operation effect. (5) Learning from the experience and methods of symptom monitoring abroad,
Study and establish a symptom monitoring system suitable for China's national conditions, so that it can reflect the real situation of public health in a timely, reliable and comprehensive manner. (6) Strengthen environmental and disease monitoring.
Combined with research, select appropriate symptoms and signs for long-term monitoring, combined with indoor and outdoor atmospheric environment monitoring data, meteorological data, cause of death monitoring data and disease spectrum.
Monitoring data, personal health records, etc. The data from different sources are analyzed and refined by statistical methods to warn the influence of the environment on people's health.
It provides scientific basis for government decision-making and guidance for people's daily life, so as to fundamentally improve the environment and improve people's quality of life.
At present, there is little research on symptom monitoring in China, including the definition of symptoms and signs, statistical analysis and other methodology and evaluation standards.