Challenge of notifiable infectious diseases reporting system in China

Notifiable infectious diseases reporting system is vital for infectious diseases surveillance and basis for infectious disease prevention and control strategy. Well formulated notifiable disease reporting system is a vital tool for public health surveillance. A qualitative survey was conducted among senior professional staffs who work on notifiable infectious diseases surveillance at provincial city, and county level Center for Disease Control and Prevention (CDC) in China via e-mail questionnaire. Informed consent was guaranteed. There were a total of 39 participants who returned questionnaires of the 42 submitted. Most participants (79.5%) agreed that case definition of hand, foot and mouth disease (HFMD) is not so clear, and 82.1% participants thought adjustment of HFMD case definition is needed. There was no statistical significance for X2 test. Most participants (76.9%) agreed that case definition of infectious diarrhea is not so clear, X2 test showed statistical significant (odds ratio (OR) = 6.88, p < 0.05) 89.7%; participants thought adjustment of infectious diarrhea case definition is needed. There were 48.7% participants who thought there was an underreporting of infectious diarrhea, X2 test showed statistical significant (OR = 9.96, p < 0.01). Most participants demonstrated that confirmed clinical laboratory reporting is more valuable than symptom case report for infectious disease surveillance. Adjustment of HFMD and infectious diarrhoea of notifiable infectious diseases should clarify the case definition and strengthen sentinel surveillance. A quality-assureed infectious disease surveillance system should integrate results from clinical laboratories and epidemiological data.   Key words: Notifiable infectious disease, surveillance, hand foot and mouth disease (HFMD), infectious diarrhea.