CNIDS: Chinese Notifiable Infectious Diseases Surveillance Project CNIDS is a project aimed at monitoring notifiable infectious diseases in Chinese mainland. The project utilizes automated technology and data analysis methods to enhance the monitoring and early warning capabilities for infectious diseases, enabling timely measures to be taken to address potential public health risks. The primary objective of the CNIDS project is to establish an efficient infectious disease Surveillance system that enables real-time surveillance of legally notifiable infectious diseases and internet news. It provides decision-makers with timely information and recommendations to facilitate appropriate measures for disease control and prevention.
In April 2024, Chinese mainland experienced a varied landscape of infectious diseases, with both rising and persisting health challenges. This month, we observed high numbers of hand, foot, and mouth disease (HFMD), with 337393 cases reported but with a relatively low mortality rate (7 deaths). Hepatitis also showed significant prevalence, particularly Hepatitis B, and C with 97362 and 21419 cases, respectively. Hepatitis B, although substantial in incidence, showed a more significant contribution to the month’s mortality, amounting to 37 deaths compared with 14 deaths due to Hepatitis C. Influenza cases were relatively high at 141202, but deaths were minimal (3). Meanwhile, tuberculosis remained a significant concern with 99555 cases and the highest number of deaths at 154.
In contrast, diseases such as cholera and poliomyelitis reported zero cases, reflecting successful control and vaccination efforts for these diseases. However, the numbers reveal a troubling high mortality in diseases such as AIDS (1863 deaths), and epidemic hemorrhagic fever (EHF) (7 deaths) despite lower incidences. The singular death from the Human infection with H7N9 virus emphasizes the potential severity of avian influenza strains. The persistent cases of echinococcosis, brucellosis, and schistosomiasis, with 340, 5484, and 47675 cases respectively, underline the challenges in controlling diseases that have strong environmental and occupational predispositions.
April’s data highlights the significant prevalence of HFMD, with over 300,000 cases representing the highest incidence among all diseases but with a relatively low mortality rate. This disease primarily affects children and is closely related to seasonal factors and the aggregation of susceptible individuals in settings such as schools and daycare centers. On the other hand, the high prevalence of hepatitis, particularly Hepatitis B with almost 100,000 cases, is of major public health concern due to the chronic nature of the disease and its association with severe liver complications, including cirrhosis and hepatocellular carcinoma.
From a public perspective, tuberculosis (TB) remains a grave concern due to its airborne transmission mode and the number of deaths associated with the disease. With nearly 100,000 cases and the highest mortality this month, it indicates an ongoing need for strengthened TB control measures. The public’s attention is also drawn to the Human infection with H7N9 virus, even though only one case was reported with an associated death; the high fatality risk of avian influenzas necessitates close monitoring.
Public health strategies should emphasize the prevention and control of HFMD, particularly in childcare settings where outbreaks are more common. Routine hygiene protocols, including handwashing and environmental sanitation, should be rigorously applied and monitored. Public awareness campaigns are essential to educate about the symptoms and the importance of rapid medical attention to prevent further spread.
Regarding hepatitis, preventative measures such as vaccination, safe injection practices, and screening and monitoring of blood transfusions are vital. Public health campaigns should also aim to increase awareness of hepatitis risk factors and promote strategies to reduce the risk of transmission, such as safe sex and reducing exposure to potentially contaminated items. The high prevalence of TB suggests a continued push for vaccination, faster and more accurate diagnostic methods, active case finding, and strict adherence to treatment regimens to prevent drug resistance.
Lastly, public surveillance systems need to remain vigilant for diseases with high mortality but lower incidence, such as the H7N9 virus. This involves controlling potential sources of infection, such as live poultry markets, and ensuring rapid response protocols are in place to manage and contain potential outbreaks. The general public should be informed about preventive measures and symptoms of severe infectious diseases, even when case numbers are low, to ensure early detection and treatment, reducing the overall disease burden and preventing mortality.
| Diseases | Cases | Comparison with 2024 March | Comparison with 2023 April | Deaths | Comparison with 2024 March | Comparison with 2023 April |
|---|---|---|---|---|---|---|
| Plague | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Cholera | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| SARS-CoV | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Acquired immune deficiency syndrome | 5,357 | -65 (-1.20%) | 420.0 (8.51%) | 1,718 | -139 (-7.49%) | -23.0 (-1.32%) |
| Hepatitis | 168,275 | -12,731 (-7.03%) | 25,529.0 (17.88%) | 231 | 71 (44.38%) | 135.0 (140.62%) |
| Hepatitis A | 1,624 | 82 (5.32%) | 510.0 (45.78%) | 0 | -2 (-100.00%) | 0.0 (/) |
| Hepatitis B | 140,564 | -12,403 (-8.11%) | 24,164.0 (20.76%) | 21 | -3 (-12.50%) | 2.0 (10.53%) |
| Hepatitis C | 21,905 | -310 (-1.40%) | 308.0 (1.43%) | 209 | 76 (57.14%) | 133.0 (175.00%) |
| Hepatitis D | 17 | -2 (-10.53%) | -2.0 (-10.53%) | 0 | 0 (/) | 0.0 (/) |
| Hepatitis E | 3,593 | -83 (-2.26%) | 587.0 (19.53%) | 1 | 1 (/) | 0.0 (0.00%) |
| Other hepatitis | 572 | -15 (-2.56%) | -38.0 (-6.23%) | 0 | -1 (-100.00%) | 0.0 (/) |
| Poliomyelitis | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Human infection with H5N1 virus | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Measles | 148 | 82 (124.24%) | 63.0 (74.12%) | 0 | 0 (/) | 0.0 (/) |
| Epidemic hemorrhagic fever | 300 | 66 (28.21%) | -5.0 (-1.64%) | 1 | 1 (/) | 0.0 (0.00%) |
| Rabies | 9 | 3 (50.00%) | -5.0 (-35.71%) | 8 | 2 (33.33%) | -3.0 (-27.27%) |
| Japanese encephalitis | 1 | 1 (/) | 0.0 (0.00%) | 0 | 0 (/) | 0.0 (/) |
| Dengue | 58 | 20 (52.63%) | 49.0 (544.44%) | 0 | 0 (/) | 0.0 (/) |
| Anthrax | 20 | -10 (-33.33%) | 1.0 (5.26%) | 0 | 0 (/) | 0.0 (/) |
| Dysentery | 2,522 | 435 (20.84%) | -272.0 (-9.74%) | 0 | 0 (/) | 0.0 (/) |
| Tuberculosis | 68,732 | -1,281 (-1.83%) | -4,114.0 (-5.65%) | 319 | 24 (8.14%) | -16.0 (-4.78%) |
| Typhoid fever and paratyphoid fever | 354 | 105 (42.17%) | -98.0 (-21.68%) | 0 | 0 (/) | 0.0 (/) |
| Meningococcal meningitis | 15 | 0 (0.00%) | 4.0 (36.36%) | 0 | 0 (/) | 0.0 (/) |
| Pertussis | 91,272 | 64,194 (237.07%) | 90,198.0 (8398.32%) | 7 | 7 (/) | 7.0 (/) |
| Diphtheria | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Neonatal tetanus | 0 | 0 (/) | -1.0 (-100.00%) | 0 | 0 (/) | 0.0 (/) |
| Scarlet fever | 6,125 | 2,515 (69.67%) | 5,023.0 (455.81%) | 0 | 0 (/) | 0.0 (/) |
| Brucellosis | 7,141 | 944 (15.23%) | -536.0 (-6.98%) | 1 | 1 (/) | 1.0 (/) |
| Gonorrhea | 8,138 | 314 (4.01%) | 207.0 (2.61%) | 0 | 0 (/) | 0.0 (/) |
| Syphilis | 61,511 | -2,650 (-4.13%) | 12,585.0 (25.72%) | 4 | -3 (-42.86%) | 3.0 (300.00%) |
| Leptospirosis | 7 | 1 (16.67%) | -1.0 (-12.50%) | 0 | 0 (/) | 0.0 (/) |
| Schistosomiasis | 2 | 1 (100.00%) | 1.0 (100.00%) | 0 | 0 (/) | 0.0 (/) |
| Malaria | 190 | 40 (26.67%) | 1.0 (0.53%) | 1 | 1 (/) | 1.0 (/) |
| Human infection with H7N9 virus | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Monkey pox | 39 | -12 (-23.53%) | / (/) | 0 | 0 (/) | / (/) |
| Influenza | 441,711 | -414,644 (-48.42%) | -1,235,300.0 (-73.66%) | 0 | -3 (-100.00%) | -31.0 (-100.00%) |
| Mumps | 9,255 | 2,289 (32.86%) | 2,227.0 (31.69%) | 0 | 0 (/) | 0.0 (/) |
| Rubella | 68 | 1 (1.49%) | -7.0 (-9.33%) | 0 | 0 (/) | 0.0 (/) |
| Acute hemorrhagic conjunctivitis | 2,803 | 127 (4.75%) | 593.0 (26.83%) | 0 | 0 (/) | 0.0 (/) |
| Leprosy | 43 | -10 (-18.87%) | 2.0 (4.88%) | 0 | 0 (/) | 0.0 (/) |
| Typhus | 153 | 102 (200.00%) | 34.0 (28.57%) | 0 | 0 (/) | 0.0 (/) |
| Kala azar | 33 | 17 (106.25%) | -1.0 (-2.94%) | 0 | 0 (/) | -1.0 (-100.00%) |
| Echinococcosis | 485 | -49 (-9.18%) | 138.0 (39.77%) | 0 | 0 (/) | 0.0 (/) |
| Filariasis | 0 | 0 (/) | 0.0 (/) | 0 | 0 (/) | 0.0 (/) |
| Infectious diarrhea | 143,289 | -53,058 (-27.02%) | 40,229.0 (39.03%) | 0 | -1 (-100.00%) | 0.0 (/) |
| Hand foot and mouth disease | 102,204 | 83,364 (442.48%) | 82,099.0 (408.35%) | 0 | 0 (/) | 0.0 (/) |
| Total | 1,120,260 | -329,889 (-22.75%) | -980,898.0 (-46.68%) | 2,290 | -39 (-1.67%) | 73.0 (3.29%) |
If you use CNIDS in your research, please cite the following paper:
Kangguo Li: Ph.D. student in Epidemiology and Biostatistics at the School of Public Health, Xiamen University, China.