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Early warning of epidemics: towards a national intelligent syndromic surveillance system (NISSS) in China
  1. Peng Jia1,2,
  2. Shujuan Yang2,3
  1. 1Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
  2. 2International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
  3. 3West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
  1. Correspondence to Dr Shujuan Yang; rekiny{at}; Dr Peng Jia; jiapengff{at}

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  • A national intelligent syndromic surveillance system (NISSS) is necessary in order to tackle the epidemic quickly during the outbreak, and forecast the outbreak accurately and robustly at early stages.

  • Doctors who see patients directly and citizens who are active on the ground are generally more sensitive to and should be enabled to report suspected cases and risk in the NISSS.

  • Hospital and other types of information systems (eg, environmental, ecological, agricultural, wildlife and animal) should be tightly linked with the NISSS to enable more timely information sharing and make syndromic surveillance.

  • Literature databases containing valuable research findings and knowledge and internet activity data reflecting cyber user awareness should be incorporated into the NISSS in a real-time way for warning or fighting the epidemic.

  • Incorporating real-time data into the NISSS could greatly facilitate the real-time tracking and consequently guide the epidemic control and prevention work on the ground for curbing the epidemic efficiently.

  • The International Institute of Spatial Lifecourse Epidemiology (ISLE), a global health collaborative research network, has committed to working with multiple stakeholders to codevelop the NISSS in China.

After the SARS pandemic in 2003, an urgent demand for an effective national disease reporting and surveillance system could not be clearer in China. The National Notifiable Disease Reporting System (NNDRS) operated by the Chinese Center for Disease Control and Prevention (CDC), also known as the China Information System for Disease Control and Prevention, was established in 2004 to facilitate the complete and timely reporting of cases during the outbreak. The outbreak of the COVID-19 has further advanced the demand for an intelligent disease reporting system, also known as the national intelligent syndromic surveillance system (NISSS),1 which would be able to analyse these suspected cases on the basis of prior knowledge and real-time information before a disease is confirmed clinically …

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