Layout 1 ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2012 Conference Abstracts The Distribution of Infectious Related Symptoms in an Internet-based Syndromic Surveillance System in Rural China Qi Zhao1, Fuqiang Yang2, Lars Palm3, Hui Yuan2, Weirong Yan4 and Biao Xu*1 1School of Public Health, Fudan University, Shanghai, China; 2Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, China; 3Future Position X, Gavle, Sweden; 4Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden Objective To describe the distribution of the infectious related symptoms in an internet-based syndromic surveillance system reported by doctors in village health stations, township and county hospitals in rural Jiangxi Province, China, and to identify the major infectious diseases for syndromic surveillance in different levels of health facility. Introduction Syndromic surveillance system, which collects non-specific syn- dromes in the early stages of disease development, has great advan- tages in promoting early detection of epidemics and reducing the burden of disease confirmation (1). It is especially effective for sur- veillance in resource-poor settings, where laboratory confirmation is not possible or practical (2). Integrating syndromic surveillance with traditional case report system may generate timely, effective and sen- sitive information for early warning and control of infectious diseases in rural China (3). A syndromic surveillance system (ISSC) has been implemented in rural Jiangxi Province of China since August 2011. Methods Doctors and health workers in the healthcare surveillance units of ISSC, including village health station, township hospital and county hospital, used an internet-based electronic system to collect infor- mation of daily outpatients, which included 10 categories of infec- tious disease related symptoms, i.e., cough, fever, sore throat, diarrhea, headache, rash, nausea/vomit, mucocutaneous hemorrhage, convulsion and disturbance of consciousness. The data from August 1st to December 31st 2011 were extracted from database and ana- lyzed using SPSS 16.0. The combination of symptoms was also an- alyzed to identify patients with the syndrome of influenza-like illness (ILI) and fever-gastrointestinal syndrome (FGS). ILI were composed by fever (>=38 degree centigrade) plus cough or fever plus sore throat, and FGS were defined as fever plus vomit or diarrhea. Results Two county hospitals (CH), 4 township hospitals (TH) and 50 vil- lage health stations (VHS) were selected as surveillance unites in the pilot study during 2011/8/1 to 2011/12/31. In total, 152270 outpatient visits were reported, and 35395 patients had a chief complain of at least one surveillance symptom. Of these symptomatic patients, 24130 (68.2%) were from VHS, 4995 (14.1%) from TH and 6810 (19.2%) from CH. The proportion of patients with targeting symp- tom accounted for 15.5%, 66.4% and 23.9% of total outpatients in CH, TH and VHS respectively. The first 3 reported symptoms were cough (61.8%), fever (28.4%), and sore throat (23.4%), whereas mu- cocutaneous hemorrhage, convulsion and disturbance of conscious- ness were the least frequently reported symptoms in all surveillance units. Overall 3582 ILI and 1160 FGS cases were reported account- ing for 35% and 11% of fever cases respectively. Of the reported ILI and FGS cases, 75% ILI and 55.9% FGS cases were reported by health workers in the VHS. Conclusions Cough, fever and sore throat were the top surveillance symptoms, and the respiratory infectious diseases had more chance to be reported in syndromic surveillance system in rural Jiangxi Province. Training on infectious disease diagnosis especially respiratory diseases for vil- lage health workers should be enhanced since large numbers of pa- tients are likely to visit the village health stations. Figure1 Distributions of symptomatic patients in different level health facili- ties of rural China Keywords Syndromic surveillance; rural; influenza-likes illness; fever-gas- trointestinal syndrome Acknowledgments This study was funded by [European Union’s] [European Atomic Energy Community’s] Seventh Framework Programme ([FP7/2007-2013] [FP7/2007-2011]) under grant agreement no. [241900]. References 1. Henning KJ. What is syndromic surveillance? MMWR Morb Mortal Wkly Rep 2004;53 Suppl:5-11. 2. Siswoyo H, Permana M, Larasati RP, et al. EWORS: using a syn- dromic-based surveillance tool for disease outbreak detection in In- donesia. BMC Proceedings 2008, 2(Suppl 3):S3 3. Reingold A. If syndromic surveillance is the answer, what is the ques- tion.Biosecur Bioterr 2003;1:1–5. *Biao Xu E-mail: bxu@shmu.edu.cn Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e77, 2013