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Abstract：
BACKGROUND: We sought to assess reporting in China\'s Pneumonia of Unknown Etiology (PUE) passive surveillance system for emerging respiratory infections and to identify ways to improve the PUE surveillance system\'s detection of respiratory infections of public health significance.
METHODS: From February 29-May 29, 2016, we actively identified and enrolled patients in two hospitals with acute respiratory infections (ARI) that met all PUE case criteria. We reviewed medical records for documented exposure history associated with respiratory infectious diseases, collected throat samples that were tested for seasonal and avian influenza, and interviewed clinicians regarding reasons for reporting or not reporting PUE cases. We described and analyzed the proportion of PUE cases reported and clinician awareness of and practices related to the PUE system.
RESULTS: Of 2619 ARI admissions in two hospitals, 335(13%) met the PUE case definition; none were reported. Of 311 specimens tested, 18(6%) were seasonal influenza virus-positive; none were avian influenza-positive. < 10% PUE case medical records documented whether or not there were exposures to animals or others with respiratory illness. Most commonly cited reasons for not reporting cases were no awareness of the PUE system (76%) and not understanding the case definition (53%).
CONCLUSIONS: Most clinicians have limited awareness of and are not reporting to the PUE system. Exposures related to respiratory infections are rarely documented in medical records. Increasing clinicians\' awareness of the PUE system and including relevant exposure items in standard medical records may increase reporting.
METHODS: From February 29-May 29, 2016, we actively identified and enrolled patients in two hospitals with acute respiratory infections (ARI) that met all PUE case criteria. We reviewed medical records for documented exposure history associated with respiratory infectious diseases, collected throat samples that were tested for seasonal and avian influenza, and interviewed clinicians regarding reasons for reporting or not reporting PUE cases. We described and analyzed the proportion of PUE cases reported and clinician awareness of and practices related to the PUE system.
RESULTS: Of 2619 ARI admissions in two hospitals, 335(13%) met the PUE case definition; none were reported. Of 311 specimens tested, 18(6%) were seasonal influenza virus-positive; none were avian influenza-positive. < 10% PUE case medical records documented whether or not there were exposures to animals or others with respiratory illness. Most commonly cited reasons for not reporting cases were no awareness of the PUE system (76%) and not understanding the case definition (53%).
CONCLUSIONS: Most clinicians have limited awareness of and are not reporting to the PUE system. Exposures related to respiratory infections are rarely documented in medical records. Increasing clinicians\' awareness of the PUE system and including relevant exposure items in standard medical records may increase reporting.
摘要：
背景：我们试图评估中国不明原因肺炎（PUE）被动监测系统中新出现的呼吸道感染的报告，并确定如何改进PUE监测系统对呼吸道感染的检测具有公共卫生意义。
方法：从2016年2月29日至5月29日，我们积极确定并招募了两家符合所有PUE病例标准的急性呼吸道感染（ARI）患者。我们回顾了记录与呼吸道传染病相关的暴露史的医疗记录，收集的喉咙样本进行了季节性和禽流感测试，并就报告或不报告PUE病例的原因采访了临床医生。我们描述并分析了报告的PUE病例的比例以及临床医生对PUE系统的认识和实践。
结果：在两家医院的2619例ARI患者中，335（13%）符合PUE病例定义；没有报告。在测试的311个样本中，18例（6%）为季节性流感病毒阳性，无禽流感阳性。<10％PUE病例医疗记录是否有暴露于动物或其他呼吸道疾病。未报告病例的最常见原因是不了解PUE系统（76％）和不了解病例定义（53％）。
结论：大多数临床医生对PUE系统的认识有限，也没有向PUE系统报告。与呼吸道感染相关的暴露很少记录在医疗记录中。提高临床医生对PUE系统的认识，并在标准医疗记录中包括相关的暴露项目，可能会增加报告。
方法：从2016年2月29日至5月29日，我们积极确定并招募了两家符合所有PUE病例标准的急性呼吸道感染（ARI）患者。我们回顾了记录与呼吸道传染病相关的暴露史的医疗记录，收集的喉咙样本进行了季节性和禽流感测试，并就报告或不报告PUE病例的原因采访了临床医生。我们描述并分析了报告的PUE病例的比例以及临床医生对PUE系统的认识和实践。
结果：在两家医院的2619例ARI患者中，335（13%）符合PUE病例定义；没有报告。在测试的311个样本中，18例（6%）为季节性流感病毒阳性，无禽流感阳性。<10％PUE病例医疗记录是否有暴露于动物或其他呼吸道疾病。未报告病例的最常见原因是不了解PUE系统（76％）和不了解病例定义（53％）。
结论：大多数临床医生对PUE系统的认识有限，也没有向PUE系统报告。与呼吸道感染相关的暴露很少记录在医疗记录中。提高临床医生对PUE系统的认识，并在标准医疗记录中包括相关的暴露项目，可能会增加报告。
