Objective  To examine the cognition on operation, principle and efficiency of early warning of China Infectious Disease Automatic Alert and Response System (CIDARS) among online management professionals and to explore major weaknesses in operation of the system for providing evidences to improving the operation of CIDARS.

  Methods  We conducted a cellphone Wechat-based survey among 77 online management professionals of CIDARS in 16 centers for disease control and prevention at municipal or district level in Shanghai with a self-designed questionnaire using Sojump platform between January and February 2017. SAS 9.2 software was adopted in data analyses.

  Results  Of all the participants aged averagely 33.04 ± 7.40 years, 48.05% (37) were males and 35.06% (27) were full-time online manager of CIDARS. The average years of working for online management of CIDARS was 3.98 years. There were 77.92% and 84.41% of the participants reporting a consumption of ≤ 10 minutes each day to deal with single case and spatial-temporal early warning signals, 79.22% of the participants considering that CIDARS has played a role in infectious disease control and prevention, and 63.64% of the participants believing that the threshold values for early warning need to be modified according to local prevalence characteristics of infectious diseases, and 70.13% of the participants not acquiring general knowledge on the principle for early warning of the CIDARS, respectively.

  Conclusion  The professionals engaged in online management of CIDARS in Shanghai city generally considered that the system has played a role in infectious disease control and prevention, but they spent less daily time to deal with early warning signals and the majority of the professionals did not know the principal for early warning and the method for adjusting thresholds for the early warning of infectious diseases.