Transcript slides

FUTURE DISEASE CHALLENGES IN
EUROPE – where modelling is needed
European Centre for Disease Prevention and Control
Tommi Asikainen, Tubingen, 22 October 2008
ecdc.europa.eu
ECDC modelling activities
•Expert meeting: Now-Casting and short-term forecasting
– Realtime modelling during an influenza pandemic
•Expert meeting: Chikungunya modelling
•Seminars
•HIV (open)
– Prevalence estimations
•Varicella (open)
– Introduction into national child vaccination schedules
2
Upcoming ECDC modelling activities
• Surveillance in an influenza pandemic meeting
– 60 participants, 20 modellers
•Pandemic influenza planning assumptions meeting
– 30 participants, 15 modellers
• HIV prevalence estimation meeting
3
Upcoming ECDC modelling activities
• Curriculum for providing modelling training meeting
• TB modelling in low prevalence countries meeting
• Use of synthetic populations meeting
– Upon budget availability
• Modelling call for tenders
– Upon budget availability
4
How will this meeting benefit you?
• Meetings
– Specialized
– With other expertise involved
• Project proposals
– DG Research (European Commission)
– EAHC Executive Agency for Health and Consumers
(former PHEA)
– ECDC
•Ways to influence
– Meeting report
– Shared with partners
– ECDC ”lobbying”
– Time frame
5
Will ECDC only rely on your opinion?
6
Top 10 future disease threats
Excellent meeting
7
Antimicrobial resistance
• Production line on developing new drugs
– Today new treatments are available after 7-10 years
– Effect on the spread by reducing this time
• Community acquired MRSA
8
Antimicrobial resistance
Some other strategies, of varying cost effectiveness
depending on how resistant and how prevalent a
particular pathogen is, would include:
1. Developing vaccines against completely resistant pathogens.
2. Increasing effectiveness of infection control methods and
technologies in the healthcare setting.
3. Developing and implementing screening and cohorting
methods to prevent exposure and transmission.
9
Antimicrobial resistance
Some other strategies, of varying cost effectiveness
depending on how resistant and how prevalent a
particular pathogen is, would include:
4. Developing effective methods for eliminating carriage of
resistant pathogens.
5. Developing and using point of care tests that detect antibiotic
susceptibility patterns to ensure appropriate treatment.
6. Developing and using point of care tests that have high
sensitivity and specificity for distinguishing viral from bacterial
infections to ensure appropriate treatment.
10
Vaccine preventable diseases
•Measles
– Can we eliminate the disease within a five year period in EU
countries?
– What happens with the groups in seventies who were not affected
and did not get a measles vaccine
•Rubella
– What is the situation within a five year period?
•Varicella
– New quadrivalent measles-mumps-rubella-varicella available in
EU
– Data from US (effectiveness, impact on herpes zoster)
– Member States need help
11
Tuberculosis
• Forecasting of impact on the epidemic in low incidence
countries of cohorts from high burden countries and the
relative impact of control measures (i.e. screening)
– Ongoing ECDC work, but in need of better modelling work
• Modelling future progress towards elimination given
current trends of transmissions and burden distribution in
low incidence countries
12
Tuberculosis
• Modelling impact of new tools on control effectiveness
–
–
–
–
–
Diagnostics
Interferon Gamma Release Assays (IGRA)
Line probe assays (rapid molecular testing)
Liquid media culture, Moxifloxacin, Gatofloxacin
Drugs reducing treatment period
13
Influenza
• School closures, closing bordures, reduced travel.....
– School closures (Simon Cauchemez et al 2008)
– Border closures, reduced travel
But.........
• Operational modelling
– Decision makers want to know optimal distribution of antivirals
and anticipated hospital occupancy
• Seasonal influenza
– Prevalence
– Vaccine effectiveness
14
Vector borne / emerging infections
• ”Climate change”
– Effect of extreme heatwaves
– MoMo (Mortality Monitoring) network
– Introduction of new pathogens
• Risk Mapping
– Risk maps of Aedes Albopictus (unpublished)
– TBE Swedish data used to predict the situation in Finland
• Linking epidemiological and environmental data
– E3 network
15
Burden of Disease
• ECDC has launched a huge tender
• Total burden for ”all” infectious diseases
16
”ECDC wish list”
• More work on vaccine effectiveness definitions
• Advice on how to measure and analyse contact patterns
– Build on the POLYMOD project
• Model comparisons
• Methodology for modelling mortality of diseases
– Baseline
– Bayesian based
17
”Top 10” future modelling challenges
18
Example 1
ECDC expert meeting on Chikungunya modelling
1. Entomological data
– ”Biased” traps
2. Effects of interventions
– Need to know how the surveillance system works
19
Example 2
Expert meeting on pandemic influenza realtime modelling
1. What data to collect
– Modellers <-> Surveillance <-> Decision maker
2. Which models to use
– What does the decision maker want to know?
20
.........the floor is now open for
discussion on what YOU think is
important.
21