Transcript Smittevernet i EU, inkludert et europeisk overvåkingssenter

Update on ECDC and EPIET
Preben Aavitsland and Jurgita Pakalniskiene
Based on material from ECDC
at
EpiTrain V, Vilnius, October 26 2007
Why was ECDC established?
• Emerging and re-emerging communicable diseases
revitalised through globalisation, bioterrorism,
interconnectivity, and EU without internal borders
• Health implications of enlarging EU
• Strengthen EU Public health capacity to help meet
EU citizen’s concerns
What does ECDC do?
Identify, assess & communicate current & emerging
health threats to human health from communicable
diseases
• EU level disease surveillance
• Scientific opinions and studies
• Early Warning system and response
• Technical assistance and training
• Epidemic intelligence
• Communication to scientific
community
• Communication to the public
Who are ECDC’s strategic partners?
Commission
Council
EU agencies
EP
MS
ECDC
Networks
Industry
CDCs
WHO
Research
community
Other
countries
NGOs
How is ECDC organised?
Director and Director's Cabinet
Management
Administrative
Services
Governance
Health
communication
External relations
Preparedness
& response
Country cooperation
Scientific
advice
Antimicrobial resistance & healthcare-associated infections
Food- & waterborne diseases
HIV, STI & Hepatitis
Influenza
Other diseases of environmental & zoonotic origin
Tuberculosis
Vaccine preventable diseases & invasive bacterial infections
Surveillance
How does ECDC communicate?
• Scientific communication
- Eurosurveillance
- Website
- Scientific reports and publications
• Information to the Public/Media
- Press/media
- Website – multilingual in 2008
- Coherence in risk communication
• Support to the Member States
- Network(s) of health communicators,
e.g. with EC on influenza
- Sharing of information and expertise
- Joint projects with MSs (in pipeline)
Some current themes
• Wide area of work
-
Antibiotic day
ESCAIDE conference
TESSy
Reports on H5N1 vaccines
Assistance to countries
Evaluations in countries
• Networks
- EuroHIV, EuroTB, EISS etc etc
• National contact points
- Vaccination
- Antibiotic resistance
- Etc
Learn more about ECDC:
www.ecdc.europa.eu | [email protected]
EPIET
• European Programme for Intervention Epidemiology
Training (EPIET)
• Created in 1994
• Funded by the European Commission (60%) and EU
Member States until 2007
• Coordinators:
– Arnold Bosman, based at ECDC in Stockholm, Sweden
(100%, leading coordinator)
– Marta Valenciano, based at Carlos III in Madrid, Spain
(100%)
– Viviane Bremer, based at RKI in Berlin, Germany (40%)
– Richard Pebody, based at HPA-CfI in London, UK (40%)
EPIET programme objectives
To:
• Strengthen CD surveillance & control in EU
• Develop a European network of intervention
epidemiologists
• Develop a response capacity inside & beyond EU:
– surveillance
– outbreak investigations
– applied research
Training objectives
• Plan, implement, evaluate a surveillance system
• Perform outbreak investigations
• Develop a research project on a relevant public
health issue
• Acquire oral and written scientific
communication skills
• Acquire teaching skills
Training format
• Theoretical training
– An introductory course (2½ weeks), open to
external participants
– At least 6 one-week training modules rotating in
EU Member States
• Learning by doing practical training
– 23 months
– At a European public health institute
– On site supervision by senior epidemiologists and from
EPIET coordinators
Time frame per cohort
Cohort 11: 16 fellows
Sept-Oct 05
Each cohort begins with an
introductory course, and ends
with a scientific seminar, where
each fellow presents his/her
work.
Sept-Oct 07
Cohort 12: 13 fellows
Sept-Oct 06
Sept-Oct 08
Cohort 13: 16? fellows
Sept-Oct 07
Sept-Oct 09
Introductory course, content
• Lectures from field
epidemiologists
• Interactive case
studies based on real
investigations
• Development of a
study protocol based
on real PH issue
• Surveillance exercise
• Communication
exercises
Since 2004 in
Menorca, Spain
Training modules in 2000-2006
• Biostatistics (Porto, Rome)
• Communication (London, Berlin)
• Rapid assessment techniques in emergency situations (Veyrier,
Berlin)
• Time series analysis and Geographic Information System
(Athens, Madrid, Veyrier, Bilthoven)
• Vaccinology (Glasgow, Helsinki, Stockholm, London, Bilthoven)
• Data management (Bilthoven)
• Computer & outbreak investigations
(Heraklion, Athens, Paris, Malta, Budapest, Vienna)
• Bioterrorism (Berlin)
• Time Series Analysis, Logistic Regression (Bordeaux)
• Scientific Writing (Berlin)
• Logistic regression (Madrid)
Training sites in Europe
“learning by doing”
•
25 Nations
+ Norway
+ Switzerland +WHO
•
24 Training sites
(16 for cohort 12)
Sites in red: was open
for cohort 13
Glasgow
Belfast
Helsinki
Helsinki
Oslo Stockholm
Stockholm
Oslo
Copenhagen
Copenhagen
Belfast Glasgow
DublinCardiff
Warsaw
Dublin Cardiff
London Bilthoven
Berlin
London Bilthoven
SouthWest
Berlin
Brussels
Prague
Prague
Paris Paris
Vienna Budapest
Geneva
Geneva
Lyon Lyon
Madrid
Madrid
Rome
Rome
Athens
Supervision of fellows
• Supervision on site by at least 1 senior
epidemiologist
• Draft protocols/reports/manuscripts sent to
coordinators
• Viadesk as virtual office
Outbreak investigations (examples)
• Campylobacter and norovirus linked to communal
water in Sweden, 2002
• Q-Fever associated with sheep market in Germany,
2002
• Avian influenza in poultry cullers in NL, 2003
• Legionella associated with cooling towers in
France, 2003
• Hepatitis A in homosexual men in Denmark, 2004
• Tuberculosis in supermarket in NL, 2005
• S. Hadar associated with roasted chicken in Spain,
2005
• Giardia linked to communal water in Norway, 2005
• S. DT 104 associated with pork meat in NL, 2005/6
EU Cross-border Investigations
1999-2006
• Salmonella paratyphi B among EU tourists returning from
Turkey, 1999
• Clostridium infection and deaths among intravenous drug
users, England, Scotland, Ireland, 2000
• EU-wide outbreak of
Salmonella typhimurium 204b, 2000
• Meningitis W135 in pilgrims returning from the Haj, 2000,
2001
• Hepatitis A in Ibiza and German tourists, 2001
• An outbreak of gastroenteritis in holiday-makers travelling to
Andorra, January-February 2002
• Hepatitis A among returning travellers from Egypt, 2004
Research Projects (examples)
• Risk factors (RF) for Hantavirus in France and
Belgium
• RF for meningococcal meningitis in day care
centres, Ireland
• RF for Q fever in Germany
• RF for sporadic cases of Listeriosis in France
• RF for MRSA in nursing homes, Germany
• RF for Hep C in hemodialysis Unit, France
• RF for sporadic campylobacteriosis, Ireland
• RF for CA-MRSA, Switzerland
• RF for syphilis, Sweden
• Influenza vaccine effectiveness, Denmark
Surveillance Projects (Examples)
• Establishment of new surveillance
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Norovirus in Sweden
Congenital toxoplasmosis in France
CA-MRSA in Switzerland
Heat and cold-related mortality in Spain
Winter mortality in the UK
Sales of flu medicine in Ireland
• Evaluation of surveillance system
–
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–
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EHEC in France
STI in Finland
Syphilis in Germany
Tuberculosis in Spain
EPIET international missions (1)
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Outbreak investigations
Infants deaths following immunisation (Egypt)
Tularaemia (Kosovo)
Suspected anthrax (Ethiopia)
Ebola (Uganda, Gabon, Sudan)
Hepatitis E (Sudan)
Marburg fever (Angola)
Measles (Nigeria, Niger, DRC)
SARS (Hongkong)
Meningitis (Sri Lanka)
Avian influenza (Vietnam, Turkey, Azerbaijian)
EPIET international missions (2)
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Surveillance projects and surveys
Cholera Surveillance (Mozambique)
Unsafe Injection Practices survey (Burkina Faso)
Assessment of neonatal tetanus status (Zimbabwe)
Vaccine coverage (Côte d’Ivoire, Republic of Guinea,
East-Timor, Pakistan)
SARS (Hong Kong)
Retrospective Mortality Survey (Darfur, Sudan)
Nutritional survey (Niger, East-Timor)
Early warning system (Pakistan after Earthquake)
Avian influenza (Georgia, Azerbaijian)
Read more
• www.epiet.org