Evoluzione dei sistemi di sorveglianza europei
European Centre for Disease Control
Dr Denis Coulombier
Head of unit for preparedness and response
European Centre for Disease Prevention and Control
Convegno CCM Sanit, Roma, 24 Giuno 2008
What is ECDC?
"An independent agency, named the European Centre for
Disease Prevention and Control"
(Regulation 851/2004)
A European Union Agency which:
– Is a member of the European Union (EU) family
– Covers EU 27, EEA/EFTA countries
– Within Neighbourhood Policy and DG Relex
reaches out to other countries beyond the EU 27
– Supports and promotes global health security
– Is financed by budget from the EU
2
What is the role of ECDC?
Identify, assess & communicate current & emerging health
threats to human health from communicable diseases
(ECDC Founding Regulation (851/2004), Article 1)
– Epidemic intelligence
– EU level disease surveillance
– Early Warning and response
– Scientific opinions and studies
– Technical assistance and training
– Communication to scientific
community
– Communication to the public
3
Public Health Stakeholders
Pre-ECDC situation
EC
HSC
DSN
ESCON EWRS
NSI
NSI
NSI
MoH
NSI
NSI
NSI: National Surveillance Institute
Ecdc: European Centre for
disease Prevention
and Control
AF: Advisory Forum
NSI: National surveillance
institute
MoH
MoH
MoH
EC: European Commission
HSC: Health Security
Committee
EWRS: Early Warning
and Response System
ESCON: European surveillance
Committee Network
MOH: Ministry of health
MoH
MoH: Ministry of Health
4
Public Health Stakeholders
ECDC established
EC
ecdc
HSC
DSN
AF
Ecdc: European Centre for
disease Prevention
and Control
AF: Advisory Forum
NSI: National surveillance
institute
EWRS
ESCON
NSI
NSI
NSI
MoH
NSI
NSI
NSI: National Surveillance Institute
MoH
MoH
MoH
EC: European Commission
HSC: Health Security
Committee
EWRS: Early Warning
and Response System
ESCON: European surveillance
Committee Network
MOH: Ministry of health
MoH
MoH: Ministry of Health
5
Epidemic Intelligence Framework
Response
Early warning
Indicator-based component
“Surveillance” systems
TESSy
Event-based component
Event monitoring
Data
Events
Collect
Analyse
Interpret
TTT
Capture
Filter
Validate
Signal
Assess
EPIS
Public health
Alert
Investigate
EWRS
Control measures
Disseminate/Notify/Communicate
IHR
Restricted access: network
inquiries, ECDC threat
bulletin
Public: Eurosurveillance,
press release, web site
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Indicator-based surveillance
European network for surveillance
Basic Surveillance Network
vCJD
DivineDivine-net
EISS
DIPDIP-net
EUCAST
EARSS
EnterEnter-Net
EUVAC
Measles
EWGLINet
EUEU-IBIS
ENIVD
ESAC
ESSTI
ESSTI
HIV/AIDS
Tuberculosis
IPSE
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Indicator-based surveillance
ECDC strategy for surveillance
• Long-term strategy for surveillance (2007-2013):
– Adopted in December 2007
• Revised EU surveillance case definitions:
– Published 28 April 2008
• Evaluation of Surveillance Networks:
– 15/17 finalised
• The European Surveillance System
(TESSy):
– Three training workshops
for Member States in 2008
– Data collection started in May 2008
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Indicator-based surveillance
Overview of 15 networks
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
DIVINE (Norovirus)
ESAC (AB consumption)
EUCAST (AST harmonisation)
EuroCJD (vCJD)
EUVACNET (measles, rubella, other)
EWGLINET (Legionnaires’ disease)
EARSS (AB resistance)
ENIVD (imported viral infections)
EISS (influenza)
IPSE (health care-associated inf.)
EuroTB (tuberculosis)
EuroHIV (HIV/AIDS)
EU-IBIS (meningococcal+Hib inf.)
Enter-net (food-borne infections)
BSN (core set all diseases)
*Grant agreement
Not continued as surveillance
Outsourced (3y)
Call out for 3 years
Contract to be awarded for 3 years
Outsourcing (2y) Jan 2009
Outsourcing (2y) Jan 2008
Outsourcing (2y) Jan 2008
Outsourcing until 30 June 2008
Outsourced until 1 Sep 2008 => Transfer
COMM GA* until June 2008 => Transfer
ECDC by end 2007
ECDC by end 2007
ECDC October 2007
ECDC October 2007
ECDC by end 2006
9
Indicator-based surveillance
The European Surveillance System
MS
MSs Data users
MS
National institutes
MS
Disease experts
MS
MS
MS
MS
MS
TESSy
The European
Surveillance System
Data access
MS
Data upload and access
MS
General public
AF members
MB members
WHO
EMCDDA
EFSA
MS
Others
MS
…
MS
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Event-based surveillance
Scanning information sources
EWRS
EWGLI
PROMED
Web
Other
ENTERNET
GPHIN
WHO
Member States
Eurosurveillance
MedISys
0
50
11
Event-based surveillance
Web scanning tools
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medusa.jrc.it/medisys
Event-based surveillance
News monitoring for tuberculosis
600
500
28/05/2007
XDR-TB case
on a long-haul
flight from USA
to Europe
400
300
08/01/2007
TB case
travelling by
bus
10/04/2007
TB case in
nursery
27/08/2007
TB case in a
student
attending a
course
12/06/2007
Italy (from
Romania):
infectious TB
case quits the
hospital
25/06/2007
TB Case in a
long haul flight
20/08/2007
TB case in a
school
20/09/2007
TB case in
plane
29/11/2007
TB case in a
plane
MDR TB case
travelling by
bus
200
100
0
27/12/2007
27/11/2007
28/10/2007
28/09/2007
29/08/2007
30/07/2007
30/06/2007
31/05/2007
01/05/2007
01/04/2007
02/03/2007
31/01/2007
01/01/2007
13
Event-based surveillance
Threat Tracking Tool (TTT)
Threats monitored in 2007
14
Event-based surveillance
Threat Tracking Tool (TTT)
15
Signal assessment
Daily round table
• 24/7 screening of news from indicator and
event-based surveillance
• Round table
– Daily threat assessment
– Daily & weekly reports
– Communication
Risk assessment
Support/coordination of outbreak response
16
Signal assessment
EU joint threat assessments
17
Communication to Member States
Weekly Communicable Disease Threat Report
18
Communication to scientific
community - Eurosurveillance
19
Communication to the public
www.ecdc.europa.eu
20
Coordination of control measures
The Early Warning and Response System
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Thank you
22
www.ecdc.europa.eu
[email protected]