Eurostat Morbidity Seminar

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Eurostat Morbidity Seminar

• January 27 - 29 2003
• London
• Stef Bronzwaer,
• European Commission, DG SANCO
• communicable, rare, and emerging diseases unit

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Public HealthArticle 152

• A high level of human health protection shall be
  ensured in the definition and implementation of
  all Community policies and activities

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New Action Programme on Public Health

• Strands of action
• Improving health information and knowledge by
• establishing a comprehensive information system
  to provide key health data to policy makers,
  professionals and the public
• Responding rapidly to health threats, such as
  communicable diseases
• Addressing health determinants through health
  promotion and disease prevention measures

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Community Network on Communicable Diseases

• Decision 2119/98/EC of the European Parliament
  and the Council defines a network for
  epidemiological surveillance and control of CD in
  the Community
• Addresses need for co-ordinated action
• MS are obliged to communicate to Network relevant
  information for prevention
• Commission should make information available to MS

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Community Network

• Commission has responsibility for technical
  implementation of Decision and is assisted by an
  expert Committee of government officials, forming
  together the Network Committee
• Depending on the situation, the Commission and
  MSs agree on action to be taken (individually of
  together)

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Pillars of the Community Network

• Early warning and response system for the
  prevention and control of communicable diseases.

• Epidemiological surveillance of communicable
  diseases and special health issues

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Added value Network

• Communication system between national
  communicable disease surveillance authorities and
  Commission
• facilitates the rapid identification of cases of
  communicable diseases
• provides authorities support for analysing and
  interpreting data
• provides authorities opportunity to consult on
  preventive measures to be taken and assess their
  effectiveness

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Factors compromising comparability of data

• effectiveness of international surveillance
  depends on quality of contributing national
  surveillance systems
• care seeking behaviour and referral practices
• access to health care services or use of
  microbiological tests
• case definitions used
• proportions of cases reported from the local
  attending physician or laboratory to the district
  / regional / national level

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Commission Decision 2000/96/EC

• Specifies the list of CDs (41 for now) to be
  placed progressively under EU-wide surveillance
• The Community Network shall be put in place by
  integrating existing Community-supported
  surveillance networks and by building new
  networks for diseases not yet covered by
  surveillance networks

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Disease Surveillance Networks
Influenza
Salmonella E. coli O157
Antimicrobial resistance
Basic surveillance
Diphtheria
Legionella
Vaccine prev. disease
Meningococci
Antimicrobial use
STI
TB
HIV/AIDS
Nosocomial infections
Viral haemorrhagic fevers
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Disease Surveillance Networks
'hubs' responsible for ongoing systematic
collection, interpretation, analysis, and
dissemination of data 'hubs' mainly at national
surveillance centres (having responsibility for
investigating outbreaks and CD prevention) a.
Inform Network on a regular basis on the results
of data collection and analysis b. Use
applicable case definitions of Decision no.
2002/253/EC c. Co-operate with EEA/EFTA and
applicant countries and with WHO.
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DSN achievements

• Detect outbreaks
• Monitor trends
• Catalyse national surveillance
• Harmonisation methodology
• QA

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Community Network - a Wide Range of Activities -
MS co-ordination
HSSCD
Research
Training
Infor mation
Incident investigation
EWRS
Community legislation
Surveillance
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Dissemination of Information

• Eurosurveillance (www.eurosurveillance.org)
• monthly printed bulletin
• weekly electronic bulletin

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Training of Epidemiologists

• EPIET Objectives
• Strengthen expertise in MS
• Develop a European network of public health
  epidemiologists
• Contribute to a common EU incident response
  capacity

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Surveillance for action

• Salmonella collaboration zoonosis
• EWGLI PH action
• Influenza preparedness plan
• Antimicrobial resistance
• Council Recommendation
• Community strategy against AMR
• UK increased MRSA mortality (death certificates)

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Comparability of data

• DSNs
• harmonisation
• QA
• Commission Decision 2002/253/EC of 19 March 2002
  laying down case definitions for reporting
  communicable diseases to the Community network
  under Decision 2119/98/EC

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Drawbacks DSN system

• Lack of central co-ordination
• Lack of sustained funding
• Not formally part of Network

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Centre on disease control

• Support Commission and MS in outbreak response
• surveillance
• information alert (EW)
• organize response
• co-operate with civil protection
• communicate situation

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Tasks of the Centre

• Provide independent scientific advice
• provide technical support
• develop surveillance
• EWRS
• training
• communication
• co-operation