Epidemic IntelligenceA new paradigm for surveillance: Epidemic Intelligence A new paradigm for surveillance Denis Coulombier ECDC


Epidemic Intelligence Model: Epidemic Intelligence Model


Epidemic IntelligenceFramework: Epidemic Intelligence Framework Report Data Capture Filter Verify Collect Analyse Interpret Assess Investigate Signal EWRS MS DSN’s EWGLI Enternet EISS… BSN EMEA, EFSA MedISys GPHIN WHO-OVL Promed OIE FAO … Event-based surveillance DSN’s BSN Laboratory network Indicator-based surveillance Control measures Public health alert EWRS MS Commission Other heath related EU agencies WHO-IHR? Disseminate


Epidemic IntelligenceDefinition: Epidemic Intelligence Definition « Epidemic intelligence is the process to detect, verify, analyze, assess and investigate signals that may represent a threat to public health. It encompasses all activities related to early warning functions but also signal assessments and outbreak investigation. »


Epidemic Intelligence: Epidemic Intelligence Input MS, EWRS, DSN’s (EWGLI, Enternet, EISS…), BSN MedISys, GPHIN, WHO outbreak verification list, Promed Verification, analysis Assessment, investigation, response In liaison with MS and Commission With a European added-value perspective Output Daily verification list (internal) Weekly summary (EWRS, epidemiologists, policy-makers) EuroSurveillance weekly? Yearly report


Epidemic intelligence Event detection: Epidemic intelligence Event detection


Event verification: Event verification The systematic process by which ECDC verifies the reality of events, their aetiology, potential for spread and the need for assistance in affected member states Focuses on events of European Public Health Concern


Event verification: Event verification


The WHO ExperienceRecorded and Verified Events by Year: The WHO Experience Recorded and Verified Events by Year


Signal assessment: Signal assessment No No Yes No Yes Yes No Yes Signal Alert of National scope requiring European information Alert of National scope Alert of national scope requiring European support Alert of European scope Requiring European coordination Significant public health impact? Insufficient national capacity for response? Risk of European spread? Need for European information? Status Decision Alert not confirmed


Criteria for Signal Assessment: Criteria for Signal Assessment Unknown illness High mortality or morbidity European disease spread Interference with travel or trade Need for European assistance Suspected accidental or deliberate release of biologic or chemical agents


Standard operating proceduresDaily Coordinating Meeting: Standard operating procedures Daily Coordinating Meeting Review incoming reports of events Monitor the verification process Determine which events should be included in the weekly bulletin Determine which events should be posted on the Early Warning and Response System Assess the need for ECDC-facilitated assistance Initiate a response to the assessed need for ECDC-facilitated assistance Monitor ECDC-facilitated assistance


Event verification list, Olympic Games EWAR system, Athens, Greece, August 2004: Event verification list, Olympic Games EWAR system, Athens, Greece, August 2004


Feedback at European Level: Feedback at European Level ECDC threat assessment weekly bulletin European commission commisionner briefing Early Warning and Response System Eurosurveillance ECDC website