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Update on ECDC and EPIET

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1 Update on ECDC and EPIET
Preben Aavitsland and Jurgita Pakalniskiene Based on material from ECDC at EpiTrain V, Vilnius, October

2 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

3 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

4 ECDC Who are ECDC’s strategic partners? MS Commission Council EP
Networks EU agencies Research community WHO NGOs CDCs Industry Other countries

5 Director and Director's Cabinet
How is ECDC organised? Director and Director's Cabinet Management Governance External relations Country cooperation Administrative Services Health communication Preparedness & response Scientific advice Surveillance 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

6 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)

7 Some current themes Wide area of work Networks National contact points
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

8 Learn more about ECDC: |

9 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%)

10 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 The objective of EPIET are to: Strengthen CD surveillance Develop European network of intervention epidemiologists Develop European response capacity Surveillance Outbreak investigations Applied research Contribute to development of Network for the surveillance and control of CD

11 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

12 Training format Learning by doing practical training
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

13 Time frame per cohort Cohort 11: 16 fellows Cohort 12: 13 fellows
Each cohort begins with an introductory course, and ends with a scientific seminar, where each fellow presents his/her work. Sept-Oct 05 Sept-Oct 07 Cohort 12: 13 fellows Sept-Oct 06 Sept-Oct 08 Cohort 13: 16? fellows Sept-Oct 07 Sept-Oct 09

14 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

15 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)

16 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 Helsinki Helsinki Oslo Oslo Stockholm Stockholm Glasgow Copenhagen Belfast Belfast Glasgow Copenhagen Cardiff Dublin Cardiff Dublin Warsaw London London Bilthoven Berlin Bilthoven SouthWest Berlin Brussels Prague Prague Paris Paris Vienna Budapest Geneva Geneva Lyon Lyon Rome Madrid Madrid Rome Athens

17 Supervision of fellows
Supervision on site by at least 1 senior epidemiologist Draft protocols/reports/manuscripts sent to coordinators Viadesk as virtual office

18 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

19 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

20 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

21 Surveillance Projects (Examples)
Establishment of new surveillance 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 EHEC in France STI in Finland Syphilis in Germany Tuberculosis in Spain

22 EPIET international missions (1)
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)

23 EPIET international missions (2)
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)

24 Read more


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