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ECDC and early detection of public health threats of EU concern: the role of media

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ECDC and early detection of public health threats of EU concern: the role of media

ECDC and early detection of public health threats of EU concern: the role of media

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  • Europeans die of infectious diseases : according to ECDC, each year in EU … around 90,000 people are diagnosed with tuberculosis: 7,800 deaths … approximately 30,000 people are diagnosed with HIV/AIDS: 1,800 deaths from AIDS-related diseases … upsurge of measles in EU in 2007-2010
  • More than one Member State affected New disease or unknown disease Request from MS or third parties for ECDC to deploy a team Request from MS or EC to prepare an assessment in control Failure in control measures Documented change in clinical/epidemiological patterns Matching EWRS criteria, IHR criteria High media impact at EU level International Health Regulations 2005 ("IHR (2005)" or "Regulations") – The international legal agreement, binding upon 194 states parties throughout the world, to prevent, control and respond to international spread of disease. 1.SERIOUS PUBLIC HEALTH IMPACT 2.EVENT UNUSUAL/UNEXPECTED 3.SIGNIFICAN RISK OF INTERNATIONAL SPREAD 4.SIGNIFICANT RISK OF INTERNATIONAL TRAVEL/TRADE RESTRICTION EWRS 1.EVENT INSIDE THE EU COMMUNITY WITH MORE THAN ONE MS IN THE EU COMMUNITY AFFECTED 2.EVENT INSIDE THE EU COMMUNITY WITH RISK OF PROPAGATION BETWEEN MS 3.EVENT OUTSIDE THE EU COMMUNITY WITH RISK PROPAGATION TO EU COMMUNITY 4.APPEARANCE/RESURGENCE OF CD THAT COULD REQUIRE COORDINATED ACTION
  • “ ..range of information sources to declare a public health emergency of international concern extended from formal notifications to informal report, including media ” (Revised International Health Regulations -IHR 2005)
  • The National Public Health Institutes of each Member State also have websites, and are a very good place to find information about the disease situation in a specific country. These are some examples from Germany (Robert Koch Institut), UK (Health Protection Agency), and France (Institut de Veille Sanitaire).
  • Transcript

    • 1. ECDC and early detection of public health threats of EU concern: the role of media Dr. Jas Mantero Epidemic Intelligence & Response Preparedness and Response Unit European Centre for Disease Prevention and Control (ECDC )
    • 2.
      • Independent EU agency established in 2005 and seated in Sweden
      • with the aim to support and promote global health security at EU
      • level ( ECDC regulation 851/2004 )
      What is ECDC? ECDC role is identify, assess & communicate current & emerging threats to human health from communicable diseases (ECDC Founding Regulation 851/2004, Article 1)
    • 3. ECDC and EC roles in EU : Public Health RISK ASSESSMENT and RISK MANAGEMENT
    • 4. ECDC Preparedness & Response Unit : EPIDEMIC INTELLIGENCE Systematic collection and collation of PH information from a variety of sources, which is then verified and analysed with the purpose to speed up the detection of potential health threats and allows timely response
      • Our outputs:
      • Daily epi-report (internal distribution + EC)
      • Weekly epi-report (for EC and national health authorities)
      • Annual report on emerging threats (includes EI report)
      • Threat assessments (when necessary)
    • 5. Data Events Collect Analyse Interpret Capture Filter Validate Signal Control measures Public health Alert Identified risks Mandatory notification Laboratory surveillance Emerging risks Syndromic surveillance Mortality monitoring Health care activity monitoring Prescription monitoring Non healthcare based
      • Domestic
      • Media review
        • EI focal points
      • International
        • Info scanning tools
        • Distribution lists
        • International agencies
        • Event monitoring
      “ Surveillance” systems
        • Event-based component
        • Indicator-based component
        • Daily Bulletin (RTR)
        • Weekly Bulletin (CDTR)
      Investigate Assess Disseminate Epidemic Intelligence Framework Specific EU relevance criteria to decide whether to follow up potential PH threat
    • 6. What is event-based surveillance (EBS)? Organised and rapid capture of information about events that are a potential risk to public health including rumours/reports through : 1) formal channels (other than standard surveillance) 2) informal channels (e.g. media reports, health workers, NGOs)
      • Traditional disease reporting mechanisms (indicator based surveillance):
      • produce credible information but reporting often slow
      • are designed for known diseases – (unknown/unusual threats?)
      • in some areas are not well established
      Why is EBS is important?
    • 7. Event Based Surveillance : FORMAL CHANNELS (official info) b) Open web-info a) Restricted web-info EWRS: information tool intended for coordination of EU PH control measures:
      • mandatory report for MS on control measures taken for events
      • information open to EC/ECDC
      Health authorities web-sites
    • 8. A virtually unlimited amount of web-based information
      • media aggregators
      • early warning systems
      • selected blogs
      • informal communications
      • social networks
      • more?
      This information needs most of the times to be verified Event Based Surveillance : INFORMAL CHANNELS (unofficial info)
    • 9. Web-based EBS : UNOFFICIAL info online Automatic Vs human moderated systems ECDC considers the two categories complementary for early detection Early Warning Systems Sophisticated applications able to gather, filter and classify web-based information for public health purposes Mechanism Advantages Disadvantages Automatic systems work with little or no human intervention near real time information False positive component, duplication, overload for analysts Moderated systems rely on human moderation analysts reduce redundancy and false positive Time delay, human selection bias
    • 10.
      • During 2009:
      • 39% of threats followed by ECDC first identified through unofficial web-based information
      • 48% of these were first identified through early warning systems (18% of total)
      Early detection: the role of unofficial information at ECDC in 2009 Important questions for the future: Is this component important in terms of public health? Should media have a greater role? What would this mean in terms of response? For international organizations (ECDC)? And at national level? PH impact of early detection through media?
    • 11.
      • Friday,18 December 2009
      • (09.00 hrs) Detection: systems detected local media reporting cases in Glasgow
      • (09:50 hrs) Verification : UK contacted; active search for official info
      • (11.30 hrs) ECDC internal team for threat assessment created
      • (17:30 hrs) Official communication from UK (EWRS)
      • (17:45 hrs) European Commission requesting ECDC to assess
      ECDC assessing before notification Example of early detection through media: anthrax among IDUs, UK (I)
      • 19-20 December 2009 (week-end)
      • Web-monitoring : update from local health authorities (web )
      • Monday , 21 December 2009
      • 10:00 hrs International media e.g. ProMed, BBC
      • 16.00 hrs: Threat assessment sent to UK
      BUT WHAT DOES THIS MEAN IN TERMS OF PUBLIC HEALTH IMPACT?!
      • Tuesday, 22 December 2009 (11.30am)
      • Final threat assessment sent to EC/shared with EU MS
      High media concern 3days after local media : TA drafted TA shared with MS <12 hrs from clear media concern TA shared with MS 1 working day after notification
    • 12.
      • Adaption of routine systems to the event
      • Tailored EI media monitoring
      • MEDISYS: Set up of alerts/targeted revision media sources
      • Interactive filtering & verification
      • Special daily bulletins
      • On-site support
      • Examples:
        • Serbia 2009 (Universiade, EXIT and Guča)
        • World athletics Berlin 2009
        • VI Jeux de la Francophonie Lebanon 2009
        • Winter Olympic Games Vancouver 2010
        • 2010 FIFA World Cup South Africa
      Early detection: Mass Gathering surveillance (media monitoring) BUT WHAT DOES THIS MEAN IN TERMS OF PUBLIC HEALTH IMPACT?!
    • 13. Thanks! [email_address]

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