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GRF One Health Summit 2012, Davos: Presentation by Nicole ROSENKÖTTER, ...

GRF One Health Summit 2012, Davos: Presentation by Nicole ROSENKÖTTER,
Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School of Public Health, Netherlands, Kingdom of the

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Risk assessment of potential health threats – Enhancing disease surveillance and health monitoring with emergency medical care data Risk assessment of potential health threats – Enhancing disease surveillance and health monitoring with emergency medical care data Presentation Transcript

  • Nicole Rosenkötter, MSc Dipl. Geogr. Alexandra Ziemann Prof. Thomas Krafft Prof. Helmut Brand Risk assessment of potential health threats – Enhancing disease surveillance and health monitoring with emergency medical care data CAPHRI School for Public Health and Primary Care
  • Roadmap
    • International Health Regulations (2005)
    • April 2010: The volcanic ash plume over Europe a PHEIC?
    • Syndromic surveillance & SIDARTHa
    • Results case study SIDARTHa
    • Discussion and Conclusion
    • Added value to the One Health Approach
    Source: www.spon.de
  • IHR (2005)
    • Is the public health impact of the event serious?
    • Is the event unusual or unexpected?
    • Is there a significant risk of international spread?
    • Is there a significant risk of international travel or trade restrictions?
    • If at least 2 questions can be answered with yes  potential
    • Public Health Emergency of International Concern (PHEIC)
  • Public Health Emergency of International Concern
    • “ extraordinary event which is determined to constitute a public health risk to other States through the international spread and to potentially require a coordinated international response.”
      • Serious, sudden, unusual or unexpected situation
      • Implications on public health beyond one’s national borders
      • Potential that international action is needed
    Source: WHO, IHR (2005) and guiding material
  • Volcanic ash plume, Europe, April 2010
    • Eyjafjallajökull eruption (Iceland): 14 April 2010
    • Dispersion of the volcanic ash plume across Europe
    • approx. 16.4.-22.4.2010
  • Events according to IHR (2005)
    • Events, irrespective of their origin or source, including those caused by biological (of infectious or non-infectious nature) chemical agents or radio nuclear materials;
    • Events where the underlying agent, disease or mode of transmission is new, newly discovered or as yet unknown at the time of notification;
    • Events involving transmission or potential transmission through persons, vectors, cargo or goods (including food products) and environmental dispersion ;
    • Events that carry potential future impact on public health and require immediate action to reduce the consequences;
    • Events arising outside of their known usual occurrence patterns.
    • Source:
    • World Health Organization: WHO Guidance for the use of Annex 2 of the IHR (2005)
  • The volcanic ash plume – a PHEIC?
    • (1) Is the public health impact of the event serious? Yes/No
      • Volcanic ash contains fine particles (25% of the particulars are less than 10 diameters)
      • Potential problem for respiratory system
      • In case of an ash fall potential of high public health impact.
    • (2) Is the event unusual or unexpected? Yes
    • (3) Is there a significant risk of international spread? Yes (no)
      • Depending on wind and air temperature the volcanic ash has the potential to spread across international borders and to get into the lower atmosphere.
    • (4) Is there a significant risk of international travel or trade restrictions?
      • No, only the exposure (volcanic ash in the atmosphere) can have the potential to result in travel restrictions
      • The resulting diseases or symptoms due to inhalation of volcanic ash are not contagious, thus no flight restrictions are necessary.
  • Syndromic suveillance definition
    • “ A real-time (or near real-time) collection, analysis, interpretation, and dissemination of health-related data
    • to enable the early identification of the impact (or absence of impact) of potential human or veterinary public health threats
    • that require effective public health action…”
    • (Triple S, 2011)
  • Syndromic Surveillance
    • Health surveillance using information generated prior to laboratory confirmed diagnoses to buy time
    • Syndromic surveillance systems implemented mainly at regional/local level
    • Emergency data one main source for syndromic surveillance
  • SIDARTHa: European emergency data-based syndromic surveillance at regional level
    • Project elements:
    • Assessment of emergency data utility for syndromic surveillance in Europe
    • Conceptualisation of a European-wide regional syndromic surveillance approach and system
    • Implementation, test and evaluation of the syndromic surveillance system SIDARTHa in four regions in Europe
    Partners: Regional consortia of emergency care services and public health authorities from 12 European countries Co-funded by European Commission (DG Sanco), 2008-2010
  • Emergency medical dispatch data from Tyrol, Austria, 2010 Emergency physician data from Göppingen, Germany, 2010 Emergency department data from Santander, Spain, 2010 Respiratory syndrome, April 2010 x x
  • Discussion and Conclusion
    • Unexpected environmental hazards can cause a potential Public Health Emergency of International Concern according to the IHR (2005).
    • Lack of systems that monitor timely non-communicable disease.
    • Emergency medical care data are supportive to gain health information in a timely manner.
    • A combination of EMS data with other data sources (e.g. temperature, PM10 concentration, pollen level) would help to gain a quick overview and could lead to a more complete picture.
    • Public health authorities which would like to be able to assess timely the risk resulting from non-communicable events like environmental hazards could make use of routinely collected EMS services data.
    • This can support the implementation of the IHR (2005) in WHO member states to report on events that might fall under the condition of a potential PHEIC.
  • Added value to the One Health Approach
    • One Health Approach – collaboration across different disciplines
    • Mutual exchange of information between frontline healthcare workers and public health authorities is important for event detection under the International Health Regulations (2005) (MacDonald et al., 2011).
    • The monitoring of syndromes (signs and symptoms) that occur in emergency medical service data can support early event detection in order to gain situational awareness.
    • Data are already available and documented (liability reasons)
    • No data collection infrastructure has to be established
    • Data is often daily and electronically available
    • To make use of EMS data public health professionals need to invest in their collaboration with local or regional emergency medical services.
  • Thanks to…
    • Castrillo L University of Cantabria, Spain
    • Vergeiner G Dispatch Centre Tyrol, Austria
    • Fischer M Klinik am Eichert, Germany
    • Lippert F Emergency Medical Care Service, Capital Region, Denmark
    • Krämer A University of Bielefeld, Germany
    • and the SIDARTHa project consortium www.sidartha.eu
    This project is co-funded by the European Commission, DG Health & Consumers (2007 208). Contact Nicole Rosenkötter, MSc Maastricht University, Faculty of Health, Medicine, and Life Sciences, CAPHRI School of Public Health and Primary Care Department International Health e-mail: nicole.rosenkoetter@ maastrichtuniversity.nl