This report is intended to inform the Council and Parliament about the events due to communicable diseases of Community relevance notified during 2006 and 2007 through the Early Warning and Response System (EWRS) under Decision 2119/98/EC of the Council and Parliament and Commission Decision 2000/57/EC.
During 2006 a total of 138 messages were posted (2.6 messages/week), with 223 comments. 43 events were related to influenza; 18 to acute diarrhoea; eight to diarrhoea and salmonellosis; 7 to measles; 6 to legionellosis; 5 to tuberculosis; 2 to cholera, death of unexplained origin, fever, food poisoning, haemorrhagic fever, hepatitis, haemolytic uremic syndrome, mumps or vCJD; and 1 each to campylobacteriosis, leptospirosis, listeriosis, septicaemia, shigellosis, soft tissue infection, sexually transmitted infection, and typhoid fever.
During 2007 a total of 85 messages were posted (1.6 messages/week), with a total of 300 comments. 10 events were related to tuberculosis and influenza; 7 to legionellosis; 5 to diarrhoea and salmonellosis; 4 to cholera and measles; 3 to acute diarrhoea; 2 to fever, food poisoning, haemorrhagic fever and multi-drug resistant tuberculosis; and 1 each to cryptosporidiosis, laryngitis, melioidosis, meningitis, mumps, pneumonia, rabies, septicaemia, shigellosis, syphilis, trichinosis and vCJD.
The Commission details the response and follow up to the main events for these years.
It notes that figures for the EWRS in 2006 and 2007 confirm previous years' trends. The number and typology of messages notified were comparable to 2004 and 2005. ‘Information level’ messages accounted for most of the EWRS messages. The total number of messages circulated in 2007 was fewer than in 2006. This most probably results from the higher number of messages related to avian influenza events notified in 2006 rather than from a change in the notification process. Additional analysis of the messages notified since the EWRS IT tool was launched (1999) is planned and should generate further evidence on the trend of EWRS use over time and will be instrumental in streamlining the use of the system, focusing more on management issues than on assessment.
As in previous years, only a limited number of the events reported in 2006 and 2007 required Community-wide coordination. This report has focused on the events which triggered such responses at different levels and which have spotlighted a number of specific areas calling for closer attention.
The Chikungunya outbreak in Italy highlighted the potential role of climate change in modifying vector-borne disease epidemiology in the EU and the need for a regional approach to monitoring and responding to these diseases (e.g. West Nile virus). In particular, it demonstrated that a disease that has never been reported in the EU can always challenge the capacities to respond and coordinate at Community level.
The upsurge of measles cases reported by a number of Member States highlights the importance of having a coordinated approach to achieving and maintaining a high level of vaccination coverage throughout Europe, with a view to the elimination of measles targeted for 2010.
Contact tracing procedures were implemented on several occasions. The results revealed that, although coordination procedures were swiftly put in place, mechanisms should be strengthened so as to trace rapidly the persons concerned and at the same time comply with current legislation on the protection of personal data. The major difficulties in obtaining data from airlines still persist.
A number of events required agreement on media messages addressed to large audiences. Coordination meetings of the EWRS authorities in Member States proved particularly useful for sharing common lines to be taken with the media. However, it was clear that further work is still needed to develop a more structured form of response.
The Commission and Member States, assisted by the ECDC, adapted swiftly to the challenge of the new International Health Regulations which entered into force on 15 June 2007. Existing legislation on communicable diseases has already been adapted and will be followed in 2010 by a proposal for a package of legal instruments covering health threats from non-communicable diseases. In the short term, specific instruments to strengthen contact tracing for public health purposes will be proposed. Mechanisms to address the global dimension of events reported outside the EU but with possible impact at Community level were activated, when needed, in order to facilitate and strengthen the management of those events taking stock of the available resources like the European Programme for Intervention Epidemiology Training (EPIET), that is now coordinated by the ECDC with close collaboration of the WHO.
A substantial upgrade of the EWRS IT application is planned in order to achieve consistency with the new communication platforms which the Commission and the ECDC are developing. In particular, the link with the ECDC EPIS platform will provide solid ground for exchanging epidemiological information on specific events. The Commission’s tools for helping Member States to share data and information during crisis situations will help the EWRS to work smoothly whenever a large number of messages are posted through the system.
Lastly, some minor modifications to the ‘simple search’ application (closure of events, message content, syndrome/disease, pathogen, reporting reason, and country of occurrence) are necessary and will be introduced soon. The need for these ‘minor’ modifications was identified in the previous report too, but the EWRS transfer phase prevented this kind of upgrading.