Public health: network for epidemiological surveillance and control of communicable diseases in the European Community EWRS

The European Commission has presented its report on the operation of the early warning and response system of the Community network for the epidemiological surveillance and control of communicable diseases (Decision 2000/57/EC) during 2002 and 2002.

The Annual Reports from the Member States and the preparation of the related Commission report 2002 were delayed due to the work overload caused by the SARS event which developed abruptly starting on mid March 2003.

The report concludes by stating that the analysis of the content of messages transmitted through EWRS indicates that notifications are sometimes delayed with respect to the date of onset of the event. This is because Member States have to be certain about the facts and about Community relevance before making formal notifications via the EWRS. Analysis of the content of messages transmitted through EWRS in 2002 and 2003 indicates that a gradual but clear improvement in the notification process is taking place. To improve timeliness of notifications, a check-list of criteria for the assessment of Community-relevant events was introduced in 2003. Application of the list facilitates a more uniform and timely notification of events to EWRS. The notification to EWRS of cases of SARS, an event which dominated EWRS activity during 2003, with clear Community relevance, was very rapid.

The SARS event represented a significant test for the usefulness of EWRS. EWRS fulfilled effectively its institutional function, not only with the timely circulation of the alert among the national authorities, but also by facilitating the exchange of information, the provision of technical-scientific advice and the formulation of common positions among the national public health authorities.

The SARS outbreak also demonstrated the utility and flexibility of the new mechanism of the Scientific Support to Policies present in the 6th Framework Programme for RTD.

The messages on the events notified in 2002 and 2003 do not indicate which criterion, among those indicated in Annex I of Decision 2000/57/EC, had been considered relevant by Member States when reporting. Indicating the relevant criterion for notification by the notifying authority is important for evaluating the relevance and functionality of the criteria as well as their consistent application. Efforts are being made to ensure that such indications are provided.

In 2003, the EWRS has been used occasionally by the national health authorities as a working tool for the exchange of different types of information, as exemplified by messages related to events 12 (poultry influenza in the Netherlands), 28 (West Nile virus in France), and 33 (influenza in EU). However, the use of EWRS as a practical tool to provide and receive information, with the aim of improving awareness and knowledge about events in a framework of co-operation among national public health authorities, was still not fully exploited. The reasons for this are being considered with the authorities of the Member States and conclusions will be drawn on improvements needed.

Analytical annual reports of the events and on the EWRS procedures applied and additional reports on specific events of particular significance have been provided by some Member States. There is clear preference for additional reporting on specific events only where there is added value besides that provided by the initial notification and report. This, together with a number of operational improvements that are deemed necessary are under active consideration.