Session 1: Welcome to the programme Facilitator notes: Legionnaires’ disease: Risk assessment, outbreak investigation and control Session 1: Welcome to the programme ECDC, 2011

Overall objectives of the programme: Epidemiological investigation To know the epidemiology of LD To know the value, steps and methods of epidemiological LD outbreak investigation To understand the LD surveillance system at European level (including case definition, what to report, when and to whom) To understand principles involved in preparing a questionnaire for an epidemiological LD outbreak investigation To understand/interpret results of epidemiological LD outbreak investigation

Overall objectives of the programme: Microbiological investigation To know clinical laboratory methods available to confirm diagnosis of LD, the time they take and their limitations To know the role and value of clinical laboratory methods in LD outbreak investigation To understand the importance of rapid communication of laboratory results To understand/interpret clinical laboratory results in LD outbreak investigation

Overall objectives of the programme: Environmental investigation To know common settings and sources of LD outbreaks, especially how manmade environments favour growth of Legionella To understand principles of risk assessment in an LD outbreak investigation To know common measures to control LD outbreaks To carry out risk assessment as part of LD outbreak investigation To understand/interpret environmental laboratory results in LD outbreak investigation

Teaching and learning methods The programme uses a range of approaches, including interactive lectures, group seminar discussions and scenario based learning sessions These methods are participatory and appropriate for professionals who bring a wealth of experience to the programme. A participatory approach enables individuals to draw on their own experience and learn in an active way. It enables a more equal relationship between participants and facilitators

Ground rules for participatory learning Treat everyone with respect at all times, regardless of gender, age or cultural differences Ensure and respect confidentiality so that facilitators and participants are able to discuss issues without fear of repercussions Agree to respect and observe time-keeping and to begin and end the sessions on time Ensure everyone has the opportunity to be heard Be willing to accept and give constructive feedback Draw on the expertise of other participants in difficult situations Adherence to the above rules will ensure an effective and enjoyable learning experience.

Introducing each other using the shield technique ME AND MY JOB WHY I AM HERE MORE ABOUT ME WHAT I HAVE TO OFFER

Day 1 Session 1: Introduction to the programme Session 2: Clinical and epidemiological aspects of LD Session 3: Ecology of Legionella and the ecological basis for control Session 4: Water systems and Legionella control measures Session 5: Laboratory investigations: diagnostics and typing

Day 2 Session 6: Principles of outbreak investigation Session 7: Major settings in relation to LD outbreaks Session 8: Risk assessment Session 9: Risk assessment workshop

Day 3 Session 10: Site visits Session 11: Feedback Session 12: Communication and media Session 13: Start of the Outbreak Investigation Workshop

Day 4 Sessions 13-15: Continuation of the Outbreak Investigation Workshop Session 16: Consolidation and evaluation/action plans

Facilitator notes: Acknowledgements The creation of this training material was commissioned in 2010 by ECDC to Health Protection Agency (UK) and the University of Chester (UK) with the direct involvement of Louise Brown, Janice Gidman, Emma Gilgunn-Jones, Ian Hall (on behalf of the ECDC Legionnaires Disease Outbreak Toolbox Development Group), Tim Harrison, Rob Johnston, Carol Joseph, Sandra Lai, John Lee, Falguni Naik, Nick Phin, Michelle Rivett, and Susanne Surman-Lee. The revision and update of this training material was commissioned in 2017 by ECDC to Transmissible (NL) with the direct involvement of Arnold Bosman and Kassiani Mellou.