1. e-Bug the EU initiative for school children Tereza Kopřivová Herotová

2. What is e-Bug project  e-Bug is a European wide antibiotic and hygiene teaching resource for junior and senior school children  Funded by DG Sanco (EU Commission)  The project is lead by the Health Protection Agency (HPA) Primary Care Unit in Gloucester, UK and involves a consortium of 18 partner EU countries: 10 Associate and 8 Collaborating

3. 10 Associate Partners 10 Associate Partners  Belgium  the Czech Republic  Denmark  France  Greece  Italy  Poland  Portugal  Spain  United Kingdom

4. 8 Collaborating Partners  Croatia  Finland  Hungary  Ireland  Latvia  Lithuania  Slovakia  Slovenia

5. E-Bug project Associate partners  46 % of Europan Population  300 mil. people  62% of European Population Collaborative partners  15% of European Population  90 mil. people

6. Why e-Bug? DH SMAC Committee 1998: Committee 1998: Teaching about antibiotics should be included as part of the National Curriculum

7. Many do not understand antibiotics Antibiotics work on most coughs & colds Antibiotics can kill bacteria Antibiotics can kill viruses Antibiotics can kill bacteria that normally live on the skin and gut Bacteria that normally live on the skin and in the gut are good for you And 16-24 year olds are less knowledgeable

8. Ferech, M. et al. JAC 2006 58:401-407 Total antibiotic use in European countries 2003

9. Antibiotic use: outpatient penicillin usage correlated with penicillin resistance, Europe, 2005 Source: Goossens et al. 2005

10. Antibiotic use: evolution of penicillin resistance of Staphylococcus aureus

11. The five key areas for containment of antimicrobial resistance Rational drug use and regulation Research and development Animal husbandry, agriculture, aquaculture Surveillance Infection prevention

12. Reducing infection rates should reduce antibiotic use in children!  Spread of infection is mainly via sneezing/coughing and contaminated hands  Handwashing interventions reduce illnesses and absenteeism in schools

13. The aims of e-Bug activities Increase understanding of microbes Increase understanding of microbes Improve personal hygiene Improve personal hygiene Teach: Teach:  Prevention better than cure  Benefits of antibiotics  Overuse of antibiotics may have adverse effect

14. Developing e-Bug style & content Brainstorming sessions with teachers & partners:  Suit range of teaching styles  Have IT links  Be student friendly  MUST link closely to National Curriculums

15. Development of Junior and Senior Characters Clothing Hair styles ‘Girly look’ Amy and Harry

16. Development of bug characters Good BugsBad Bugs Junior bugsSenior bugs Bacteria Fungus Viruses

17. e-Bug Lesson Plan Junior school 1. Introduction to microbes  They are found everywhere even though you can’t see them.  There are three types of micro-organisms 2. Good Microbes  Good bacteria keep us healthy,  Bacteria can be put to good use 3. Bad Microbes  Sometimes microbes can make us sick 4. Prevention of Infection  Prevention when possible is better than cure  Keep your bad microbes to yourself  Our body helps defend against microbes Hand hygiene How, When and Why to wash your hands Respiratory hygiene Cover your coughs and sneezes Vaccines Vaccines are important to prevent a range of infections (including the flu)There are not vaccines for ALL infections 5. Treatment of Infection  Most common infections get better on their own through time, bed rest, liquid intake and healthy living  Antibiotics : If you have antibiotics, finish the course

18. Junior Microbe activity

19. Respiratory Hygiene activity Best part: sneezing because you get to use the snot gun Holding a tissue in front of your nose spreads less germs

20. Junior antibiotic activity It really hurts and I think I’m getting a cough. Don’t you have any antibiotics at home you can take? Reading the comic Not to use someone elses antibiotics Best part: What we learnt: All antibiotics are different

21. e-Bug Lesson Plan Senior school 1. Introduction to microbes  There are three different types of micro organism (bacteria, virus, fungi)  They are found everywhere even though you can’t see them  They are found in your body 2. Good Microbes  Good bacteria can help keep us healthy  Most Microbes are good for us, They can be put to good use  We need bacterial colonisation to live a healthy life (normal flora) Protect your flora 3. Spread and Prevention of Infection  Sometimes microbes can make us sick  Prevention where possible is better than cure  Don’t spread your bad microbes to others  Our body helps defend against microbes  Different routes of infection are hands, water, air, STI, blood 1.Hand hygiene - How, When and Why to wash your hands 2.Respiratory hygiene - Cover your coughs and sneezes How and why this is important 3.Vaccines - Vaccines help prevent a range of bacterial and viral infections Previously common infections are rare due to vaccines There are not vaccines for all infections Most common infections are not prevented by vaccines 4.Sexual transmitted infecions 4. Treatment of Infection  Most common infections get better on their own through time, bed rest, liquid intake and healthy living  Antibiotics - If you have antibiotics, finish the course; Do not use leftover or other people antibiotics; Overuse of antibiotics can damage our normal / good bacteria; Bacteria are becoming resistant to antibiotics due to overuse

22. Senior antibiotic activity That’s amazing – this bug’s killed by all of them

23. Food hygiene activity Seeing the microbes was really cool It was a different type of lesson I never knew bacteria were alive It was really hard to keep the bacteria off the salad Germs can spread very easily Always wash hands when dealing with food

24. Hand hygiene activity There are loads of bacteria on your body I learnt how to stop microbes spreading I learnt to wash your hands all the time

25. Development of Website www.e-Bug.eu www.e-Bug.eu  All pack content  Teacher presentations to aid lesson plans  Games for classroom or home play  Revision sections for students

26. e-Bug Time-lines 1-3m Jun 06 - Aug 06 appoint UK staff 3-12m Sep 06 - May 07 research across Europe 13-21m Jun 07 - Feb 08 pack and website in England 22-27m Mar 08 - Aug 08 translation in 9 AP countries 27-39m Aug 08 - Aug 09 dissemination in AP countries 22-39m Mar 08 - Aug 09 evaluation in 3 AP countries 36m May 09 presentation to collaborating countries

27. Pack Evaluation   France, Czech Republic and England   Control and Intervention schools   86 schools and 6290 students (52% senior)   Questionnaires pre and 2-4 weeks post activities   Significant increase in knowledge in all activity areas

28. Where e-Bug fits into the Curriculum ScienceScienceSpain ScienceSciencePortugal Religion Perio ScienceSciencePoland ScienceScienceItaly ScienceScienceGreece PSHE BiologyScienceScience Great Britain ScienceScienceFrance ScienceScienceDenmark Homeland study Chemistry BiologyScience Science* Czech Republic ScienceScienceBelgium PrimarySecondary * And in Slovenia, Slovakia and Latvia science (natural and social) account for the largest portion of time in the curriculum.

29. e-Bug in the Czech Republic Implementation   Review - adaptation to the CR school system   Translation - pack and website (available Sept. 09)   Promotion - Teachers fairs and science fairs (2008 - 2010). − Links in packs to related websites and vice versa. − Information letter to all primary and secondary schools (August ’09). − Teachers magazines and websites − Science teachers networks   Endorsement - Project supported by Ministries of Health and Education and Johnson&Johnson   Printing – All Czech primary and secondary schools receive a free printed copy (4,000 primary and 3,600 secondary schools)

30. Conclusion Distribution of over 13.000 free copies in Belgium + Further promotion of e-bug website = Maximum possible coverage of over 1.5 million students (15% of total population)

31. Thank you for your attention