1. The epidemic intelligence meeting Katrine Borgen Department of Infectious Disease Epidemiology Norwegian Institute of Public Health EpiTrain V, Vilnius October 2007

2. Epidemic intelligence Conseptual framework Systematic –collection –verification –communication of information on potential health threats

3. Objective Detect/identify Verify Rapidly assess …information on potential (inter)national health threats, which may affect populations in your country or your countrys nationals worldwide Recommend public health measures!

4. Indicator-based surveillance National & International ReportData Capture Filter Verify Assess Investigate Signal Event-based surveillance Control measures Public health alert Collect Analyse Interpret Disseminate Who & how?

5. How do we practically do this?

6. Organising epidemic intelligence Regular meetings Quality control systems Outbreak responsible unit Data base for possible threats Bulletin for reporting threats

7. The epidemic intelligence meeting

8. Structure Participants Frequency and duration Information sources Reporting Target group Evaluation

9. Participants Laboratory Epidemiology Authorities Specialists? Decision makers? Feasible Limit no. of participants

10. Frequency Weekly Monthly When needed Where should the meeting be held?

11. Information sources National Surveillance systems Early warning system Laboratories Clinicians Participants Networks Media International WHO – IHR ECDC EWRS NGOs Disease networks Eurosurveillance ProMED Literature

12. How, what and when to report? Written summary All alerts or only assessed alerts? Timely distribution by e-mail the same day Confidentiality?

13. Who receives the report? Participants National authorities Public health professionals –National, regional, local level Other partners? –Depending on the alerts –International counterparts

14. Evaluation Does the meeting meet its objective? Are alerts assessed appropriately and timely? Changes in structure according to needs?

15. Dutch example Since 1999 at National Public Health Inst. Weekly early warning committee meetings –Medical microbiologists –Infectious disease epidemiologists –Food authorities national level –National coordination centre infectious disease Participants report possible alerts Assess alerts – recommend action Report

16. The IHR surveillance system National IHR Focal Point WHO Local level Mass media, GPHIN, MediSYS, Google, NGOs, ProMED etc + other countries assess national events do surveillance notify, inform, consult in confidence verify do surveillance

17. IHR Obligations to build capacities Article 5+13 and Annex 1A Epidemic intelligence Detect events Report events Assess events Notify events to WHO Respond to events

18. Communications within IHR National IHR Focal Point WHO EURO IHR Focal Point Surveillance responsible Points of entry Public health services Clinics and hospitals The Epidemic intelligence meeting is one way to structure this communication