ECDC Round Table Report and ProMed-mail most useful international information sources for the Netherlands Early Warning Committee

摘要

The Netherlands Early Warning Committee (NEWC) aims to identify infectious diseases causing a potential threat to Dutch public health. Threats are assessed and published as (information) alerts for public health experts. To identify threats from abroad, the NEWC screens 10 sources reporting disease outbreaks each week. To identify the sources essential for complete and timely reporting, we retrospectively analysed 178 international alerts published between 31 January 2013 and 30 January 2014. In addition, we asked the four NEWC coordinators about the required time to scan the information sources. We documented the date and source in which the signal was detected. The ECDC Round Table (RT) Report and ProMED-mail were the most complete and timely sources, reporting 140 of 178 (79%) and 121 of 178 (68%) threats respectively. The combination of both sources reported 169 (95%) of all threats in a timely manner. Adding any of the other sources resulted in minor increases in the total threats found, but considerable additional time investment per additional threat. Only three potential relevant threats (2%) would have been missed by only using the ECDC RT Report and ProMed-mail. We concluded that using only the ECDC RT Report and ProMed-mail to identify threats from abroad maintains a sensitive Early Warning System. Keywords: Europe, The Netherlands, surveillance, epidemiology, early warningIntroductionInfectious disease outbreaks are threats to public health that usually come unexpectedly and can have considerable consequences especially in case of epidemics and/or pandemics [1]. The Netherlands Early Warning Committee (NEWC) was established in 1999 at the National Institute for Public Health and the Environment (RIVM), in order to identify threats to public health caused by infectious diseases in the Netherlands, in a timely and complete fashion [2]. The weekly NEWC report aims to inform health professionals in order to improve infectious disease prevention and control in the Netherlands through enhancing awareness and ensuring the early detection and reporting of new cases or events.The NEWC was evaluated in 2006 and 2008 [2,3]. In 2006, a retrospective and descriptive evaluation was performed on the completeness of threat detection in the Netherlands by the NEWC. It was found that the NEWC recognised nearly all national threats in a complete and timely manner. In addition, in 2008, a retrospective descriptive study was performed on the value of ProMed-mail for the NEWC. It was concluded that ProMED-mail has an added value over other sources used by the NEWC in the early detection of threats. Furthermore, ProMED-mail was appreciated for providing background and preliminary outbreak information.The coordinator of the NEWC scans 10 international sources once a week and selects infectious disease threats based on criteria outlined in a NEWC protocol (available from the authors on request). These criteria are: (i) an unexpected change in the incidence or prevalence of infectious disease; (ii) the occurrence of an infectious disease within a specific population or in a specific location; (iii) the emergence of a new or unknown disease; (iv) an unexpected change in the prevention, treatment or diagnosis of an infectious disease; (v) expected problems or obstacles in the prevention and control of the disease; (vi) an infectious disease threat receiving attention in the media.During weekly meetings, the NEWC assesses the gathered information from the 10 international information sources (Table 1), decides whether the event is a direct or potential threat to Dutch public health and determines if additional information is needed or whether prevention or control measures need to be taken [4]. The weekly meeting of the NEWC takes place at the National Institute for Public Health and the Environment (RIVM). The participants are microbiologists, epidemiologists and consultants in communicable disease control from various RIVM departments, as well as representatives from the Dutch Food Safety Authority. Table 1 International information sources used by the Netherlands Early Warning Committee, January 2013–January 2014 Organisation Bulletin / report Website Frequency World Health OrganizationWeekly Epidemiological Records (WER)http://www.who.int/wer/en/WeeklyDisease Outbreak News (DON)http://www.who.int/csr/don/en/Not applicable~(a)Event Information Site for International Health Regulations (EIS)http://apps.who.int/ihr/eventinformation/?ReturnHomeURL=./IHR/CurrentEvents.aspxNot applicable~(a)European?Union?or European Centre for Disease Prevention and Control (ECDC)ECDC Round Table ReportControlled circulation by EmailWorkdays Eurosurveillance http://www.eurosurveillance.org/WeeklyEuropean Early Warning and Response System (EWRS)~(b)https://ewrs.ecdc.europa.eu/Default.aspxNot applicable~(a)Epidemic?Intelligence?Information?System?for?Food- and Waterborne Diseases and Zoonoses (EPIS FWD)http://zwpepishome.ecdcdmz.europa.eu/fwd