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MEMO/01/370
Brussels, 14 November 2001
Communciable Diseases - European Networks
Communicable diseases such as Tuberculosis, Measles, Influenza, AIDs, Hepatitis
C, represent a serious risk to human health, although the advent of interventions
such as antibiotics and vaccines has reduced the threat. Communicable diseases do
not respect national frontiers and can spread rapidly if actions are not taken to
combat them. They have an impact on individuals regardless of age, lifestyle, or
socioeconomic status. Not only do they cause illness and impose a heavy financial
burden on society, they also contribute to about one third of all deaths occurring
globally.
New diseases such as AIDS are continuing to emerge and others are developing
drug-resistant forms such as multi-drug resistant tuberculosis, and methicillin
resistant staphylococcus aureus. In addition, new scientific developments on the role
of infectious agents in chronic conditions such as cancer, heart diseases or allergies
are under investigation.
The identification, monitoring and control of communicable disease outbreaks are
greatly facilitated by well-functioning surveillance systems. Surveillance systems
provide information for early detection of and rapid response to outbreaks or
potential outbreaks, and also help to identify disease trends, risk factors, and the
need for interventions. They provide information for priority setting, planning,
implementation and resource allocation for preventive programmes and for
evaluating preventive programmes and control measures.
Communicable Diseases Network of the EU
In responding to these various issues the Commission proposal for a network for the
epidemiological surveillance and control of communicable diseases in the EU was
established by Decision 2119/98/EC of the European Parliament and the Council
and started work in 1999. The Communicable Diseases Network was set up to
detect and control communicable disease in people regardless of the cause and
manner of transmission. Its principal aim is to prevent further transmission of the
disease to other persons; by epidemiological surveillance and investigation of the
outbreak to try to identify its cause; and through investigation of cases of human
disease to identify control measures. It takes account of the need to integrate this
objective into international endeavours to reduce these diseases It provides the
necessary information to take preventive action and is particularly concerned with a
situation which may develop at EU level.
How is the communicable diseases network structured?
The communicable diseases network consists of two pillars:

Tracking Diseases A surveillance network designed as a network of national
surveillance institutes on specific diseases and health related issues.
Commission Decision 2000/96/EC specifies the list of communicable diseases
to be placed progressively under EU-wide surveillance and the criteria for their
selection. (See Annex 1). The network ´s main task is to monitor and track
developments. Within that network disease-specific sub-networks have been
created. (See Annex 2)
 Rapid Alert The second pillar of the network is an early warning and response
system (EWRS) to alert public health authorities in Member States and the
Commission on outbreaks with greater than national dimensions, so that a coordinated EU action may be required. Commission Decision 2000/57/EC on the
EWRS makes it clear that all events which could lead to outbreaks of EU-wide
significance should be reported under the EWRS irrespective of whether or not
a disease-specific network at EU level has been set up.
Depending on the specific situation, the Commission and Member States agree on
the appropriate action to be taken individually or together.
The EWRS is a sophisticated telematic system linking the designated authorities in
Member States and the Commission. The system allows for immediate exchange of
views on risk assessment and risk management crucial for timely public health
action. Several systems on communicable disease surveillance (e.g. legionellosis,
salmonellosis, tuberculosis) are already functioning. These have already proven to
be a useful tool during a number of outbreaks/incidents (paratyphoid fever in Turkey;
Legionnaires's disease in Belgium, Lassa fever in Germany).
In addition, the Commission also funds publications like "Eurosurveillance Monthly"
and the internet based "Eurosurveillance Weekly" as well as providing financial
support for training programmes for field epidemiologists.
The first progress report of the operation of the network was issued on 7 September
2000 (see (COM 2000) 471 final or
http://europa.eu.int/comm/health/ph/key_doc/index_en.html)
covering the period from July 1999 to May 2000.
Annex1
1. COMMUNICABLE DISEASES AND SPECIAL HEALTH ISSUES TO BE
PROGRESSIVELY COVERED BY THE COMMUNITY NETWORK
1.1
For the diseases/health issues listed below, surveillance within the EU network
will be performed by standardised collection and analysis of data in a way that
will be determined for each disease/health issue when specific EU surveillance
networks are put in place.
2. DISEASES
2.1
Diseases preventable by vaccination
Diphtheria
Infections with haemophilus influenza group B
Influenza
Measles
Mumps
Pertussis
Poliomyelitis
Rubella
2.2
Sexually transmitted diseases
Chlamydia infections
Gonococcal infections
HIV-infection
Syphilis
2.3
Viral hepatitis
Hepatitis A
Hepatitis B
Hepatitis C
2.4
Food- and water-borne diseases and diseases of environmental origin
Botulism
Campylobacteriosis
Cryptosporidiosis
Giardiasis
Infection with Enterohaemorrhagic E.coli
Leptospirosis
Listeriosis
Salmonellosis
Shigellosis
Toxoplasmosis
Trichinosis
Yersinosis
2.5
Other diseases
2.5.1. Diseases transmitted by non-conventional agents
Transmissible spongiform encephalopathies variant (CJD)
2.5.2. Air-borne diseases
Legionellosis
Meningococcal disease
Pneumococcal infections
Tuberculosis
2.5.3. Zoonoses (other than in 2.4)
Brucellosis
Echinococcosis
Rabies
2.5.4. Serious imported diseases
Cholera
Malaria
Plague
Viral haemorrhagic fevers
3. SPRECIAL HEALTH ISSUES
3.1
Nosocomial infections
3.2
Antimicrobial resistance
Annex 2
TABLE 1 - Disease specific networks
Area covered
Acronym
Operating hub
OPERATIONAL:
Legionellosis
Salmonellosis, infection with
E. coli O157
Tuberculosis
EWGLI
PHLS, Communicable Disease Surveillance
Centre (CDSC), London
Enter-net
PHLS, Communicable Disease Surveillance
Centre (CDSC), London
EuroTB
Institut de la Veille Sanitaire (InVS), Paris
HIV/AIDS
Euro HIV
Institut de la Veille Sanitaire (InVS), Paris
Influenza
EISS
Nederlands instituut onderzoek van de
gezondheidszorg (NIVEL)
Viral haemorrhagic fevers
ENIVD
Robert Koch Institut (RKI), Berlin
Antimicrobial resistance
EARSS
Rijksinstituut voor Volksgezondheid en Milieu
(RIVM)
Nosocomial infections
Helics
Université Claude Bernard – Lyon I
PILOT PHASE:
Hepatitis C
Smittskyddsinstitutet (SMI), Stockholm
Campylobacteriosis
Robert Koch Institut (RKI), Berlin
Meningococcal disease
PHLS, Communicable Disease Surveillance
Centre (CDSC), London
Measles, pertussis,
Statens Seruminstitut (SSI), Copenhagen /
Istituto Superiore di Sanità, Rome
Infection with H. influenzae
Brucellosis, rabies
National Centre for Surveillance and
Intervention, Athens
Basic surveillance network
Smittskyddsinstitutet (SMI), Stockholm