Download Protecting health in Europe - the new European Centre for Disease

Tuberculosis in the EU:
An ECDC perspective
World TB day
European Parliament
22 March 2007
Zsuzsanna Jakab
ECDC Director
The issues...
• Public health
• Socio-economical
• Scientific
• Regional
Regional gradient in TB cases,
Europe 2005
Cases per 100,000 population
Not included
No data
0 – 10
11 – 20
21 – 50
>50
FSU
110/100,000
EU-27
19/100,000
Balkan states
29/100,000
Source: EuroTB
TB trends in Europe, 1995-2005
Cases per 100,000 population
120
100
FSU (exc. Baltic)
80
Europe-53
60
Balkans
40
EU-27
20
EU-25
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: EuroTB
Migration patterns change
the epidemiology of TB
TB cases of foreign origin, Europe 2005
Percentage cases foreign origin
No data
0%–4%
5 % – 19 %
20 % – 49 %
>49 %
19% EU cases
of foreign origin
Source: EuroTB
TB/HIV co infection in the EU,
2000-2005*
Percentage cases with HIV
18
16
14
12
10
8
6 United Kingdom
4
2
0
2000
2001
Portugal
Spain
Estonia
Latvia
2002
2003
2004
2005
* countries with >50 TB cases/year and with data for > two years
Source: EuroTB
TB in vulnerable populations in
a low incidence country
400
Rate/100,000
370
217 Highest rate in Europe (KAZ)
104 FSU
174
94
14 EU
0
18
32
Country City
average aver.
33
Eld. Foreign Inner Prisons
74+ males city
Data 2003, Sources: BES.
Agencia Salut Publica Barcelona.
Dirección General IIPP
Scientific issue
•
•
•
Vaccine does not reduce transmission
•
Operational research needed
New drugs and diagnostic methods needed
Drug resistance (MDR and XDR) an obstacle
for successful treatment
Multi drug resistance (MDR),
EU 2005
Percentage per tested cases
Latvia
Cyprus
Romania
Hungary*
Spain*
Bulgaria*
Italy*
Germany
Slovakia
Austria
Portugal*
Ireland*
Czech Republic*
Greece*
France
Denmark
Belgium
Finland
United Kingdom
Slovenia
Netherlands
Malta*
Luxembourg
0
5
10
15
Estonia
Lithuania
20
25
* Countries with incomplete data
Source: EuroTB
TB challenges for the EU
TB PATTERN
CHALLENGES
Move towards elimination
Low incidence
EU, 20 countries
Moderate to high
incidence
EU, 7 countries
High incidence
neighbouring countries
TB increasingly rare
Vulnerable groups
Containing outbreaks
Maintain awareness and expertise
Population-level control
HIV
Drug resistance (MDR, XDR)
Collaboration with neighbouring
countries
ECDC strategies for TB in 2007
•
•
•
•
Further strengthen surveillance
Strengthen laboratory capacity
Develop scientific guidance
Analyse national action plans with
countries to further sterngthen them
• Develop European Action Plan at request
of Commissioner Kyprianou
Conclusions
• TB remains an issue of concern for all countries
• Strategies to be developed according to the
epidemiological situation
• Pursue effective partnership
• Progress towards elimination only
achievable if the global burden of
TB decreases
Thank you!
[email protected]
Zsuzsanna Jakab
Director, ECDC
ecdc.europa.eu