1
|
Marou V, Vardavas CI, Aslanoglou K, Nikitara K, Plyta Z, Leonardi-Bee J, Atkins K, Condell O, Lamb F, Suk JE. The impact of conflict on infectious disease: a systematic literature review. Confl Health 2024; 18:27. [PMID: 38584269 PMCID: PMC11000310 DOI: 10.1186/s13031-023-00568-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/28/2023] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Conflict situations, armed or not, have been associated with emergence and transmission of infectious diseases. This review aims to identify the pathways through which infectious diseases emerge within conflict situations and to outline appropriate infectious disease preparedness and response strategies. METHODS A systematic review was performed representing published evidence from January 2000 to October 2023. Ovid Medline and Embase were utilised to obtain literature on infectious diseases in any conflict settings. The systematic review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis). No geographical restrictions were imposed. FINDINGS Our review identified 51 studies covering AIDS, Hepatitis B, Tuberculosis, Cholera, Coronavirus 2, Ebola, Poliomyelitis, Malaria, Leishmaniasis, Measles, Diphtheria, Dengue and Acute Bacterial Meningitis within conflict settings in Europe, Middle East, Asia, and Africa since October 2023. Key factors contributing to disease emergence and transmission in conflict situations included population displacement, destruction of vital infrastructure, reduction in functioning healthcare systems and healthcare personnel, disruption of disease control programmes (including reduced surveillance, diagnostic delays, and interrupted vaccinations), reduced access by healthcare providers to populations within areas of active conflict, increased population vulnerability due to limited access to healthcare services, and disruptions in the supply chain of safe water, food, and medication. To mitigate these infectious disease risks reported preparedness and response strategies included both disease-specific intervention strategies as well as broader concepts such as the education of conflict-affected populations through infectious disease awareness programmes, investing in and enabling health care in locations with displaced populations, intensifying immunisation campaigns, and ensuring political commitment and intersectoral collaborations between governments and international organisations. CONCLUSION Conflict plays a direct and indirect role in the transmission and propagation of infectious diseases. The findings from this review can assist decision-makers in the development of evidence-based preparedness and response strategies for the timely and effective containment of infectious disease outbreaks in conflict zones and amongst conflict-driven displaced populations. FUNDING European Centre for Disease Prevention and Control under specific contract No. 22 ECD.13,154 within Framework contract ECDC/2019/001 Lot 1B.
Collapse
Affiliation(s)
- Valia Marou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Constantine I Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | | | - Zinovia Plyta
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kirsty Atkins
- Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Orla Condell
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden.
| |
Collapse
|
2
|
Vardavas C, Zisis K, Nikitara K, Lagou I, Marou V, Aslanoglou K, Athanasakis K, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Sandmann F, Pharris A, Deogan C, Suk JE. Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU/UK/OECD: a systematic review. BMJ Open 2023; 13:e077602. [PMID: 37907290 PMCID: PMC10619092 DOI: 10.1136/bmjopen-2023-077602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role. DESIGN A systematic literature review was conducted to estimate the cost of the COVID-19 pandemic and the cost-effectiveness of pharmaceutical or non-pharmaceutical interventions. All cost data were adjusted to the 2021 Euro, and interventions compared with null. DATA SOURCES Ovid MEDLINE and EMBASE were searched from January 2020 through 22 April 2021. ELIGIBILITY CRITERIA Studies regarding COVID-19 outbreak or public health preparedness measures or interventions with outcome measures related to the direct and indirect costs for disease and preparedness and/or response in countries of the European Union (EU), the European Economic Area (EEA), the UK and the Organisation for Economic Co-operation and Development (OECD) of all relevant epidemiological designs which estimate cost within the selected time frame were considered eligible. DATA EXTRACTION AND SYNTHESIS Studies were searched, screened and coded independently by two reviewers with high measure of inter-rater agreement. Data were extracted to a predefined data extraction sheet. The risk of bias was assessed using the Consensus on Health Economic Criteria checklist. RESULTS We included data from 41 economic studies. Ten studies evaluated the cost of the COVID-19 pandemic, while 31 assessed the cost-benefit of public health surveillance, preparedness and response measures. Overall, the economic burden of the COVID-19 pandemic was found to be substantial. Community screening, bed provision policies, investing in personal-protective-equipment and vaccination strategies were cost-effective. Physical distancing measures were associated with health benefits; however, their cost-effectiveness was dependent on the duration, compliance and the phase of the epidemic in which it was implemented. CONCLUSIONS COVID-19 pandemic is associated with substantial short-term and long-term economic costs to healthcare systems, payers and societies, while interventions including testing and screening policies, vaccination and physical distancing policies were identified as those presenting cost-effective options to deal with the pandemic, dependent on population vaccination and the Re at the stage of the pandemic.
Collapse
Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Konstantinos Zisis
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Public Health Policy, University of West Attica, Egaleo, Greece
| | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Greece
| | | | | | - Revati Phalkey
- Public Health England, London, UK
- University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence-Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Charlotte Deogan
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Solna, Sweden
| |
Collapse
|
3
|
Vardavas C, Nikitara K, Aslanoglou K, Lagou I, Marou V, Phalkey R, Leonardi-Bee J, Fernandez E, Vivilaki V, Kamekis A, Symvoulakis E, Noori T, Wuerz A, Suk JE, Deogan C. Social determinants of health and vaccine uptake during the first wave of the COVID-19 pandemic: A systematic review. Prev Med Rep 2023; 35:102319. [PMID: 37564118 PMCID: PMC10410576 DOI: 10.1016/j.pmedr.2023.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Social determinants of health significantly impact population health status. The aim of this systematic review was to examine which social vulnerability factors or determinants of health at the individual or county level affected vaccine uptake within the first phase of the vaccination program. We performed a systematic review of peer-reviewed literature published from January 2020 until September 2021 in Medline and Embase (Bagaria et al., 2022) and complemented the review with an assessment of pre-print literature within the same period. We restricted our criteria to studies performed in the EU/UK/EEA/US that report vaccine uptake in the general population as the primary outcome and included various social determinants of health as explanatory variables. This review provides evidence of significant associations between the early phases of vaccination uptake for SARS-CoV-2 and multiple socioeconomic factors including income, poverty, deprivation, race/ethnicity, education and health insurance. The identified associations should be taken into account to increase vaccine uptake in socially vulnerable groups, and to reduce disparities in uptake, in particular within the context of public health preparedness for future pandemics. While further corroboration is needed to explore the generalizability of these findings across the European setting, these results confirm the need to consider vulnerable groups and social determinants of health in the planning and roll-out of SARS-CoV-2 vaccination programs and within the context of future respiratory pandemics.
Collapse
Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Revati Phalkey
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de. Ellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, Spain
- Centre of Biomedical Research Network on Respiratory Diseases (CIBERES de Enfermedaes Respiratorias), Insituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Teymur Noori
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrea Wuerz
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E. Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Charlotte Deogan
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| |
Collapse
|
4
|
Vardavas CI, Nikitara K, Aslanoglou K, Kamekis A, Puttige Ramesh N, Symvoulakis E, Agaku I, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Deogan C, Suk JE. Systematic review of outbreaks of COVID-19 within households in the European region when the child is the index case. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001718. [PMID: 36649374 PMCID: PMC9835947 DOI: 10.1136/bmjpo-2022-001718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/07/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This systematic review aims to identify the secondary attack rates (SAR) to adults and other children when children are the index cases within household settings. METHODS This literature review assessed European-based studies published in Medline and Embase between January 2020 and January 2022 that assessed the secondary transmission of SARS-CoV-2 within household settings. The inclusion criteria were based on the Population, Exposure, Outcome framework for systematic reviews. Thus, the study population was restricted to humans within the household setting in Europe (population), in contact with paediatric index cases 1-17 years old (exposure) that led to the transmission of SARS-CoV-2 reported as either an SAR or the probability of onward infection (outcome). RESULTS Of 1819 studies originally identified, 19 met the inclusion criteria. Overall, the SAR ranged from 13% to 75% in 15 studies, while there was no evidence of secondary transmission from children to other household members in one study. Evidence indicated that asymptomatic SARS-CoV-2 index cases also have a lower SAR than those with symptoms and that younger children may have a lower SAR than adolescents (>12 years old) within household settings. CONCLUSIONS SARS-CoV-2 secondary transmission from paediatric index cases ranged from 0% to 75%, within household settings between January 2020 and January 2022, with differences noted by age and by symptomatic/asymptomatic status of the index case. Given the anticipated endemic circulation of SARS-CoV-2, continued monitoring and assessment of household transmission is necessary.
Collapse
Affiliation(s)
- Constantine I Vardavas
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece.,Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | - Katerina Nikitara
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Katerina Aslanoglou
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Apostolos Kamekis
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Nithya Puttige Ramesh
- Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | | | - Israel Agaku
- Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | - Revati Phalkey
- Centre for Evidence Based Healthcare, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvithe (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,CIBER Respiratory Diseases (CIBERES), Madrid, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Charlotte Deogan
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| |
Collapse
|
5
|
Vardavas CI, Mathioudakis AG, Nikitara K, Stamatelopoulos K, Georgiopoulos G, Phalkey R, Leonardi-Bee J, Fernandez E, Carnicer-Pont D, Vestbo J, Semenza JC, Deogan C, Suk JE, Kramarz P, Lamb F, Penttinen P. Prognostic factors for mortality, intensive care unit and hospital admission due to SARS-CoV-2: a systematic review and meta-analysis of cohort studies in Europe. Eur Respir Rev 2022; 31:220098. [PMID: 36323422 PMCID: PMC9724816 DOI: 10.1183/16000617.0098-2022] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND As mortality from coronavirus disease 2019 (COVID-19) is strongly age-dependent, we aimed to identify population subgroups at an elevated risk for adverse outcomes from COVID-19 using age-/gender-adjusted data from European cohort studies with the aim to identify populations that could potentially benefit from booster vaccinations. METHODS We performed a systematic literature review and meta-analysis to investigate the role of underlying medical conditions as prognostic factors for adverse outcomes due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including death, hospitalisation, intensive care unit (ICU) admission and mechanical ventilation within three separate settings (community, hospital and ICU). Cohort studies that reported at least age and gender-adjusted data from Europe were identified through a search of peer-reviewed articles published until 11 June 2021 in Ovid Medline and Embase. Results are presented as odds ratios with 95% confidence intervals and absolute risk differences in deaths per 1000 COVID-19 patients. FINDINGS We included 88 cohort studies with age-/gender-adjusted data from 6 653 207 SARS-CoV-2 patients from Europe. Hospital-based mortality was associated with high and moderate certainty evidence for solid organ tumours, diabetes mellitus, renal disease, arrhythmia, ischemic heart disease, liver disease and obesity, while a higher risk, albeit with low certainty, was noted for chronic obstructive pulmonary disease and heart failure. Community-based mortality was associated with a history of heart failure, stroke, diabetes and end-stage renal disease. Evidence of high/moderate certainty revealed a strong association between hospitalisation for COVID-19 and solid organ transplant recipients, sleep apnoea, diabetes, stroke and liver disease. INTERPRETATION The results confirmed the strong association between specific prognostic factors and mortality and hospital admission. Prioritisation of booster vaccinations and the implementation of nonpharmaceutical protective measures for these populations may contribute to a reduction in COVID-19 mortality, ICU and hospital admissions.
Collapse
Affiliation(s)
- Constantine I Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Revati Phalkey
- Centre for Evidence Based Healthcare, Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Dolors Carnicer-Pont
- Catalan Institute of Oncology, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvithe (IDIBELL), Barcelona, Spain
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Charlotte Deogan
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Piotr Kramarz
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| |
Collapse
|
6
|
de Bruin M, Suk JE, Baggio M, Blomquist SE, Falcon M, Forjaz MJ, Godoy-Ramirez K, Leurs M, Rodriguez-Blazquez C, Romay-Barja M, Uiters E, Kinsman J. Behavioural insights and the evolving COVID-19 pandemic. Euro Surveill 2022; 27:2100615. [PMID: 35514309 PMCID: PMC9074394 DOI: 10.2807/1560-7917.es.2022.27.18.2100615] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
Behavioural sciences have complemented medical and epidemiological sciences in the response to the SARS-CoV-2 pandemic. As vaccination uptake continues to increase across the EU/EEA - including booster vaccinations - behavioural science research remains important for both pandemic policy, planning of services and communication. From a behavioural perspective, the following three areas are key as the pandemic progresses: (i) attaining and maintaining high levels of vaccination including booster doses across all groups in society, including socially vulnerable populations, (ii) informing sustainable pandemic policies and ensuring adherence to basic prevention measures to protect the most vulnerable population, and (iii) facilitating population preparedness and willingness to support and adhere to the reimposition of restrictions locally or regionally whenever outbreaks may occur. Based on mixed-methods research, expert consultations, and engagement with communities, behavioural data and interventions can thus be important to prevent and effectively respond to local or regional outbreaks, and to minimise socioeconomic and health disparities. In this Perspective, we briefly outline these topics from a European viewpoint, while recognising the importance of considering the specific context in individual countries.
Collapse
Affiliation(s)
- Marijn de Bruin
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Marianna Baggio
- Joint Research Centre, European Commission, Brussels, Belgium
| | | | - María Falcon
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), University of Murcia, Murcia, Spain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | | | - Mariken Leurs
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - María Romay-Barja
- Infectious Disease Network Research Center (CIBERINFEC), Madrid, Spain
- National Centre of Tropical Medicine, Carlos III Health Institute, Madrid, Spain
| | - Ellen Uiters
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - John Kinsman
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| |
Collapse
|
7
|
Suk JE, Pharris A, Beauté J, Colzani E, Needham H, Kinsman J, Niehus R, Grah R, Omokanye A, Plachouras D, Baka A, Prasse B, Sandmann F, Severi E, Alm E, Wiltshire E, Ciancio B. Public health considerations for transitioning beyond the acute phase of the COVID-19 pandemic in the EU/EEA. Euro Surveill 2022; 27. [PMID: 35485272 PMCID: PMC9052765 DOI: 10.2807/1560-7917.es.2022.27.17.2200155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many countries, including some within the EU/EEA, are in the process of transitioning from the acute pandemic phase. During this transition, it is crucial that countries’ strategies and activities remain guided by clear COVID-19 control objectives, which increasingly will focus on preventing and managing severe outcomes. Therefore, attention must be given to the groups that are particularly vulnerable to severe outcomes of SARS-CoV-2 infection, including individuals in congregate and healthcare settings. In this phase of pandemic management, a strong focus must remain on transitioning testing approaches and systems for targeted surveillance of COVID-19, capitalising on and strengthening existing systems for respiratory virus surveillance. Furthermore, it will be crucial to focus on lessons learned from the pandemic to enhance preparedness and to enact robust systems for the preparedness, detection, rapid investigation and assessment of new and emerging SARS-CoV-2 variants. Filling existing knowledge gaps, including behavioural insights, can help guide the response to future resurgences of SARS-CoV-2 and/or the emergence of other pandemics. Finally, ‘vaccine agility’ will be needed to respond to changes in people’s behaviours, changes in the virus, and changes in population immunity, all the while addressing issues of global health equity.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Howard Needham
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - John Kinsman
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rene Niehus
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rok Grah
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Ajibola Omokanye
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Agoritsa Baka
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bastian Prasse
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Ettore Severi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Erik Alm
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Emma Wiltshire
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bruno Ciancio
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
8
|
Abstract
OBJECTIVES School closures have been used as a core non-pharmaceutical intervention (NPI) during the COVID-19 pandemic. This review aims at identifying SARS-CoV-2 transmission in educational settings during the first waves of the pandemic. METHODS This literature review assessed studies published between December 2019 and 1 April 2021 in Medline and Embase, which included studies that assessed educational settings from approximately January 2020 to January 2021. The inclusion criteria were based on the PCC framework (P-Population, C-Concept, C-Context). The study Population was restricted to people 1-17 years old (excluding neonatal transmission), the Concept was to assess child-to-child and child-to-adult transmission, while the Context was to assess specifically educational setting transmission. RESULTS Fifteen studies met inclusion criteria, ranging from daycare centres to high schools and summer camps, while eight studies assessed the re-opening of schools in the 2020-2021 school year. In principle, although there is sufficient evidence that children can both be infected by and transmit SARS-CoV-2 in school settings, the SAR remain relatively low-when NPI measures are implemented in parallel. Moreover, although the evidence was limited, there was an indication that younger children may have a lower SAR than adolescents. CONCLUSIONS Transmission in educational settings in 2020 was minimal-when NPI measures were implemented in parallel. However, with an upsurge of cases related to variants of concern, continuous surveillance and assessment of the evidence is warranted to ensure the maximum protection of the health of students and the educational workforce, while also minimising the numerous negative impacts that school closures may have on children.
Collapse
Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | | | - Alexander G Mathioudakis
- Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Michele Hilton Boon
- WISE Centre for Economic Justice, Glasgow Caledonian University, Glasgow, UK
| | - Revati Phalkey
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Anastasia Pharris
- Epidemic Prone Diseases, Coronavirus and Influenza, Disease Programmes Unit, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Charlotte Deogan
- Epidemic Prone Diseases, Coronavirus and Influenza, Disease Programmes Unit, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- Emergency Preparedness and Response Support, Public Health Functions Unit, European Centre for Disease Prevention and Control, Solna, Sweden
| |
Collapse
|
9
|
Bundle N, Dave N, Pharris A, Spiteri G, Deogan C, Suk JE. COVID-19 trends and severity among symptomatic children aged 0-17 years in 10 European Union countries, 3 August 2020 to 3 October 2021. Euro Surveill 2021; 26. [PMID: 34915968 PMCID: PMC8728490 DOI: 10.2807/1560-7917.es.2021.26.50.2101098] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
We estimated risks of severe outcomes in 820,404 symptomatic paediatric COVID-19 cases reported by 10 European Union countries between August 2020 and October 2021. Case and hospitalisation rates rose as transmission increased but severe outcomes were rare: 9,611 (1.2%) were hospitalised, 640 (0.08%) required intensive care and 84 (0.01%) died. Despite increased individual risk (adjusted odds ratio hospitalisation: 7.3; 95% confidence interval: 3.3–16.2; intensive care: 8.7; 6.2–12.3) in cases with comorbidities, most (83.7%) hospitalised children had no comorbidity.
Collapse
Affiliation(s)
- Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Nishi Dave
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Gianfranco Spiteri
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Charlotte Deogan
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | -
- The Study group members are listed under Investigators
| |
Collapse
|
10
|
Suk JE, Vaughan EC, Cook RG, Semenza JC. Natural disasters and infectious disease in Europe: a literature review to identify cascading risk pathways. Eur J Public Health 2021; 30:928-935. [PMID: 31169886 PMCID: PMC7536539 DOI: 10.1093/eurpub/ckz111] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Natural disasters are increasing in their frequency and complexity. Understanding how their cascading effects can lead to infectious disease outbreaks is important for developing cross-sectoral preparedness strategies. The review focussed on earthquakes and floods because of their importance in Europe and their potential to elucidate the pathways through which natural disasters can lead to infectious disease outbreaks. Methods A systematic literature review complemented by a call for evidence was conducted to identify earthquake or flooding events in Europe associated with potential infectious disease events. Results This review included 17 peer-reviewed papers that reported on suspected and confirmed infectious disease outbreaks following earthquakes (4 reports) or flooding (13 reports) in Europe. The majority of reports related to food- and water-borne disease. Eleven studies described the cascading effect of post-disaster outbreaks. The most reported driver of disease outbreaks was heavy rainfall, which led to cross-connections between water and other environmental systems, leading to the contamination of rivers, lakes, springs and water supplies. Exposure to contaminated surface water or floodwater following flooding, exposure to animal excreta and post-disaster living conditions were among other reported drivers of outbreaks. Conclusions The cascade effects of natural disasters, such as earthquakes and floods, include outbreaks of infectious disease. The projection that climate change-related extreme weather events will increase in Europe in the coming century highlights the importance of strengthening preparedness planning and measures to mitigate and control outbreaks in post-disaster settings.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | | | - Jan C Semenza
- European Centre for Disease Prevention and Control, Solna, Sweden
| |
Collapse
|
11
|
Crawshaw AF, Deal A, Rustage K, Forster AS, Campos-Matos I, Vandrevala T, Würz A, Pharris A, Suk JE, Kinsman J, Deogan C, Miller A, Declich S, Greenaway C, Noori T, Hargreaves S. What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants? J Travel Med 2021; 28:6189154. [PMID: 33772312 PMCID: PMC8083646 DOI: 10.1093/jtm/taab048] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023]
Abstract
Migrants have been disproportionately impacted by COVID-19 and emerging evidence suggests they may face barriers to COVID-19 vaccination. Participatory approaches and engagement strategies are urgently needed to strengthen uptake, alongside innovative delivery mechanisms and sharing of best practice, to ensure migrants are better consider within countries’ existing vaccine priority structures.
Collapse
Affiliation(s)
- Alison F Crawshaw
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
| | - Anna Deal
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK.,Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, WC1E 7HT London, UK
| | - Kieran Rustage
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
| | - Alice S Forster
- Department of Behavioural Science and Health, University College London, WC1E 6BT London, UK
| | - Ines Campos-Matos
- Health Improvement Division, Public Health England, SE1 8UG London, UK and UCL Collaborative Centre for Inclusion Health, University College London, WC1E 6BT London, UK
| | - Tushna Vandrevala
- Department of Psychology, Kingston University London, Kingston KT2 7LB, UK
| | - Andrea Würz
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Anastasia Pharris
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Jonathan E Suk
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - John Kinsman
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Charlotte Deogan
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Anna Miller
- Policy & Advocacy Division, Doctors of the World UK, part of the Médicins du Monde network, E14 5AA London, UK
| | - Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Roma RM, Italy
| | - Chris Greenaway
- Department of Medicine, McGill University Montreal, H3A 1A1 Quebec, Canada
| | - Teymur Noori
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
| |
Collapse
|
12
|
Vardavas C, Nikitara K, Zisis K, Athanasakis K, Phalkey R, Leonardi-Bee J, Johnson H, Tsolova S, Ciotti M, Suk JE. Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis. BMJ Open 2021; 11:e045113. [PMID: 33926982 PMCID: PMC8094385 DOI: 10.1136/bmjopen-2020-045113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Respiratory infectious disease outbreaks pose a threat for loss of life, economic instability and social disruption. We conducted a systematic review of published econometric analyses to assess the direct and indirect costs of infectious respiratory disease outbreaks that occurred between 2003 and 2019. SETTING Respiratory infectious disease outbreaks or public health preparedness measures or interventions responding to respiratory outbreaks in OECD countries (excluding South Korea and Japan) so as to assess studies relevant to the European context. The cost-effectiveness of interventions was assessed through a dominance ranking matrix approach. All cost data were adjusted to the 2017 Euro, with interventions compared with the null. We included data from 17 econometric studies. PRIMARY AND SECONDARY OUTCOME MEASURES Direct and indirect costs for disease and preparedness and/or response or cost-benefit and cost-utility were measured. RESULTS Overall, the economic burden of infectious respiratory disease outbreaks was found to be significant to healthcare systems and society. Indirect costs were greater than direct costs mainly due to losses of productivity. With regard to non-pharmaceutical strategies, prehospitalisation screening and the use of protective masks were identified as both an effective strategy and cost-saving. Community contact reduction was effective but had ambiguous results for cost saving. School closure was an effective measure, but not cost-saving in the long term. Targeted antiviral prophylaxis was the most cost-saving and effective pharmaceutical intervention. CONCLUSIONS Our cost analysis results provide evidence to policymakers on the cost-effectiveness of pharmaceutical and non-pharmaceutical intervention strategies which may be applied to mitigate or respond to infectious respiratory disease outbreaks.
Collapse
Affiliation(s)
| | | | | | - Konstantinos Athanasakis
- Department of Public Health Policy, School of Public Health, University of West Attica, Egaleo, Greece
| | - Revati Phalkey
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK
| | - Helen Johnson
- Epidemiological Methods, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Svetla Tsolova
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Massimo Ciotti
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| |
Collapse
|
13
|
Riccardo F, Bolici F, Fafangel M, Jovanovic V, Socan M, Klepac P, Plavsa D, Vasic M, Bella A, Diana G, Rosi L, Pezzotti P, Andrianou XD, Di Luca M, Venturi G, Maraglino F, Pervanidou D, Cenciarelli O, Baka A, Young J, Bakonyi T, Rezza G, Suk JE. Correction to: West Nile virus in Europe: after action reviews of preparedness and response to the 2018 transmission season in Italy, Slovenia, Serbia and Greece. Global Health 2020; 16:55. [PMID: 32616065 PMCID: PMC7333285 DOI: 10.1186/s12992-020-00580-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Flavia Riccardo
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy.
| | - Francesco Bolici
- OrgLab, University of Cassino and Southern Lazio, Cassino, Italy
| | - Mario Fafangel
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Verica Jovanovic
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Maja Socan
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Petra Klepac
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Dragana Plavsa
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Milena Vasic
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Gabriele Diana
- OrgLab, University of Cassino and Southern Lazio, Cassino, Italy
| | - Luca Rosi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Xanthi D Andrianou
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Marco Di Luca
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Giulietta Venturi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | | | | | - Orlando Cenciarelli
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Agoritsa Baka
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Johanna Young
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Tamas Bakonyi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Giovanni Rezza
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
14
|
Riccardo F, Bolici F, Fafangel M, Jovanovic V, Socan M, Klepac P, Plavsa D, Vasic M, Bella A, Diana G, Rosi L, Pezzotti P, Andrianou XD, Di Luca M, Venturi G, Maraglino F, Pervanidou D, Cenciarelli O, Baka A, Young J, Bakonyi T, Rezza G, Suk JE. West Nile virus in Europe: after action reviews of preparedness and response to the 2018 transmission season in Italy, Slovenia, Serbia and Greece. Global Health 2020; 16:47. [PMID: 32423479 PMCID: PMC7236470 DOI: 10.1186/s12992-020-00568-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background After Action Reviews (AAR) with a One Health perspective were performed in Slovenia, Italy, Serbia and Greece following a severe West Nile virus (WNV) transmission season in 2018. A protocol combining traditional techniques and organizational process analysis was developed and then implemented in each country. Results In 2018, response to the unusually intense transmission season of WNV in Slovenia, Italy, Serbia and Greece took place through routine response mechanisms. None of the four countries declared a national or subnational emergency. We found a very strong consensus on the strengths identified in responding to this event. All countries indicated the availability of One Health Plans for surveillance and response; very high laboratory diagnostic capacity in the human, veterinary and entomology sectors and strong inter-sectoral collaboration with strong commitment of engaged institutions as critical in the management of the event. Finally, countries implementing One Health surveillance for WNV (in terms of early warning and early activation of prevention measures) consistently reported a positive impact on their activities, in particular when combining mosquito and bird surveillance with surveillance of cases in humans and equids. Recurring priority areas for improvement included: increasing knowledge on vector-control measures, ensuring the sustainability of vector monitoring and surveillance, and improving capacity to manage media pressure. Conclusions The AARs presented here demonstrate the benefit of cross-sectoral and cross-disciplinary approaches to preparedness for West Nile virus outbreaks in Europe. In the coming years, priorities include fostering and strengthening arrangements that: enable coordinated One Health surveillance and response during WNV transmission seasons; ensure adequate laboratory capacities; strengthen risk communication; and fund longer-term research to address the knowledge gaps identified in this study.
Collapse
Affiliation(s)
- Flavia Riccardo
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy.
| | - Francesco Bolici
- OrgLab, University of Cassino and Southern Lazio, Cassino, Italy
| | - Mario Fafangel
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Verica Jovanovic
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Maja Socan
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Petra Klepac
- Nacionalni inštitut za javno zdravje, Ljubljana, Slovenia
| | - Dragana Plavsa
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Milena Vasic
- Institut za Javno Zdravlje Srbije "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Gabriele Diana
- OrgLab, University of Cassino and Southern Lazio, Cassino, Italy
| | - Luca Rosi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Xanthi D Andrianou
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Marco Di Luca
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Giulietta Venturi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | | | | | - Orlando Cenciarelli
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Agoritsa Baka
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Johanna Young
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Tamas Bakonyi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Giovanni Rezza
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
15
|
Abstract
Climate change has already impacted the transmission of a wide range of vector-borne diseases in Europe, and it will continue to do so in the coming decades. Climate change has been implicated in the observed shift of ticks to elevated altitudes and latitudes, notably including the Ixodes ricinus tick species that is a vector for Lyme borreliosis and tick-borne encephalitis. Climate change is also thought to have been a factor in the expansion of other important disease vectors in Europe: Aedes albopictus (the Asian tiger mosquito), which transmits diseases such as Zika, dengue and chikungunya, and Phlebotomus sandfly species, which transmits diseases including Leishmaniasis. In addition, highly elevated temperatures in the summer of 2010 have been associated with an epidemic of West Nile Fever in Southeast Europe and subsequent outbreaks have been linked to summer temperature anomalies. Future climate-sensitive health impacts are challenging to project quantitatively, in part due to the intricate interplay between non-climatic and climatic drivers, weather-sensitive pathogens and climate-change adaptation. Moreover, globalisation and international air travel contribute to pathogen and vector dispersion internationally. Nevertheless, monitoring forecasts of meteorological conditions can help detect epidemic precursors of vector-borne disease outbreaks and serve as early warning systems for risk reduction.
Collapse
Affiliation(s)
- Jan C Semenza
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, Stockholm, S-171 83, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, Stockholm, S-171 83, Sweden
| |
Collapse
|
16
|
Graham M, Suk JE, Takahashi S, Metcalf CJ, Jimenez AP, Prikazsky V, Ferrari MJ, Lessler J. Challenges and Opportunities in Disease Forecasting in Outbreak Settings: A Case Study of Measles in Lola Prefecture, Guinea. Am J Trop Med Hyg 2018. [PMID: 29532773 PMCID: PMC5953353 DOI: 10.4269/ajtmh.17-0218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report on and evaluate the process and findings of a real-time modeling exercise in response to an outbreak of measles in Lola prefecture, Guinea, in early 2015 in the wake of the Ebola crisis. Multiple statistical methods for the estimation of the size of the susceptible (i.e., unvaccinated) population were applied to weekly reported measles case data on seven subprefectures throughout Lola. Stochastic compartmental models were used to project future measles incidence in each subprefecture in both an initial and a follow-up iteration of forecasting. Measles susceptibility among 1- to 5-year-olds was estimated to be between 24% and 43% at the beginning of the outbreak. Based on this high baseline susceptibility, initial projections forecasted a large outbreak occurring over approximately 10 weeks and infecting 40 children per 1,000. Subsequent forecasts based on updated data mitigated this initial projection, but still predicted a significant outbreak. A catch-up vaccination campaign took place at the same time as this second forecast and measles cases quickly receded. Of note, case reports used to fit models changed significantly between forecast rounds. Model-based projections of both current population risk and future incidence can help in setting priorities and planning during an outbreak response. A swiftly changing situation on the ground, coupled with data uncertainties and the need to adjust standard analytical approaches to deal with sparse data, presents significant challenges. Appropriate presentation of results as planning scenarios, as well as presentations of uncertainty and two-way communication, is essential to the effective use of modeling studies in outbreak response.
Collapse
Affiliation(s)
- Matthew Graham
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jonathan E Suk
- World Health Organization, Geneva, Switzerland.,European Centre for Disease Prevention and Control, Solna, Sweden
| | - Saki Takahashi
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey
| | - C Jessica Metcalf
- Woodrow Wilson School, Princeton University, Princeton, New Jersey.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey
| | - A Paez Jimenez
- World Health Organization, Geneva, Switzerland.,European Centre for Disease Prevention and Control, Solna, Sweden
| | - Vladimir Prikazsky
- World Health Organization, Geneva, Switzerland.,European Centre for Disease Prevention and Control, Solna, Sweden
| | - Matthew J Ferrari
- Department of Statistics, Pennsylvania State University, University Park, Pennsylvania.,Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, Pennsylvania
| | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
17
|
Suk JE, Paez Jimenez A, Kourouma M, Derrough T, Baldé M, Honomou P, Kolie N, Mamadi O, Tamba K, Lamah K, Loua A, Mollet T, Lamah M, Camara AN, Prikazsky V. Post-Ebola Measles Outbreak in Lola, Guinea, January-June 2015(1). Emerg Infect Dis 2018; 22:1106-8. [PMID: 27191621 PMCID: PMC4880080 DOI: 10.3201/eid2206.151652] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During public health crises such as the recent outbreaks of Ebola virus disease in West Africa, breakdowns in public health systems can lead to epidemics of vaccine-preventable diseases. We report here on an outbreak of measles in the prefecture of Lola, Guinea, which started in January 2015.
Collapse
|
18
|
Tjaden NB, Suk JE, Fischer D, Thomas SM, Beierkuhnlein C, Semenza JC. Modelling the effects of global climate change on Chikungunya transmission in the 21 st century. Sci Rep 2017. [PMID: 28630444 PMCID: PMC5476675 DOI: 10.1038/s41598-017-03566-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these viruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
Collapse
Affiliation(s)
- Nils B Tjaden
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Dominik Fischer
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany.,Technical University of Munich (TUM), Munich, Germany
| | | | | | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| |
Collapse
|
19
|
O'Brien EC, Taft R, Geary K, Ciotti M, Suk JE. Best practices in ranking communicable disease threats: a literature review, 2015. ACTA ACUST UNITED AC 2017; 21:30212. [PMID: 27168585 DOI: 10.2807/1560-7917.es.2016.21.17.30212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 11/09/2015] [Indexed: 12/23/2022]
Abstract
The threat of serious, cross-border communicable disease outbreaks in Europe poses a significant challenge to public health and emergency preparedness because the relative likelihood of these threats and the pathogens involved are constantly shifting in response to a range of changing disease drivers. To inform strategic planning by enabling effective resource allocation to manage the consequences of communicable disease outbreaks, it is useful to be able to rank and prioritise pathogens. This paper reports on a literature review which identifies and evaluates the range of methods used for risk ranking. Searches were performed across biomedical and grey literature databases, supplemented by reference harvesting and citation tracking. Studies were selected using transparent inclusion criteria and underwent quality appraisal using a bespoke checklist based on the AGREE II criteria. Seventeen studies were included in the review, covering five methodologies. A narrative analysis of the selected studies suggests that no single methodology was superior. However, many of the methods shared common components, around which a 'best-practice' framework was formulated. This approach is intended to help inform decision makers' choice of an appropriate risk-ranking study design.
Collapse
|
20
|
Domanović D, Cassini A, Bekeredjian-Ding I, Bokhorst A, Bouwknegt M, Facco G, Galea G, Grossi P, Jashari R, Jungbauer C, Marcelis J, Raluca-Siska I, Andersson-Vonrosen I, Suk JE. Prioritizing of bacterial infections transmitted through substances of human origin in Europe. Transfusion 2017; 57:1311-1317. [DOI: 10.1111/trf.14036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 12/19/2016] [Accepted: 12/22/2016] [Indexed: 12/17/2022]
Affiliation(s)
| | - Alessandro Cassini
- European Centre for Disease Prevention and Control; Stockholm Sweden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht; Utrecht the Netherlands
| | | | | | - Martijn Bouwknegt
- National Institute for Public Health and the Environment; Utrecht the Netherlands
| | - Giuseppina Facco
- Italian National Blood Centre, National Institute of Health; Rome Italy
| | - George Galea
- National Blood Transfusion Service; Valletta Malta
| | - Paolo Grossi
- Università degli Studi dell'Insubria; Varese Italy
| | | | | | | | | | | | - Jonathan E. Suk
- European Centre for Disease Prevention and Control; Stockholm Sweden
| |
Collapse
|
21
|
Semenza JC, Carrillo-Santisteve P, Zeller H, Sandgren A, van der Werf MJ, Severi E, Pastore Celentano L, Wiltshire E, Suk JE, Dinca I, Noori T, Kramarz P. Public health needs of migrants, refugees and asylum seekers in Europe, 2015: Infectious disease aspects. Eur J Public Health 2016; 26:372-3. [PMID: 27053729 DOI: 10.1093/eurpub/ckw023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jan C Semenza
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | | | - Herve Zeller
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Andreas Sandgren
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Marieke J van der Werf
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Ettore Severi
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Lucia Pastore Celentano
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Emma Wiltshire
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Irina Dinca
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| | - Piotr Kramarz
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, S-171 83 Stockholm, Sweden
| |
Collapse
|
22
|
Kentikelenis A, Karanikolos M, Williams G, Mladovsky P, King L, Pharris A, Suk JE, Hatzakis A, McKee M, Noori T, Stuckler D. How do economic crises affect migrants' risk of infectious disease? A systematic-narrative review. Eur J Public Health 2015; 25:937-44. [PMID: 26318852 PMCID: PMC4668330 DOI: 10.1093/eurpub/ckv151] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs. METHODS We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research. RESULTS The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants. CONCLUSIONS There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for addressing this vulnerability.
Collapse
Affiliation(s)
| | - Marina Karanikolos
- 2 European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
| | - Gemma Williams
- 3 LSE Health, London School of Economics and Political Science, London, UK
| | - Philipa Mladovsky
- 4 Department of International Development, London School of Economics and Political Science, London, UK
| | - Lawrence King
- 1 Department of Sociology, University of Cambridge, Cambridge, UK
| | - Anastasia Pharris
- 5 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jonathan E Suk
- 5 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Martin McKee
- 2 European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
| | - Teymur Noori
- 5 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - David Stuckler
- 7 Department of Sociology, University of Oxford, Oxford, UK
| |
Collapse
|
23
|
Williams GA, Bacci S, Shadwick R, Tillmann T, Rechel B, Noori T, Suk JE, Odone A, Ingleby JD, Mladovsky P, Mckee M. Measles among migrants in the European Union and the European Economic Area. Scand J Public Health 2015; 44:6-13. [PMID: 26563254 PMCID: PMC4741262 DOI: 10.1177/1403494815610182] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 11/16/2022]
Abstract
Aims: Progress towards meeting the goal of measles elimination in the EU and the European Economic Area (EEA) by 2015 is being obstructed, as some children are either not immunized on time or never immunized. One group thought to be at increased risk of measles is migrants; however, the extent to which this is the case is poorly understood, due to a lack of data. This paper addresses this evidence gap by providing an overview of the burden of measles in migrant populations in the EU/EEA. Methods: Data were collected through a comprehensive literature review, a country survey of EU/EEA member states and information from measles experts gathered at an infectious disease workshop. Results: Our results showed incomplete data on measles in migrant populations, as national surveillance systems do not systematically record migration-specific information; however, evidence from the literature review and country survey suggested that some measles outbreaks in the EU/EEA were due to sub-optimal vaccination coverage in migrant populations. Conclusions: We conclude that it is essential that routine surveillance of measles cases and measles, mumps and rubella (MMR) vaccination coverage become strengthened, to capture migrant-specific data. These data can help to inform the provision of preventive services, which may need to reach out to vulnerable migrant populations that currently face barriers in accessing routine immunization and health services.
Collapse
Affiliation(s)
- Gemma A Williams
- LSE Health, London School of Economics and Political Science (LSE), London, UK
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rebecca Shadwick
- LSE Health, London School of Economics and Political Science (LSE), London, UK
| | - Taavi Tillmann
- ECOHOST, London School of Hygiene and Tropical Medicine, London, UK
| | - Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anna Odone
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK Department of Global Health and Social Medicine, Harvard School of Public Health, Harvard University, Boston, MA, USA
| | | | - Philipa Mladovsky
- LSE Health, London School of Economics and Political Science (LSE), London, UK
| | - Martin Mckee
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
24
|
Bouwknegt M, Havelaar A, Neslo R, de Roda Husman AM, Hogerwerf L, van Steenbergen J, Kretzschmar M, Ciotti M, Cassini A, Suk JE. Ranking infectious disease risks to support preparedness prioritization in the European Union. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Affiliation(s)
- Jonathan E Suk
- 1 Country Preparedness Support Section, Public Health Capacity and Communication Unit, European Centre for Disease Prevention and Control, SE-171 83 Stockholm, Sweden
| | - Jan C Semenza
- 2 Office of the Chief Scientist, European Centre for Disease Prevention and Control, SE-171 83 Stockholm, Sweden
| |
Collapse
|
26
|
Nikolopoulos GK, Fotiou A, Kanavou E, Richardson C, Detsis M, Pharris A, Suk JE, Semenza JC, Costa-Storti C, Paraskevis D, Sypsa V, Malliori MM, Friedman SR, Hatzakis A. National income inequality and declining GDP growth rates are associated with increases in HIV diagnoses among people who inject drugs in Europe: a panel data analysis. PLoS One 2015; 10:e0122367. [PMID: 25875598 PMCID: PMC4398461 DOI: 10.1371/journal.pone.0122367] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/16/2015] [Indexed: 11/18/2022] Open
Abstract
Background There is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA). Methods We used panel data (2003–2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated. Findings In multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested. Interpretation Given the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable groups.
Collapse
Affiliation(s)
- Georgios K. Nikolopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
- Hellenic Centre for Disease Control and Prevention, Amarousio, Greece
- * E-mail:
| | - Anastasios Fotiou
- Greek Reitox Focal Point of the EMCDDA, University Mental Health Research Institute, Athens, Greece
- Department of Psychiatry, Athens University Medical School, Athens, Greece
| | - Eleftheria Kanavou
- Greek Reitox Focal Point of the EMCDDA, University Mental Health Research Institute, Athens, Greece
| | - Clive Richardson
- Greek Reitox Focal Point of the EMCDDA, University Mental Health Research Institute, Athens, Greece
- Panteion University of Social and Political Sciences, Athens, Greece
| | - Marios Detsis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jonathan E. Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jan C. Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Claudia Costa-Storti
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
| | | | - Samuel R. Friedman
- National Development and Research Institutes, New York, New York, United States of America
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
| |
Collapse
|
27
|
Vogel KM, Ozin AJ, Suk JE. Biosecurity and dual-use research: gaining function - but at what cost? Front Public Health 2015; 3:13. [PMID: 25699244 PMCID: PMC4313596 DOI: 10.3389/fpubh.2015.00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/09/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Amanda J Ozin
- European Centre for Disease Control and Prevention , Stockholm , Sweden
| | - Jonathan E Suk
- European Centre for Disease Control and Prevention , Stockholm , Sweden
| |
Collapse
|
28
|
Semenza JC, Sudre B, Miniota J, Rossi M, Hu W, Kossowsky D, Suk JE, Van Bortel W, Khan K. International dispersal of dengue through air travel: importation risk for Europe. PLoS Negl Trop Dis 2014; 8:e3278. [PMID: 25474491 PMCID: PMC4256202 DOI: 10.1371/journal.pntd.0003278] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/18/2014] [Indexed: 12/04/2022] Open
Abstract
Background The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. Aedes albopictus is a competent vector for dengue viruses (DENV) and is now established in numerous regions of Europe. Viremic travellers arriving in Europe from dengue-affected areas of the world can become catalysts of local outbreaks in Europe. Local dengue transmission in Europe is extremely rare, and the last outbreak occurred in 1927–28 in Greece. However, autochthonous transmission was reported from France in September 2010, and from Croatia between August and October 2010. Methodology We compiled data on areas affected by dengue in 2010 from web resources and surveillance reports, and collected national dengue importation data. We developed a hierarchical regression model to quantify the relationship between the number of reported dengue cases imported into Europe and the volume of airline travellers arriving from dengue-affected areas internationally. Principal Findings In 2010, over 5.8 million airline travellers entered Europe from dengue-affected areas worldwide, of which 703,396 arrived at 36 airports situated in areas where Ae. albopictus has been recorded. The adjusted incidence rate ratio for imported dengue into European countries was 1.09 (95% CI: 1.01–1.17) for every increase of 10,000 travellers; in August, September, and October the rate ratios were 1.70 (95%CI: 1.23–2.35), 1.46 (95%CI: 1.02–2.10), and 1.35 (95%CI: 1.01–1.81), respectively. Two Italian cities where the vector is present received over 50% of all travellers from dengue-affected areas, yet with the continuing vector expansion more cities will be implicated in the future. In fact, 38% more travellers arrived in 2013 into those parts of Europe where Ae. albopictus has recently been introduced, compared to 2010. Conclusions The highest risk of dengue importation in 2010 was restricted to three months and can be ranked according to arriving traveller volume from dengue-affected areas into cities where the vector is present. The presence of the vector is a necessary, but not sufficient, prerequisite for DENV onward transmission, which depends on a number of additional factors. However, our empirical model can provide spatio-temporal elements to public health interventions. The global disease burden of dengue is staggering. Continuous expansion and vaccine failures illustrate the limitations of current dengue control efforts. Novel approaches and additional tools are required to combat and contain the disease. In Europe, dengue infections are rare and the last outbreak of dengue occurred in the late 1920s, in Greece. In 2010, however, local transmission occurred in France and Croatia. Based on 2010 data, we present a novel quantitative model of the risk of dengue importation for Europe. The 2010 model predicts the risk of dengue importation to be greatest for Milan, Rome and Barcelona in August, September and October, precisely when vector activity is the highest. With the current expansion of the vector in Europe, more cities are projected to be at risk in the future. Thus, the model based on 2010 data quantifies the likelihood and timing of importation. This approach employs global travel data to assess dengue importation risk in the EU and illustrates how quantitative models could tailor infectious disease control to certain regions and time periods.
Collapse
Affiliation(s)
- Jan C. Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- * E-mail:
| | - Bertrand Sudre
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jennifer Miniota
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Massimiliano Rossi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Wei Hu
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - David Kossowsky
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jonathan E. Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Wim Van Bortel
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Kamran Khan
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
29
|
Suk JE, Van Cangh T, Beauté J, Bartels C, Tsolova S, Pharris A, Ciotti M, Semenza JC. The interconnected and cross-border nature of risks posed by infectious diseases. Glob Health Action 2014; 7:25287. [PMID: 25308818 PMCID: PMC4195207 DOI: 10.3402/gha.v7.25287] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/16/2014] [Accepted: 09/16/2014] [Indexed: 01/01/2023] Open
Abstract
Infectious diseases can constitute public health emergencies of international concern when a pathogen arises, acquires new characteristics, or is deliberately released, leading to the potential for loss of human lives as well as societal disruption. A wide range of risk drivers are now known to lead to and/or exacerbate the emergence and spread of infectious disease, including global trade and travel, the overuse of antibiotics, intensive agriculture, climate change, high population densities, and inadequate infrastructures, such as water treatment facilities. Where multiple risk drivers interact, the potential impact of a disease outbreak is amplified. The varying temporal and geographic frequency with which infectious disease events occur adds yet another layer of complexity to the issue. Mitigating the emergence and spread of infectious disease necessitates mapping and prioritising the interdependencies between public health and other sectors. Conversely, during an international public health emergency, significant disruption occurs not only to healthcare systems but also to a potentially wide range of sectors, including trade, tourism, energy, civil protection, transport, agriculture, and so on. At the same time, dealing with a disease outbreak may require a range of critical sectors for support. There is a need to move beyond narrow models of risk to better account for the interdependencies between health and other sectors so as to be able to better mitigate and respond to the risks posed by emerging infectious disease.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control, Stockholm, Sweden; Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK;
| | - Thomas Van Cangh
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cornelius Bartels
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Massimo Ciotti
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jan C Semenza
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| |
Collapse
|
30
|
Suk JE, Bartels C, Broberg E, Struelens MJ, Ozin AJ. Dual-use research debates and public health: better integration would do no harm. Front Public Health 2014; 2:114. [PMID: 25309890 PMCID: PMC4162379 DOI: 10.3389/fpubh.2014.00114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/23/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jonathan E. Suk
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cornelius Bartels
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Eeva Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marc J. Struelens
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Amanda J. Ozin
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| |
Collapse
|
31
|
Schijven J, Bouwknegt M, de Roda Husman AM, Rutjes S, Sudre B, Suk JE, Semenza JC. A decision support tool to compare waterborne and foodborne infection and/or illness risks associated with climate change. Risk Anal 2013; 33:2154-67. [PMID: 23781944 DOI: 10.1111/risa.12077] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Climate change may impact waterborne and foodborne infectious disease, but to what extent is uncertain. Estimating climate-change-associated relative infection risks from exposure to viruses, bacteria, or parasites in water or food is critical for guiding adaptation measures. We present a computational tool for strategic decision making that describes the behavior of pathogens using location-specific input data under current and projected climate conditions. Pathogen-pathway combinations are available for exposure to norovirus, Campylobacter, Cryptosporidium, and noncholera Vibrio species via drinking water, bathing water, oysters, or chicken fillets. Infection risk outcomes generated by the tool under current climate conditions correspond with those published in the literature. The tool demonstrates that increasing temperatures lead to increasing risks for infection with Campylobacter from consuming raw/undercooked chicken fillet and for Vibrio from water exposure. Increasing frequencies of drought generally lead to an elevated infection risk of exposure to persistent pathogens such as norovirus and Cryptosporidium, but decreasing risk of exposure to rapidly inactivating pathogens, like Campylobacter. The opposite is the case with increasing annual precipitation; an upsurge of heavy rainfall events leads to more peaks in infection risks in all cases. The interdisciplinary tool presented here can be used to guide climate change adaptation strategies focused on infectious diseases.
Collapse
Affiliation(s)
- Jack Schijven
- National Institute of Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, the Netherlands
| | | | | | | | | | | | | |
Collapse
|
32
|
Fischer D, Thomas SM, Suk JE, Sudre B, Hess A, Tjaden NB, Beierkuhnlein C, Semenza JC. Climate change effects on Chikungunya transmission in Europe: geospatial analysis of vector's climatic suitability and virus' temperature requirements. Int J Health Geogr 2013; 12:51. [PMID: 24219507 PMCID: PMC3834102 DOI: 10.1186/1476-072x-12-51] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 07/10/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chikungunya was, from the European perspective, considered to be a travel-related tropical mosquito-borne disease prior to the first European outbreak in Northern Italy in 2007. This was followed by cases of autochthonous transmission reported in South-eastern France in 2010. Both events occurred after the introduction, establishment and expansion of the Chikungunya-competent and highly invasive disease vector Aedes albopictus (Asian tiger mosquito) in Europe. In order to assess whether these outbreaks are indicative of the beginning of a trend or one-off events, there is a need to further examine the factors driving the potential transmission of Chikungunya in Europe. The climatic suitability, both now and in the future, is an essential starting point for such an analysis. METHODS The climatic suitability for Chikungunya outbreaks was determined by using bioclimatic factors that influence, both vector and, pathogen. Climatic suitability for the European distribution of the vector Aedes albopictus was based upon previous correlative environmental niche models. Climatic risk classes were derived by combining climatic suitability for the vector with known temperature requirements for pathogen transmission, obtained from outbreak regions. In addition, the longest potential intra-annual season for Chikungunya transmission was estimated for regions with expected vector occurrences.In order to analyse spatio-temporal trends for risk exposure and season of transmission in Europe, climate change impacts are projected for three time-frames (2011-2040, 2041-2070 and 2071-2100) and two climate scenarios (A1B and B1) from the Intergovernmental Panel on Climate Change (IPCC). These climatic projections are based on regional climate model COSMO-CLM, which builds on the global model ECHAM5. RESULTS European areas with current and future climatic suitability of Chikungunya transmission are identified. An increase in risk is projected for Western Europe (e.g. France and Benelux-States) in the first half of the 21st century and from mid-century onwards for central parts of Europe (e.g. Germany). Interestingly, the southernmost parts of Europe do not generally provide suitable conditions in these projections. Nevertheless, many Mediterranean regions will persist to be climatically suitable for transmission. Overall, the highest risk of transmission by the end of the 21st century was projected for France, Northern Italy and the Pannonian Basin (East-Central Europe). This general tendency is depicted in both, the A1B and B1 climate change scenarios. CONCLUSION In order to guide preparedness for further outbreaks, it is crucial to anticipate risk as to identify areas where specific public health measures, such as surveillance and vector control, can be implemented. However, public health practitioners need to be aware that climate is only one factor driving the transmission of vector-borne disease.
Collapse
Affiliation(s)
- Dominik Fischer
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
- Present address: Technische Universität München (TUM), Munich, Germany
| | | | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Bertrand Sudre
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Andrea Hess
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | - Nils B Tjaden
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | | | - Jan C Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
33
|
Lindgren E, Andersson Y, Suk JE, Sudre B, Semenza JC. Public health. Monitoring EU emerging infectious disease risk due to climate change. Science 2012; 336:418-9. [PMID: 22539705 DOI: 10.1126/science.1215735] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Elisabet Lindgren
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | |
Collapse
|
34
|
Semenza JC, Herbst S, Rechenburg A, Suk JE, Höser C, Schreiber C, Kistemann T. Climate Change Impact Assessment of Food- and Waterborne Diseases. Crit Rev Environ Sci Technol 2012; 42:857-890. [PMID: 24808720 PMCID: PMC3996521 DOI: 10.1080/10643389.2010.534706] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The PubMed and ScienceDirect bibliographic databases were searched for the period of 1998-2009 to evaluate the impact of climatic and environmental determinants on food- and waterborne diseases. The authors assessed 1,642 short and concise sentences (key facts), which were extracted from 722 relevant articles and stored in a climate change knowledge base. Key facts pertaining to temperature, precipitation, water, and food for 6 selected pathogens were scrutinized, evaluated, and compiled according to exposure pathways. These key facts (corresponding to approximately 50,000 words) were mapped to 275 terminology terms identified in the literature, which generated 6,341 connections. These relationships were plotted on semantic network maps to examine the interconnections between variables. The risk of campylobacteriosis is associated with mean weekly temperatures, although this link is shown more strongly in the literature relating to salmonellosis. Irregular and severe rain events are associated with Cryptosporidium sp. outbreaks, while noncholera Vibrio sp. displays increased growth rates in coastal waters during hot summers. In contrast, for Norovirus and Listeria sp. the association with climatic variables was relatively weak, but much stronger for food determinants. Electronic data mining to assess the impact of climate change on food- and waterborne diseases assured a methodical appraisal of the field. This climate change knowledge base can support national climate change vulnerability, impact, and adaptation assessments and facilitate the management of future threats from infectious diseases. In the light of diminishing resources for public health this approach can help balance different climate change adaptation options.
Collapse
Affiliation(s)
- Jan C. Semenza
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Susanne Herbst
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Andrea Rechenburg
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Jonathan E. Suk
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Christoph Höser
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Christiane Schreiber
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Thomas Kistemann
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| |
Collapse
|
35
|
Semenza JC, Suk JE, Estevez V, Ebi KL, Lindgren E. Mapping climate change vulnerabilities to infectious diseases in Europe. Environ Health Perspect 2012; 120:385-92. [PMID: 22113877 PMCID: PMC3295348 DOI: 10.1289/ehp.1103805] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 11/23/2011] [Indexed: 05/03/2023]
Abstract
BACKGROUND The incidence, outbreak frequency, and distribution of many infectious diseases are generally expected to change as a consequence of climate change, yet there is limited regional information available to guide decision making. OBJECTIVE We surveyed government officials designated as Competent Bodies for Scientific Advice concerning infectious diseases to examine the degree to which they are concerned about potential effects of climate change on infectious diseases, as well as their perceptions of institutional capacities in their respective countries. METHODS In 2007 and 2009/2010, national infectious disease experts from 30 European Economic Area countries were surveyed about recent and projected infectious disease patterns in relation to climate change in their countries and the national capacity to cope with them. RESULTS A large majority of respondents agreed that climate change would affect vector-borne (86% of country representatives), food-borne (70%), water-borne (68%), and rodent-borne (68%) diseases in their countries. In addition, most indicated that institutional improvements are needed for ongoing surveillance programs (83%), collaboration with the veterinary sector (69%), management of animal disease outbreaks (66%), national monitoring and control of climate-sensitive infectious diseases (64%), health services during an infectious disease outbreak (61%), and diagnostic support during an epidemic (54%). CONCLUSIONS Expert responses were generally consistent with the peer-reviewed literature regarding the relationship between climate change and vector- and water-borne diseases, but were less so for food-borne diseases. Shortcomings in institutional capacity to manage climate change vulnerability, identified in this assessment, should be addressed in impact, vulnerability, and adaptation assessments.
Collapse
Affiliation(s)
- Jan C Semenza
- Office of the Chief Scientist, European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
36
|
Semenza JC, Höuser C, Herbst S, Rechenburg A, Suk JE, Frechen T, Kistemann T. Knowledge Mapping for Climate Change and Food- and Waterborne Diseases. Crit Rev Environ Sci Technol 2012; 42:378-411. [PMID: 24771989 PMCID: PMC3996524 DOI: 10.1080/10643389.2010.518520] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The authors extracted from the PubMed and ScienceDirect bibliographic databases all articles published between 1998 and 2009 that were relevant to climate change and food- and waterborne diseases. Any material within each article that provided information about a relevant pathogen and its relationship with climate and climate change was summarized as a key fact, entered into a relational knowledge base, and tagged with the terminology (predefined terms) used in the field. These terms were organized, quantified, and mapped according to predefined hierarchical categories. For noncholera Vibrio sp. and Cryptosporidium sp., data on climatic and environmental influences (52% and 49% of the total number of key facts, respectively) pertained to specific weather phenomena (as opposed to climate change phenomena) and environmental determinants, whereas information on the potential effects of food-related determinants that might be related to climate or climate change were virtually absent. This proportion was lower for the other pathogens studied (Campylobacter sp. 40%, Salmonella sp. 27%, Norovirus 25%, Listeria sp. 8%), but they all displayed a distinct concentration of information on general food-and water-related determinants or effects, albeit with little detail. Almost no information was available concerning the potential effects of changes in climatic variables on the pathogens evaluated, such as changes in air or water temperature, precipitation, humidity, UV radiation, wind, cloud coverage, sunshine hours, or seasonality. Frequency profiles revealed an abundance of data on weather and food-specific determinants, but also exposed extensive data deficiencies, particularly with regard to the potential effects of climate change on the pathogens evaluated. A reprioritization of public health research is warranted to ensure that funding is dedicated to explicitly studying the effects of changes in climate variables on food- and waterborne diseases.
Collapse
Affiliation(s)
- Jan C. Semenza
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Address correspondence to Jan, C. Semenza, Head of Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11A, S-171 83 Stockholm, Sweden. E-mail:
| | - Christoph Höuser
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Susanne Herbst
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Andrea Rechenburg
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jonathan E. Suk
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Tobias Frechen
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| | - Thomas Kistemann
- Institute for Hygiene and Public Health, Department of Medical Geography and Public Health, University of Bonn, Bonn, Germany
| |
Collapse
|
37
|
Rechel B, Suhrcke M, Tsolova S, Suk JE, Desai M, McKee M, Stuckler D, Abubakar I, Hunter P, Senek M, Semenza JC. Economic crisis and communicable disease control in Europe: A scoping study among national experts. Health Policy 2011; 103:168-75. [DOI: 10.1016/j.healthpol.2011.06.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 05/11/2011] [Accepted: 06/28/2011] [Indexed: 11/30/2022]
|
38
|
Pharris A, Wiessing L, Sfetcu O, Hedrich D, Botescu A, Fotiou A, Nikolopoulos GK, Malliori M, Salminen M, Suk JE, Griffiths P, van de Laar MJ. Human immunodeficiency virus in injecting drug users in Europe following a reported increase of cases in Greece and Romania, 2011. Euro Surveill 2011; 16:20032. [PMID: 22172301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Greece and Romania reported an increased number of HIV cases among injecting drug users (IDUs) during 2011. Most European countries reported no changes in the rate of newly diagnosed cases of HIV or HIV prevalence in IDUs; however, six countries did report increases and several additional countries reported increases in injecting risk indicators or low coverage of prevention services. These indicate a potential risk for increased HIV transmission and future outbreaks unless adequate prevention is implemented.
Collapse
Affiliation(s)
- A Pharris
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Pharris A, Wiessing L, Sfetcu O, Hedrich D, Botescu A, Fotiou A, Nikolopoulos GK, Malliori M, Salminen M, Suk JE, Griffiths P, van de Laar MJ. Human immunodeficiency virus in injecting drug users in Europe following a reported increase of cases in Greece and Romania, 2011. Euro Surveill 2011. [DOI: 10.2807/ese.16.48.20032-en] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Greece and Romania reported an increased number of HIV cases among injecting drug users (IDUs) during 2011. Most European countries reported no changes in the rate of newly diagnosed cases of HIV or HIV prevalence in IDUs; however, six countries did report increases and several additional countries reported increases in injecting risk indicators or low coverage of prevention services. These indicate a potential risk for increased HIV transmission and future outbreaks unless adequate prevention is implemented.
Collapse
Affiliation(s)
- A Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - L Wiessing
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - O Sfetcu
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - D Hedrich
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - A Botescu
- National Observatory on Drugs, National Anti-Drug Agency, Bucharest, Romania
| | - A Fotiou
- National Focal Point of the EMCDDA, University Mental Health Research Institute, Athens, Greece
| | - G K Nikolopoulos
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - M Malliori
- Organisation Against Drugs (OKANA), Athens, Greece
| | - M Salminen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - P Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - M J van de Laar
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
40
|
Zmorzynska A, Suk JE, Biederbick W, Maidhof H, Sasse J, Semenza JC, Hunger I. Unfinished business: efforts to define dual-use research of bioterrorism concern. Biosecur Bioterror 2011; 9:372-8. [PMID: 22060036 DOI: 10.1089/bsp.2011.0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Biotechnological research poses a special security problem because of the duality between beneficial use and misuse. In order to find a balance between regulating potentially dangerous research and assuring scientific advancement, a number of assessments have tried to define which types of research are especially open to misuse and should therefore be considered dual-use research of special concern requiring rigorous oversight. So far, there has been no common understanding of what such activities are. Here we present a review of 27 assessments focusing on biological dual-use issues published between 1997 and 2008. Dual-use research activities identified by these assessments as being of special concern were compiled and compared. Moreover, from these 27 assessments, the primary research publications explicitly identified as examples of concerning research activities were extracted and analyzed. We extracted a core list of 11 activities of special concern and show that this list does not match with the reasons why primary research publications were identified as being of special concern. Additionally, we note that the 11 activities identified are not easily conducted or replicated, and therefore the likelihood of their being used in a high-tech mass casualty bioterrorism event should be reevaluated.
Collapse
Affiliation(s)
- Anna Zmorzynska
- Research Group for Biological Arms Control, Weizsäcker Centre for Science and Peace Research, University of Hamburg, Hamburg, Germany.
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
We examined how different drivers of infectious disease could interact to threaten control efforts in Europe. We considered projected trends through 2020 for 3 broad groups of drivers: globalization and environmental change, social and demographic change, and health system capacity. Eight plausible infectious disease threats with the potential to be significantly more problematic than they are today were identified through an expert consultation: extensively drug-resistant bacteria, vector-borne diseases, sexually transmitted infections, food-borne infections, a resurgence of vaccine-preventable diseases, health care-associated infections, multidrug-resistant tuberculosis, and pandemic influenza. Preemptive measures to be taken by the public health community to counteract these threats were identified.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | |
Collapse
|
42
|
Suhrcke M, Stuckler D, Suk JE, Desai M, Senek M, McKee M, Tsolova S, Basu S, Abubakar I, Hunter P, Rechel B, Semenza JC. The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLoS One 2011; 6:e20724. [PMID: 21695209 PMCID: PMC3112201 DOI: 10.1371/journal.pone.0020724] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 05/11/2011] [Indexed: 11/19/2022] Open
Abstract
There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
Collapse
Affiliation(s)
- Marc Suhrcke
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - David Stuckler
- Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jonathan E. Suk
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Monica Desai
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michaela Senek
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Svetla Tsolova
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sanjay Basu
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Ibrahim Abubakar
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Paul Hunter
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Boika Rechel
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | - Jan C. Semenza
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
43
|
Suk JE, Zmorzynska A, Hunger I, Biederbick W, Sasse J, Maidhof H, Semenza JC. Dual-use research and technological diffusion: reconsidering the bioterrorism threat spectrum. PLoS Pathog 2011; 7:e1001253. [PMID: 21249234 PMCID: PMC3020926 DOI: 10.1371/journal.ppat.1001253] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jonathan E Suk
- Scientific Advice Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | | | | | | | | | | | | |
Collapse
|
44
|
Suhrcke M, Stuckler D, Suk JE, Desai M, Senek M, McKee M, Tsolova S, Basu S, Abubakar I, Hunter P, Rechel B, Semenza JC. The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLoS One 2011. [PMID: 21695209 DOI: 10.1371/2fjournal.pone.0020724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
Collapse
Affiliation(s)
- Marc Suhrcke
- Norwich School of Medicine, University of East Anglia, Norwich, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Affiliation(s)
- J C Semenza
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - S Tsolova
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| |
Collapse
|
46
|
|
47
|
Abstract
In Europe, wealth inequality is directly related to tuberculosis (TB) notification (R2 = 0.69), while in countries with lower TB rates, higher proportions of TB cases occur in foreign-born persons. Particularly during times of financial upheaval, efforts to eliminate TB must address social inequality.
Collapse
Affiliation(s)
- Jonathan E Suk
- European Centre for Disease Prevention and Control Scientific Advice Unit, Stockholm S-171 83, Sweden
| | | | | | | |
Collapse
|
48
|
Suhrcke M, McKee M, Stuckler D, Suk JE, Tsolova S, Semenza JC. The economic crisis and infectious disease control. Euro Surveill 2009. [DOI: 10.2807/ese.14.45.19401-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Suhrcke
- London School of Hygiene & Tropical Medicine, United Kingdom
- University of East Anglia, United Kingdom
| | - M McKee
- European Observatory on Health Systems and Policies, Belgium
- London School of Hygiene & Tropical Medicine, United Kingdom
| | - D Stuckler
- University of Oxford, United Kingdom
- London School of Hygiene & Tropical Medicine, United Kingdom
| | - J E Suk
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control, Sweden
| | - S Tsolova
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control, Sweden
| | - J C Semenza
- Future Threats and Determinants Section, Scientific Advice Unit, European Centre for Disease Prevention and Control, Sweden
| |
Collapse
|
49
|
Suk JE, Lyall C, Tait J. Mapping the future dynamics of disease transmission: risk analysis in the United Kingdom Foresight Programme on the detection and identification of infectious diseases. Euro Surveill 2008. [DOI: 10.2807/ese.13.44.19021-en] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This paper reflects on the qualitative risk analysis framework developed for a Foresight study on the Detection and Identification of Infectious Diseases, which was coordinated in 2005 by the United Kingdom (UK) under what is now the Government Office for Science, Department for Innovation, Universities and Skills. The risk assessment covered human, plant and animal diseases in the UK and Africa in the years 2015 and 2030. Through engaging a diverse pool of experts, we developed a model conceptualising disease spread as the outcome of interactions among sources, pathways and drivers. We then used this model to conduct a Delphi survey of experts. The factors perceived most likely to contribute to infectious disease spread in 2015 and 2030 included geographic extension of existing pathogens (partially due to climate change), over-use of antibiotics/antivirals/pesticides leading to drug resistance, and zoonoses. Our methodology provides a framework for those who need to integrate a wide range of perspectives and factors into their planning and analyses.
Collapse
Affiliation(s)
- J E Suk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Economic and Social Research Council (ESRC) Innogen Centre, Institute for the Study of Science, Technology and Innovation (ISSTI), University of Edinburgh, United Kingdom
| | - C Lyall
- Economic and Social Research Council (ESRC) Innogen Centre, Institute for the Study of Science, Technology and Innovation (ISSTI), University of Edinburgh, United Kingdom
| | - J Tait
- Economic and Social Research Council (ESRC) Innogen Centre, Institute for the Study of Science, Technology and Innovation (ISSTI), University of Edinburgh, United Kingdom
| |
Collapse
|
50
|
|