Joint meeting of the ECDC Emerging and Vectorborne Diseases Network, the EFSA Scientific Network for Risk Assessment in Animal Health and Welfare and the EFSA Task Force on Zoonoses Data Collection

ECDC, Stockholm, Sweden, 5-6 December 2013

2

Table of Contents Table of Contents ............................................................................................................ 2 Summary ......................................................................................................................... 3 Objectives of the meeting ................................................................................................ 3 Participants ..................................................................................................................... 3 Introduction to the meeting .............................................................................................. 4 Networks ......................................................................................................................... 4

Presentation of EVD network ....................................................................................... 4 EFSA Scientific Network for Risk Assessment in Animal Health and Welfare .............. 5 Presentation of EFSA Task Force on Zoonoses Data Collection ................................. 6

Animal and human health sector collaborations .............................................................. 7 ECDC-EFSA collaboration: Collaboration at the animal-human interface on non-foodborne zoonotic and potential zoonotic diseases .................................................... 7 UK and Sweden - Examples from existing animal health-public health collaboration within MS ..................................................................................................................... 8 VectorNet - a project for a common database on vectors of public and animal health . 9 Extranet platform for communication for networks ..................................................... 10 Activities on non-foodborne Zoonoses Data .............................................................. 10 Workshop: contributions and future plans for the joint networks activities .................. 11

Roadmap for ECDC and EFSA networks ...................................................................... 13 Conclusions................................................................................................................... 14 I. Annex 1 – Agenda ................................................................................................. 15 II. Annex 2 – List of participants ................................................................................. 17

3

Summary The first joint meeting of the ECDC Emerging and Vectorborne Disease Network (EVD), the EFSA Scientific Network for Risk Assessment in Animal Health and Welfare (AHAW) and the EFSA Task Force on Zoonoses Data Collection (TFZDC) was held on 5 and 6 December 2013 in Stockholm. The main aim of the joint meeting was to enhance collaboration at the animal-human interface on non-foodborne zoonotic and potential zoonotic diseases at national and European level. The designated experts from EU Member States from the human and animal health side were presented with (i) ECDC and EFSA activities and joint initiatives regarding non-foodborne zoonoses and vectors; (ii) the examples of collaboration between human and animal health sectors in the UK and Sweden; and (iii) participated in the discussions about status and needs of surveillance of non-foodborne zoonoses in animals, in humans exposed to animals, and of information exchange modalities between both sectors.

Objectives of the meeting

• To present the agencies and networks to meeting participants • To present the background, actions and plans for collaboration between human

and animal health sectors on non-foodborne zoonotic diseases at EU level (agencies and MSs), including the common vector database and a potential extranet platform for communication

• To agree upon a roadmap for the interactions between ECDC-EVD network and the relevant EFSA networks

See ANNEX 1 for the detailed agenda. Participants The meeting was attended by 44 participants from the ECDC EVD Network, the EFSA-AHAW Network and the EFSA TFZDC.

See ANNEX 2 for the detailed list of participants.

4

Introduction to the meeting After a short introduction to welcome meeting participants by Johan Giesecke, Chief Scientist of ECDC, an outline of the general meeting objectives was given by Andrea Gervelmeyer, Animal Health and Welfare Unit, EFSA; they were to present the background, actions and plans for collaboration between human and animal health on non-foodborne zoonotic diseases at EU level (agencies) and in Member States, to discuss ways of improvement, and to agree upon a roadmap for the interactions between ECDC-EVD network and the relevant EFSA networks. A tour de table was proposed to allow participants to present themselves (name, country, organisation, areas of expertise).

Networks

Presentation of EVD network Herve Zeller, head of the Emerging and Vector-borne Disease (EVD) Programme at ECDC, presented briefly ECDC’s mandate and EVD activities. ECDC has five main domains of activity: (i) Epidemic intelligence which consists of threat monitoring (media and other sources of information) and handling the Early Warning and Response System (EWRS) (confidential communication platform between EU ministries of health); (ii) EU level disease surveillance through data collection from MS in The European Surveillance System (TESSy) on 52 notifiable diseases or conditions; (iii) scientific advice based on expert consultations and procurements for research work; (iv) technical assistance and training for MSs and potential candidate countries to the EU; and (v) communication to the professional, scientific and general community. There are eight disease programmes at ECDC: Antimicrobial Resistance and Healthcare-associated Infections; HIV, STI and Blood-borne Viruses; Acute Respiratory Illness; Tuberculosis; Vaccine-preventable Diseases and Invasive Bacterial Infections; Food- and Waterborne Diseases and Zoonoses; Emerging and Vector-borne Diseases; and Health Inequalities and Migrant Health. The EVD programme deals with mosquito-borne diseases (West Nile fever, dengue, chikungunya, malaria, yellow fever), tick-borne diseases (tick-borne encephalitis, Lyme borreliosis, rickettsiosis, Crimean-Congo haemorrhagic fever), sandfly-borne diseases (leishmaniasis, sandfly fevers), other non-food-borne zoonoses (Q fever, rabies, plague, hantavirus infections, arenaviruses, filoviruses, Rift Valley fever, …). The on-going and planned activities concerning the main diseases are split into: surveillance (annual analysis of collected data or real-time reporting for West Nile fever for example), developing risk assessment and prediction tools, elaborating guidance on disease diagnosis/detection and vector surveillance, and providing updated information on vector and pathogen distribution. EVD collaboration with external stakeholders is done through contacts with professional networks and on-going EU funded research projects, a network of national focal points (nominated by MS) that meets annually, with ad hoc nominated experts for specific topics, an ECDC funded network of public health entomologists (VBORNET, www.vbornet.eu) and an ECDC funded network of laboratories specialized in diagnosis of exotic and emerging viral diseases (ENIVD, www.enivd.de).

5

The EVD network is a new entity of nominated experts from EU/EEA Member states who to advise the Disease Programme on surveillance, prevention and control or any other disease related technical, epidemiological or scientific aspects, together with enhancing networking by reinforcing national and international connections of multidisciplinary experts. The experts met for the first time yesterday on 4 December 2013.

EFSA Scientific Network for Risk Assessment in Animal Health and Welfare

Andrea Gervelmeyer, senior officer of the EFSA Animal Health and Welfare Unit, briefly introduced the mandate of the European Food Safety Authority (see presentation “EFSA_AHAW” on extranet). Based on its funding Regulation (EC) No 178/2002, EFSA is tasked to provide scientific advice and scientific and technical support for the Community's legislation and policies on food and feed safety, to collect and analyse data to allow the characterisation and monitoring of risks linked to food and feed safety as well as provide independent information and communicate on risks. Its work is based on four fundamental elements: independence, scientific and technical quality, transparency and collaboration with Member States. The EFSA Panel on Animal Health and Welfare (AHAW Panel) together with the EFSA Unit on Animal Health and Welfare (AHAW Unit) provides independent scientific advice on all aspects of animal diseases and animal welfare of predominantly, but not limited to food producing animals, including fish. For its scientific opinions and advice, the EFSA AHAW Panel reviews scientific information and data and applies them in its risk assessments to evaluate risks as consequences of a hazard. The scientific opinions produced by the panel serve as a science-based foundation for European policies and legislation and support risk managers in taking balanced and timely decisions. The AHAW Panel often has to assess the risks of introduction and spread of exotic pathogens into the EU as well as options for control and prevention, including diagnostic tools and treatments. EFSA’s role in animal health consists of advising the European Commission on surveillance options, assessing surveillance system results and advising European Commission and MS on the data to be collected in surveillance activities. The EFSA Scientific Network for Risk Assessment in Animal Health and Welfare has been established in 2010. It consists of nationally appointed EU Member State organisations with expertise in animal health and welfare risk assessment as well as observers from the Commission and neighboring countries. Its main objective is to facilitate scientific cooperation in the field of EFSA’s mission between EFSA and Member States. Specifically, it facilitates harmonisation of risk assessment practices and methodologies, enhances exchange of information and data between EFSA and MS, tries to achieve synergies in risk assessment activities in the area of animal health and welfare and strives to improve collaboration between animal health and public health on non-foodborne zoonotic and potential zoonotic issues. In addition to the general meetings, the network also carries out activities dedicated to specific questions. In the area of bovine tuberculosis the network members shared data from scientific studies on diagnostic test performance with EFSA. Regarding the recent emergence of Schmallenberg virus (SBV) the network and EFSA jointly developed the case definition and the data model for surveillance and EFSA coordinated an inventory of research initiatives on SBV in EU Member States. With it network members, EFSA has harmonised Member States’ approaches to Echinococcus multilocularis surveillance

6

and the ensuing surveillance reports. In the field of broiler welfare, the network was instrumental in the preparation of a data collection system of welfare indicators in EU broilers’ slaughterhouses. In a recent review, network members acknowledged that the network succeeds in harmonising approaches to tasks that all or several MS have to address (e.g. demonstration of diseases freedom), that it assists in bringing together expertise and stakeholders needed, disseminates information on current, past, future activities of EFSA, MS. It was also seen to identify research needs and priorities for research in the area of animal health and welfare. So far, five general meetings were held, focusing on information exchange on respective ongoing and planned risk assessment activities, combined with dedicated sessions on methodological aspects of risk assessment in animal welfare, the use of modeling in risk assessment and on the needs for, the availability of and the access to data for risk assessments. For 2014, the network has planned 2 general meetings, to be held in June and November, each with one day dedicated to animal welfare and one day to animal health day. In addition, it is foreseen to have a workshop dedicated to wildlife surveillance and to document current animal health early warning systems/syndromic surveillance systems of MS.

Presentation of EFSA Task Force on Zoonoses Data Collection Frank Boelaert, deputy head of EFSA’s Biological Monitoring Unit, presented briefly the work related to EFSA’s Task Force on Zoonoses Data Collection (presentation “EFSA_TFZDC” on extranet). This EFSA network, established in 2004, carries out its data collection work according to pre-arranged procedures set by European legislation. It consists of a pan-European network of national representatives and international organisations that assist EFSA by gathering and sharing information on zoonoses in their respective countries. It advices EFSA in the development of electronic reporting tools and databases, development of harmonised monitoring and reporting specifications for Member States (MSs), definition of the most optimal ways to analyse the data, setting priorities for the harmonisation of monitoring and for collection of data, exchange of information and data between EFSA and MSs; and review, use and publication of the data collected. EFSA uses these data to monitor and analyse the situation with regard to zoonoses, antimicrobial resistance and food-borne outbreaks across Europe. The results are presented in the annual European Union Summary Reports (EUSRs) on zoonoses, food-borne outbreaks and antimicrobial resistance and in other reports on specific zoonoses issues. Data collection and analysis helps identifying sources and trends of zoonoses and zoonotic agents and provides the bases to develop evidence-informed health policy. These analyses help in identifying appropriate priority-setting goals, such as reduction targets, and provide the means to evaluate the adequate development of control programmes in the EU. The Task Force on Zoonoses data collection holds regular meetings to discuss work in progress. For these meetings, EFSA publishes the minutes following their approval. It is the European Union (EU) Directive 2003/99/EC that obligates the EU MSs to collect data on zoonoses and zoonotic agents every year, and that requests the EFSA to analyse these data and to publish an annual European Union Summary Report (EUSR).

7

EFSA’s Biological Monitoring (BIOMO) Unit is in charge for this zoonoses data collection and, in collaboration with the European Centre for Disease Prevention and Control (ECDC), analysis the data and produces the annual EUSRs. The monitoring and reporting system used is based on that of MSs, and in a few cases it is harmonised by EU legislation to the extent that the results from the monitoring are directly comparable between MSs. MSs have to submit data each year of eight zoonoses (Annex I of Directive 2003/99/EC, list A) and food-borne outbreaks: Salmonella (+ antimicrobial resistance), Campylobacter (+ antimicrobial resistance), Listeria monocytogenes, Brucella, Tuberculosis due to Mycobacterium bovis, verotoxigenic Escherichia coli, Trichinella and Echinococcus.

Animal and human health sector collaborations

ECDC-EFSA collaboration: Collaboration at the animal-human interface on non-foodborne zoonotic and potential zoonotic diseases

Andrea Gervelmeyer introduced the initiative of EFSA and ECDC to improve the collaboration at the animal-human interface on non-foodborne zoonotic and potential zoonotic diseases (presentation “ECDC_EFSA_Collaboration” on extranet). While approximately 61% of infectious human pathogens are zoonotic, 75 % of emerging pathogens are zoonotic. Drivers for emergence of zoonotic disease emergence are agricultural intensification, population growth, climate change, but also increasing human encroachment into wildlife habitats. Recent examples of non-foodborne zoonotic or potential zoonotic hazards challenging the EU include the large Q-Fever outbreak in the Netherlands, the emergence of Influenza A/H1N1/pdm09 virus and, most recently, Schmallenberg virus, whose zoonotic potential had to be assessed when it emerged. It is obvious that diseases that are integrated in animals, humans and in the environment can best be tackled by using integrated approaches. These encompass integrated approaches to predicting risk for outbreaks of diseases in humans and animals, integrated investigation of outbreaks of zoonotic diseases and, finally, integrated interventions targeting humans, animal, and the environment, with “integrated” implying a collaboration of animal health, public health and environmental health. The EFSA-ECDC initiative has the objectives to strengthen collaboration between the animal health and public health sector with view to non-foodborne zoonotic and emerging diseases and to early detection and rapid joint risk assessment of these. It aims at identifying existing mechanisms for collaboration and for joint risk assessments and at identifying any remaining gaps and developing plans for filling these gaps. Specifically, EFSA and ECDC would like to take the lead in facilitating a closer collaboration between animal health and public health sectors at EU Member States’ and at the EU level to increase the European preparedness for outbreaks of non-foodborne zoonotic and potential zoonotic diseases. Through joint activities of the animal health and public health networks, the capacity for joint risk assessments of non-foodborne zoonotic diseases at the European level should be improved. A better collaboration between the sectors within Member States and a rapid and timely exchange of information and data to underpin rapid risk assessment shall be facilitated. Finally, the agencies could coordinate cross border investigations of supranational outbreaks.

8

The proposed means for such collaboration are meetings and a collaboration platform. Joint meetings of networks could be used to identify non-foodborne zoonotic diseases that require a supranational approach and to identify research needs and priority questions on non-foodborne zoonotic diseases. A collaboration platform could facilitate the exchange about new potential non-foodborne zoonotic threats, to agree on data and information needs regarding outbreak investigations, to exchange data and information on outbreaks and surveillance activities as well as to develop and store tools (case definitions, data models, risk assessment frameworks).

UK and Sweden - Examples from existing animal health-public health collaboration within MS

Dilys Morgan from “Public Health England” presented the animal health and public health collaboration in the UK (presentation “UK_Animal_Human” on extranet). The Human-Animal Infections and Risk Surveillance (HAIRS) Group was established in 2003. It is a multiagency group meeting every month and acting as a forum to identify and discuss infections with potential for interspecies transfer and particularly zoonotic infections (http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/EmergingInfections/HAIRS/). It is composed of Public Health England (chair and secretariat), the Department of Health, the Department for Environment, Food & Rural Affairs, the Animal Health & Veterinary Laboratories Agency, the Food Standards Agency, Public Health Wales/ Welsh Government, Health Protection Scotland/ Scottish Government, Public Health Agency Northern Ireland and the Department of Agriculture and Rural Development of Northern Ireland. It deals with hazard identification in identifying and reviewing potentially zoonotic incidents In UK or internationally, with risk assessment in a multidisciplinary, cross-sectorial team if needed and no other group or committee is responsible, and with risk management by advising on or implementing risk reduction measures. Communication is also part of the assignment, through widely shared notifications, statements, assessments, enquiry replies, monthly summary reports, yearly reports, guidance documents and standard operating procedures. Close working relationships and networking have developed also through regular reporting activities and joint outbreak investigations. The group is recognised as providing a multidisciplinary focal point for referring potential zoonotic incidents. Ann Lindberg, from the Swedish Zoonosis Centre at the National Veterinary Institute (SVA), presented the Animal health - Public health collaboration in Sweden (presentation “SWEDEN_Animal_Human” on extranet). Three fora between the Board of Agriculture, the National Veterinary Institute, the National Food Agency, the National Board of Health and Welfare, the Public Health Agency, the Work Environment Authority, the Environmental Protection Agency, the Agency for Marine and Water Management and regional/local administration, have been set up:

– The Swedish Zoonosis Council (secretariat at the Zoonosis Centre of National Veterinary Institute) which operates periodically to facilitate coordination of activities concerning zoonoses, facilitate exchange of information with other collaborative platforms, identify and set research priorities and develop guidelines.

9

– ”Zoonossamverkansgruppen” (summoned by National Board of Health and Welfare) which is an incident management group set up to coordinate and exchange information in an outbreak situation

– Central Outbreak Group (CUG) which is charge of continuous information exchange between bodies regarding food-borne outbreaks.

The collaboration between these fora was developed as a project funded by Swedish Civil Contingencies Agency 2011-2013 with the objective to facilitate and streamline collaboration and make it more cost-efficient, and to improve joint situation assessment regarding zoonoses. Joint strategy and prioritisation documents, data sharing, outbreak investigations methods and ways of joint communication were developed. Over time and with the help of the project the degree of interaction between concerned parties evolved from passive consultation through more reactive cooperation to proactive coordination and strategic planning. The discussion after the presentations highlighted that documents on the collaboration are publicly available albeit in Swedish for Sweden. Also, joint training courses on zoonoses are held for veterinarians and public health workers. It was specified that incident assessment was more based on expert opinion in the UK, while an approach based on literature was privileged in Sweden, with a more structured integration of activities in the work plan of all involved bodies and common funding. Currently the Ministry of Environment is only involved when solicited, because of budget restrictions; probably the development of wildlife/ecohealth surveillance would improve this aspect. It was also mentioned that a platform for communication at the EU level would be helpful to elaborate on EWRS alerts, and include RASSF alerts if relevant. In Italy, both animal and public health are in the same ministry, and cooperation is materialized by weekly information exchange, development of common reporting standards and automatic data exchange. In Ireland a bottom-up approach is used with local/regional groups dealing first with an issue who could than get together at national level.

VectorNet - a project for a common database on vectors of public and animal health

Wim Van Bortel presented the inter-institutional VectorNet: A European network for sharing data on the geographic distribution of arthropod vectors, transmitting human and animal disease agents, launched recently by ECDC and EFSA (presentation “VectorNet project” on extranet). This collaborative project between the European Food Safety Agency (EFSA) and the European Centre for Disease Prevention and Control (ECDC) aims to improve the preparedness and responsiveness for vector-borne diseases in the European Union (EU). The purpose of the project is: (i) to maintain a web-based data repository on the geographic distribution of vectors and the pathogens they transmit to humans and/or animals; (ii) to extend the existing network of medical entomologists and public health professionals, originally established during the VBORNET project (i.e. the network of medical entomologists and public health experts funded by the ECDC); and (iii) to include veterinary entomologists and veterinarians working in the field of vectors and /or vector-borne diseases (VBD) to the existing network.

10

The deliverables from this project will also strengthen the existing collaboration between EFSA and ECDC in the context of VBD. Previously, data collections on geographic distributions of vectors and vector-borne pathogens have been exchanged on a regular basis and comments on draft calls for proposals or scientific reports have been provided in both directions between the two agencies. Furthermore, joint data collection activities could bring a synergistic effect and added value to individual databases both agencies already developed, through an enlarged coverage of included vector species, hosts and pathogens and would avoid a duplication of effort. Strengthened collaboration between the two agencies is more cost effective and it would fit under the collaboration agreement on non-food borne zoonotic and potential zoonotic diseases between the agencies, already endorsed by ECDC and EFSA. A key aspect of the project is to extend the network of medical entomologists and public health professionals, already established during the VBORNET project, to include veterinary entomologists and veterinarians working in the field of vectors and /or vector-borne diseases. This will improve the visibility, communication and collaboration between experts and organisations from the medical and veterinary domains and is in line with other “One Health” initiatives. The involvement of the Network with expertise in vectors and vector-borne disease research, surveillance and monitoring is required for active data collection, and improvements in validation and quality assessment protocols. The deliverables from this framework contract (in particular the availability of fully validated datasets) will result in better preparedness for risk assessments and facilitate the delivery of rapid outbreak assessments, ensuring a timely and appropriate response to vector-borne diseases.

Extranet platform for communication for networks Cristian Avram from ECDC presented the proof of concept for the collaboration platform (Extranet) that ECDC can potentially put in place should network members find it beneficial. Such a collaboration platform would provide members the opportunity to work on documents, be in a closer contact with the network’s activities, have the chance to contribute to shared documents etc. Additional benefits of using an ECDC extranet would be that only nominated users would have access to it, in a controlled, nomination based manner. EVD extranet is available under: http://nextranet.ecdcdmz.europa.eu/EVD/default.aspx. With user credential, all the meeting documents and presentations can be accessed.

Activities on non-foodborne Zoonoses Data Frank Boelaert gave a brief overview of EFSA’s activities on annual non-foodborne zoonoses data collection (presentation “EFSA_ZoonosesData” on extranet). According to Directive 2003/99/EC, the reporting of information on other zoonoses (Annex I, list B) than the eight mandatory ones (Salmonella, Campylobacter, Listeria monocytogenes, Brucella, Tuberculosis due to Mycobacterium bovis, verotoxigenic Escherichia coli, Trichinella and Echinococcus) takes place on the basis of the epidemiological situation in the country, which means that MSs should report the information if this zoonotic agent is considered to be of importance in their country. Currently, EFSA’s zoonoses data collection covers seven additional zoonoses, amongst which rabies, Q fever, West Nile virus (WNV), Yersinia, and Toxoplasma. The year 2012 was the first one when the MSs reported data on WNV in animals, with the majority of positive findings in horses reported in south of Europe. The meeting commented that, for

11

certain non-foodborne zoonoses, clear case definitions are needed (e.g. serological results versus clinical signs) and that surveillance system (active versus passive) in place in different MSs should be added for specific zoonoses (e.g. WNV) to avoid misinterpretation of data.

Workshop: contributions and future plans for the joint networks activities The aim of the workshop was to make an overview of existing surveillance activities concerning livestock, pets and wildlife, concerning humans exposed to animals, and information exchange facilities between human and animal health; it was also to discuss how to improve the surveillance of non-food-borne zoonoses at EU level, to meet MSs needs. Participants were split in three groups, one for each topic. Livestock, wildlife and pet surveillance for non-foodborne zoonotic diseases The discussion aimed to capture the current status of surveillance for non-foodborne zoonotic diseases in animals and define needs for further developments. The group consisted of network representatives from the United Kingdom, Finland, Belgium, Estonia, Spain, Norway, Bulgaria and Italy. While all MS are operating both active and passive surveillance for a range of zoonotic diseases in a range of animal species, the case definitions and the data models used are very variable between countries. The interaction between public and animal health sectors also varies from regular and formalised collaboration to informal exchanges, which are sometimes limited to the local level. Often it was the repeated occurrence of important zoonotic events that led to an improved inter-sectorial collaboration and information exchanges. Some MS involve private veterinarians in gathering information about zoonotic events, while others rely solely on official veterinary services. It was highlighted that due to non-compliance of private laboratories to report diagnoses of listed diseases to competent MS’s authorities, some outbreaks in animals will not be detected early. All countries carry out monitoring of diseases listed in the Zoonoses Directive 2003/99/EC. Meeting participants inquired about the prioritisation process that has led to the diseases currently listed in the Directive and if it would be updated in the near future to reflect current priorities. Specifically, the need to include new rare resistant serotypes in the monitoring was mentioned. Surveillance of humans exposed to animals (livestock, wildlife): The objective of this discussion group was to assess the status of the current surveillance of non-food-borne zoonoses in humans exposed to animals (which surveillance objectives, which professions, which agents, which approach…) and to assess needs for future developments in order to find ways to improve the surveillance of non-food-borne zoonoses at EU level. The group of participants was composed of 19 representatives from the three present networks, of whom a part have been recently involved in outbreaks of non-food-borne zoonotic (Q fever) or potentially zoonotic (Schmallenberg) diseases. The discussed surveillance objectives were varied and encompassed early warning, the planning of preventive measures, the quantification of disease burden (trend analysis) and evaluation of transmission rates. Methods mentioned were event-based surveillance, surveys and development of networks/exchange between veterinarian and public health sectors. Approaches were often adapted through learning by mistakes. The status of the current surveillance of non-food-borne zoonoses in humans exposed to animals is summarised in the table below. Country representatives indicated by a + or a

12

+/- if the given type of surveillance activity was present to their knowledge in their country.

Table 1: Current surveillance of non-foodborne zoonoses in humans

Regular monitoring, laboratory

Regular monitoring,syndrome

Self-reporting

survey ad-hoc post event

Awarness, preparedness

other

Veterinarian +/- + + ++ ++ ++ + project

Farmers +/- + + +++++ ++ project

Hunter + +++ + +

Abattoir + + + + +

Rendering plans

+ + + +

Laboratory ++ + + + +++

Bat handler + + ++

Forestry +/- + + +

Port inspection

+ ++

Zoo shop + +

It can be seen from the table that ad-hoc post event surveillance is the most frequent across all exposed professions. Hunters and veterinarians are more often screened through surveys and laboratory personnel benefits from regular monitoring. Systematic screening for MRSA is done for pig farmers entering the hospital in the Netherlands. Awareness rising is done for all professions and also among medical staff following these professionals, especially for laboratory personnel, veterinarians, farmers, but also port inspectors and bat handlers. To assess needs regarding disease detection and early-warning systems, a few example diseases (endemic but prevalence unknown, exotic) were examined and exposed professionals that should be monitored were discussed. It was suggested for example that for Hepatitis E veterinarians, pig farmers, hunters and abattoir workers as well as blood donors should be screened. Regarding Rift Valley fever, veterinarians, abattoir workers and port inspectors should be under scrutiny, while for monkey pox, veterinarians, laboratory workers, port inspectors and especially pet/zoo shop workers would be exposed in the first line. Thus it became apparent that different diseases put different professions at risk, and there is no “one fits all” surveillance system. However a strategy for preparedness should be developed at the national level together with guidance on diseases to be screened by risk groups (define the risks, level of risk and type of surveillance), and screening criteria should be defined. Also the

13

development of multi-array diagnostic tools covering a broad spectrum of pathogens (or pathogen families) might be useful for fast reaction to an event or even for detection, but also for mass screening. In any way awareness rising among risk groups and health care workers dealing with risk groups is essential for preparedness with definition of evocative symptoms according to disease and corresponding diagnostic tools. Information exchange at national and EU level The objective of this discussion group was to assess the status of the current information exchange procedures and experiences on non-food-borne zoonoses at the national level (between which sectors, which objectives, which methods, which roles and responsibilities, which limitations …) and to assess needs for future developments of these exchanges at EU or MS level. The group of participants was composed of 16 representatives from the three present networks, of whom a part had information exchange experience. Discussions showed, that all the countries have established some communication between animal and human health sector but the level of exchange varies widely. Before establishing a platform to support the exchange of information at the EU level, the WG recommended to make a need assessment among the MS to better define which aspects of the communication need to be strengthened according to a clear objective. The platform should be linked with already existing systems in order to avoid duplication of work. Respect of confidentiality was highlighted as of major importance. Further, to ensure interaction between animal and human health sector, the WG supported the organisation of regular meeting like this joint ECDC-EFSA meeting. This is the perfect opportunity to discuss cross-sectorial topics and exchange information with expert from other sectors. In some countries it is also a good way to strengthen collaboration at the national level, as experts are not exchanging information or meeting outside of these international meeting. The WG observed a need to prioritise zoonotic disease in term of importance for surveillance and outbreak response activities. This activity should be carried out at EU level.

Roadmap for ECDC and EFSA networks The objective of the last plenary discussion session was to collect participants’ points of view on future collaboration of the networks and joint activities. Participants were also asked to specify actions expected from ECDC and EFSA as regards collaboration on non-foodborne zoonotic diseases at the animal-human interface. Information flow support between networks, Member States, EU agencies and the EC, as well as specific topics to be worked on were discussed. First it was agreed that a glossary of epidemiological terms used in human and animal health should be set up for easier understanding. Also the non-food-borne zoonoses concept has to be defined with included and excluded diseases. Another subject addressed was the mapping of roles, responsibilities, expertise and activities regarding non-foodborne zoonoses in the Member States. Specifically, national and regional collaborations regarding outbreak investigation and risk management, and activities like surveillance/monitoring and existing projects should be listed.

14

Regarding collaboration processes in MS, it was suggested to share the terms of references of systems in the UK (HAIRS) and Sweden for other MS to use. Also at the EU level, it was proposed to organise disease (or disease group/region) specific meetings and exchange fora, in addition to yearly general meetings. Information exchange support should be as light as possible, preferably linking existing information exchange platforms. Prioritisation of the diseases relevant for the animal-human health collaboration at EU level was strongly asked for. MSs should be consulted for this and existing initiatives (EmZoo project in the Netherlands etc.) should be taken into account. Proposed areas concerned zoonoses linked to wildlife and vector-borne diseases. Also MSs would be asked to suggest activities to be done at the EU level regarding these priority diseases. One proposal discussed at the meeting was West Nile fever, with activities on case definition for animals, data collection on vectors, the environment, migratory/residential wild birds; the EU agencies should also help MSs in doing efficient investigations. Data collection in MSs would be enhanced through activities engaged by the EU agencies.

Conclusions The first ECDC EVD programme meeting was important milestone in the phase of setting-up a dedicated network of representatives from EU/EEA Member States to interact specifically on emerging and vector-borne diseases. Network structure and functioning, programme activities and specific surveillance issues were presented and discussed. As many non-foodborne diseases are zoonotic, it was deemed important to establish very soon a first contact with homologous networks of ECDC’s partner agency EFSA. Therefore, representatives of EFSA’s AHAW network/Task Force for Zoonoses Data Collection were invited to join for the second part of the meeting, in order to address specifically how cross-disciplinary networking could improve assessment and response to non-foodborne zoonotic diseases at the European level. Important feedback on disease prioritization, programme and surveillance activities according to disease was collected which will be used to fine tune the ECDC Disease Programme in the area of particular disease or disease group surveillance, prevention and control and other technical, epidemiological or scientific aspects. Furthermore, essential information on paths for future collaborations between human and animal health at MS and EU level was gathered. The physical networking of multidisciplinary experts reinforced national and international connections and was widely appreciated.

15

I. Annex 1 – Agenda DAY 1

Thursday 5th December Proposed speaker

13h15-13h30

Welcome and meeting objectives

Johan Giesecke/ Herve Zeller, Andrea Gervelmeyer

13h30-14h15

Tour de table (name, MS, affiliation)

All

14h15 -14h30

Presentation of EVD network, EFSA Scientific Network for Risk Assessment in Animal Health and Welfare Presentation of EFSA Task Force on Zoonoses Data Collection

Herve Zeller, Andrea Gervelmeyer Frank Boelaert

14h30-15h00 ECDC- EFSA collaboration: agencies’ mandates, past joint activities, position paper (= interaction at EU level and proposal for future actions)

EFSA, ECDC

15H00 – 15H30

Coffee Break

15h30 – 16h30

UK and Sweden - Examples from existing animal health-public health collaboration within MS (15 min each, followed by discussion)

UK, Sweden, All

16h30 – 16H45

Project for common database on vectors

Wim van Bortel

16h45 - 17h00 Extranet platform for communication for networks (demo)

Cristian Avram

17h00 - 17h15 Activities on non-foodborne Zoonoses Data Collection

Frank Boelaert

16

DAY 2

Friday 6th December Proposed speaker

08H40 – 08H55

Registration

09H00 –10H15 Group discussions on contributions and future plans for the joint networks activities: Proposed topics:

• Livestock, wildlife and pet surveillance for non-foodborne zoonotic diseases

• Surveillance of humans exposed to animals (livestock, wildlife)

• Information exchange at national and EU level

All Meeting rooms: Auditorium, 335, 435

10H15 – 10H45

Coffee Break Reimbursement of expenses – Missions and Meetings representative will be on site to collect reimbursement forms and answer queries.

10H45 – 11H30

Feedback from group discussions on joint network activity

All

11H30 – 12H30

Roadmap for ECDC and EFSA networks All

12H30 – 13H30

Lunch

II. Annex 2 – List of participants

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

Austria Friedrich Schmoll Peter Much

AGES - Austrian Agency for

Health and Food Safety Austrian Agency for Health and Food Safety

friedrich.schmoll@ages.at Peter.much@ages.at

Belgium Luc Vanholme

Federal Agency for the Safety of the

Food Chain

Luc.vanholme@favv.be

Bulgaria Nikolay Kalvatchev Georgi Georgiev Donka Popova-Mincheva

National Centre of Infectious and Parasitic Diseases

NDRVMI - Bulgarian Food Safety Agency

National Veterinary Services

nkalvat@yahoo.com georgivet2@yahoo.com donka.popova@nvms.government.bg

Croatia Iva Pem Novosel Tomislav Mikus Drazen Knezevic

Croatian National Institute of Public Health

Croatian Food Agency Croatian Food Agency

iva.pem-novosel@hzjz.hr mikus@veinst.hr dknezevic@hah.hr

Czech

Republic Bohumír Križ Eva Renčová Petr Satran

18

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

National Institute of Public Health Veterniary Research Institute State Veterinary Administration of the

Czech Republic

bohukriz@szu.cz rencova@vri.cz p.satran@svscr.cz

Denmark Peter Henrik Andersen Kristian Møller Birgitte Borck Hog

Statens Serum Institut DTU Veterinary Institute Technical University of Denmark pea@ssi.dk krmol@vet.dtu.dk bobo@food.dtu.dk

Estonia Irina Golovljova Arvo Viltrop Jelena Sogel

National Institute for Health Development

Estonian University of Life Sciences (EMÜ)

Veterinary and Food Board

Irina.golovljova@tai.ee arvo.viltrop@emu.ee Jelena.sogel@vet.agri.ee

Finland Markku Kuusi Saara Raulo

National Institute for Health and Welfare

Finnish Food Safety Authority EVIRA

markku.kuusi@thl.fi Saara.raulo@evira.fi

France Henriette de Valk Gilles Salvat Jean Baptiste Perrin

Institut de Veille Sanitaire ANSES Ploufragan/Plouzané Ministere de l’Agriculture et de la

Peche

h.devalk@invs.sante.fr Gilles.SALVAT@anses.fr jean-

baptiste.perrin@agriculture.gouv.fr

Germany Mirko Faber Klaus Depner Matthias Hartung

Robert Koch Institut Friedrich-Loeffler-Institut FLI Federal Institute for Risk Assessment

19

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

FaberM@rki.de klaus.depner@fli.bund.de Matthias.hartung@bfr.bund.de

Greece Danai Pervanidou

Hellenic Centre for Disease Control

and Prevention pervanidou@keelpno.gr

Hungary Katalin Krisztalovics Mark Hovari

National Centre for Epidemiology Ministry of Agriculture and Rural

Development

krisztalovics.katalin@oek.antsz.hu HovariM@nebih.gov.hu

Iceland Vigdis Tryggvadóttir

Icelandic Food and Veterinary

Authority MAST

Vigdis.Tryggvadottir@mast.is

Ireland Paul Mckeown Sally Gaynor Kilian Unger

Health Protection Surveillance Centre

Department of Agriculture, Food & Forestry

Department of Agriculture and Food & Forestry

paulj.mckeown@hse.ie Sally.Gaynor@agriculture.gov.ie Kilian.unger@agriculture.gov.ie

Italy Caterina Rizzo

Paolo Calistri Simona Iannetti

20

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

Istituto Superiore di Sanità Istituto Zooprofilattico

Sperimentale "G. Caporale" Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise

caterina.rizzo@iss.it p.calistri@izs.it s.iannetti@izs.it

Latvia Tatjana Ribakova

Food and Veterinary Service,

Veterinary Surveillance Department

Tatjana.Ribakova@pvd.gov.lv

Lithuania Milda Žygutienė Snieguole Sceponaviciene

Centre for Communicable Diseases and AIDS

National Food and Veterinary Risk Assessment Institutie

m.zygutiene@ulac.lt ssceponaviciene@vet.lt

Luxembourg Pierre Weicherding Joseph Schon

Inspection Sanitaire, Direction de la Santé

Laboratorire de Medecine Veterimaire

pierre.weicherding@ms.etat.lu Joseph.schon@asv.etat.lu

Netherlands Wilfrid van Pelt B. W. (Wim) Ooms Rob Van Oosterom

National Institute for Public Health and the Environment (RIVM)

Netherlands Food and Consumer Products Safety Authority

Netherlands Food and Consumer Product Safety Authority

Wilfrid.van.Pelt@rivm.nl wim.ooms@vwa.nl Rob.van.oosterom@vwa.nl

Norway Line Vold Ingfrid Slaatto Næss Berit Tafjord Heier

21

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

Norwegian Institute of Public Health

Norwegian Institute of Public Health

Norwegian Veterinary Institute

line.vold@fhi.no ingfrid.slaatto.naess@fhi.no berit.tafjord.heier@fhi.no

Poland Malgorzata Sadkowska-Todys Kinga Wieczorek

National Institute of Public Health, National Institute of Hygiene

National Veterinary Research Institute

mtodys@pzh.gov.pl kinga.wieczorek@piwet.pulawy.pl

Portugal Paula Vasconcelos Miguel Fernandes

Directorate General of Health General Directorate of Food and

Veterinary Affairs

pvasconcelos@dgs.pt miguel.fernandes@dgav.pt

Slovakia Monika Musilova Regional Public Health Authority monika.musilova@vzbb.sk

Slovenia Maja Sočan National Institute of Public Health maja.socan@ivz-rs.si

Spain German Caceres Gema Lopez Orozco

Ministerio de Agricultura, Alimentación y Medio Ambiente MAGRAMA

Ministrio de Agricolutra, Alimentacion y Medio Ambiente

22

ECDC Emerging and Vectorborne Diseases Network

EFSA Animal Health and Animal Welfare network

EFSA Task Force on Zoonoses Data Collection

gcaceres@magrama.es GLOrozco@magrama.es

Sweden Marika Hjertqvist Ann Lindberg Elina Lahti

Swedish Institute for Communicable Disease Control

National Veterinary Institute, SVA

National Veterinary Institute

marika.hjertqvist@smi.se Ann.lindberg@sva.se Elina.lahti@sva.se

Lena Hult Swedish Board of Agriculture

lena.hult@jordbruksverket.se

Switzerland Jurg Danuser

Federal Veterinary Office Juerg.danuser@bvet.admin.ch

United

Kingdom Dilys Morgan Helen Roberts Lesley Larkin

Public Health England Department for Environment

Food and Rural Affairs DEFRA Dept for Environment Food and Rural Affairs DEFRA

Dilys.Morgan@phe.gov.uk helen.roberts@defra.gsi.gov.uk Lesley.larkin@ahvla.gsi.gov.uk

Observers Albania Eugena Tomini Institute of Public Health of Albania genatomini@yahoo.com Bosnia and Herzegovina Jovan Zivkovic Public health institute of Republic of Srpska dr.jovan.epi@gmail.com Montenegro Igor Galic Institute of Public Health igor.galic@ijzcg.me The former Yugoslav Republic of Macedonia Kristina Stavridis Institute for Public Health of the Republic of Macedonia ketistavridis@gmail.com Serbia Bojana Grgic lnstitute of Public Health of Serbia "Dr Milan Jovanovic Batut" bojana_grgic@batut.org.rs

Turkey Seher Topluoglu Turkish Public Health Institute Ministry of Health seher.topluoglu@yahoo.com Interim Coordination Group France Henriette de Valk Institut de Veille Sanitaire h.devalk@invs.sante.fr EFSA - European Food Safety Authority Andrea Gervelmeyer Andrea.Gervelmeyer@efsa.europa.eu Frank Boelaert Frank.Boelaert@efsa.europa.eu Justyna Jaskiewicz Justyna.Jaskiewicz@efsa.europa.eu

ECDC – European Centre for Disease Prevention and Control Bertrand Sudre Bertrand.Sudre@ecdc.europa.eu Céline Gossner Celine.Gossner@ecdc.europa.eu Cornelia Adhloch Cornelia.Adloch@ecdc.europa.eu Eva Warns-Petit Eva.Warns-Petit@ecdc.europa.eu Hervé Zeller Herve.Zeller@ecdc.europa.eu Isabelle Devaux Isabelle.Devaux@ecdc.europa.eu Laurence Marrama Laurence.Marrama@ecdc.europa.eu Phillip Zucs Phillip.Zucs@ecdc.europa.eu Piotr Kramarz Piotr.Kramarz@ecdc.europa.eu Wim van Bortel Wim.VanBortel@ecdc.europa.eu