#Resistance #proportions for eight priority #antibiotic – #bacterium combinations in #OECD, #EU/EEA and #G20 countries 2000 to 2030: a modelling study (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study

Tiago Cravo Oliveira Hashiguchi1, Driss Ait Ouakrim1, Michael Padget1, Alessandro Cassini2, Michele Cecchini1

Affiliations: 1 Organisation for Economic Co-operation and Development (OECD), Paris, France; 2 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

Correspondence:  Tiago Cravo Oliveira Hashiguchi

Citation style for this article: Cravo Oliveira Hashiguchi Tiago , Ait Ouakrim Driss , Padget Michael, Cassini Alessandro, Cecchini Michele. Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study. Euro Surveill. 2019;24(20):pii=1800445. https://doi.org/10.2807/1560-7917.ES.2019.24.20.1800445

Received: 10 Aug 2018;   Accepted: 21 Mar 2019




Antimicrobial resistance is widely considered an urgent global health issue due to associated mortality and disability, societal and healthcare costs.


To estimate the past, current and projected future proportion of infections resistant to treatment for eight priority antibiotic-bacterium combinations from 2000 to 2030 for 52 countries.


We collated data from a variety of sources including ResistanceMap and World Bank. Feature selection algorithms and multiple imputation were used to produce a complete historical dataset. Forecasts were derived from an ensemble of three models: exponential smoothing, linear regression and random forest. The latter two were informed by projections of antibiotic consumption, out-of-pocket medical spending, populations aged 64 years and older and under 15 years and real gross domestic product. We incorporated three types of uncertainty, producing 150 estimates for each country-antibiotic-bacterium-year.


Average resistance proportions across antibiotic-bacterium combinations could grow moderately from 17% to 18% within the Organisation for Economic Co-operation and Development (OECD; growth in 64% of uncertainty sets), from 18% to 19% in the European Union/European Economic Area (EU/EEA; growth in 87% of uncertainty sets) and from 29% to 31% in Group of Twenty (G20) countries (growth in 62% of uncertainty sets) between 2015 and 2030. There is broad heterogeneity in levels and rates of change across countries and antibiotic-bacterium combinations from 2000 to 2030.


If current trends continue, resistance proportions are projected to marginally increase in the coming years. The estimates indicate there is significant heterogeneity in resistance proportions across countries and antibiotic-bacterium combinations.

© This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Antibiotics; Drugs Resistance; European Region; EU.


#WNV and #Usutu Virus #Infections and Challenges to #Blood #Safety in the #EU (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 6—June 2019 / Perspective

West Nile and Usutu Virus Infections and Challenges to Blood Safety in the European Union

Dragoslav Domanović  , Celine M. Gossner, Ryanne Lieshout-Krikke, Wolfgang Mayr, Klara Baroti-Toth, Alina Mirella Dobrota, Maria Antonia Escoval, Olaf Henseler, Christof Jungbauer, Giancarlo Liumbruno, Salvador Oyonarte, Constantina Politis, Imad Sandid, Miljana Stojić Vidović, Johanna J. Young, Inês Ushiro-Lumb, and Norbert Nowotny

Author affiliations: European Centre for Disease Prevention and Control, Solna, Sweden (D. Domanović, C.M. Gossner, J.J. Young); European Blood Alliance, Amsterdam, the Netherlands (R. Lieshout-Krikke); Austrian Red Cross, Vienna, Austria (W. Mayr, C. Jungbauer); National Competent Authority for Blood, Budapest, Hungary (K. Baroti-Toth); National Competent Authority for Blood, Bucharest, Romania (A.M. Dobrota); National Competent Authority for Blood, Lisbon, Portugal (M.A. Escoval); Paul Ehrlich Institute, Langen, Germany (O. Henseler); Italian National Blood Centre, National Institute of Health, Rome, Italy (G. Liumbruno); National Competent Authority for Blood, Madrid, Spain (S. Oyonarte); Hellenic Center for Disease Control and Prevention (KEELPNO), Athens, Greece (C. Politis); National Competent Authority for Blood, Paris, France (I. Sandid); Croatian Institute for Transfusion Medicine, Zagreb, Croatia (M.S. Vidović); National Health Service Blood and Transplant (NHSBT), London, UK (I. Ushiro-Lumb); University of Veterinary Medicine, Vienna, Austria (N. Nowotny); Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates (N. Nowotny)



West Nile virus (WNV) and Usutu virus (USUV) circulate in several European Union (EU) countries. The risk of transfusion-transmitted West Nile virus (TT-WNV) has been recognized, and preventive blood safety measures have been implemented. We summarized the applied interventions in the EU countries and assessed the safety of the blood supply by compiling data on WNV positivity among blood donors and on reported TT-WNV cases. The paucity of reported TT-WNV infections and the screening results suggest that blood safety interventions are effective. However, limited circulation of WNV in the EU and presumed underrecognition or underreporting of TT-WNV cases contribute to the present situation. Because of cross-reactivity between genetically related flaviviruses in the automated nucleic acid test systems, USUV-positive blood donations are found during routine WNV screening. The clinical relevance of USUV infection in humans and the risk of USUV to blood safety are unknown.

Keywords: Usutu virus; WNV; Blood safety; EU.


The use of #aminoglycosides in #animals within the #EU: development of #resistance in animals and possible #impact on #human and animal #health: a review (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

The use of aminoglycosides in animals within the EU: development of resistance in animals and possible impact on human and animal health: a review

Engeline van Duijkeren, Christine Schwarz, Damien Bouchard, Boudewijn Catry, Constança Pomba, Keith Edward Baptiste, Miguel A Moreno, Merja Rantala, Modestas Ružauskas, Pascal Sanders, Christopher Teale, Astrid L Wester, Kristine Ignate, Zoltan Kunsagi, Helen Jukes

Journal of Antimicrobial Chemotherapy, dkz161, https://doi.org/10.1093/jac/dkz161

Published: 19 April 2019



Aminoglycosides (AGs) are important antibacterial agents for the treatment of various infections in humans and animals. Following extensive use of AGs in humans, food-producing animals and companion animals, acquired resistance among human and animal pathogens and commensal bacteria has emerged. Acquired resistance occurs through several mechanisms, but enzymatic inactivation of AGs is the most common one. Resistance genes are often located on mobile genetic elements, facilitating their spread between different bacterial species and between animals and humans. AG resistance has been found in many different bacterial species, including those with zoonotic potential such as Salmonella spp., Campylobacter spp. and livestock-associated MRSA. The highest risk is anticipated from transfer of resistant enterococci or coliforms (Escherichia coli) since infections with these pathogens in humans would potentially be treated with AGs. There is evidence that the use of AGs in human and veterinary medicine is associated with the increased prevalence of resistance. The same resistance genes have been found in isolates from humans and animals. Evaluation of risk factors indicates that the probability of transmission of AG resistance from animals to humans through transfer of zoonotic or commensal foodborne bacteria and/or their mobile genetic elements can be regarded as high, although there are no quantitative data on the actual contribution of animals to AG resistance in human pathogens. Responsible use of AGs is of great importance in order to safeguard their clinical efficacy for human and veterinary medicine.

Issue Section: Review

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Aminoglycosides; Food safety.


#PublicHealth–Driven #Research and Innovation for Next-Generation #Influenza #Vaccines, #EU (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 2—February 2019 / Online Report

Public Health–Driven Research and Innovation for Next-Generation Influenza Vaccines, European Union

Adoración Navarro-Torné  , Finnian Hanrahan, Barbara Kerstiëns, Pilar Aguar, and Line Matthiessen

Author affiliations: European Commission Directorate-General for Research and Innovation, Brussels, Belgium



Influenza virus infections are a major public health threat. Vaccination is available, but unpredictable antigenic changes in circulating strains require annual modification of seasonal influenza vaccines. Vaccine effectiveness has proven limited, particularly in certain groups, such as the elderly. Moreover, preparedness for upcoming pandemics is challenging because we can predict neither the strain that will cause the next pandemic nor the severity of the pandemic. The European Union fosters research and innovation to develop novel vaccines that evoke broadly protective and long-lasting immune responses against both seasonal and pandemic influenza, underpinned by a political commitment to global public health.

Keywords: Pandemic Influenza; Pandemic Preparedness; Vaccines; EU.


The #EU #summary #report on #surveillance for the presence of transmissible spongiform #encephalopathies (#TSEs) in 2017 (EFSA, abstract)

[Source: European Food Safety Authority (EFSA), full page: (LINK). Abstract, edited.]

Scientific Report  / Open Access

The European Union summary report on surveillance for the presence of transmissible spongiform encephalopathies (TSEs) in 2017

European Food Safety Authority (EFSA) / First published: 28 November 2018 / DOI:  https://doi.org/10.2903/j.efsa.2018.5492

Correspondence: zoonoses@efsa.europa.eu

Requestor: European Commission

Question number: EFSA‐Q‐2017‐00753

Acknowledgements: EFSA wishes to thank for the support provided to this scientific output to the EFSA staff members: Yves Van der Stede, Angel Ortiz Pelaez, Valentina Rizzi, Pietro Stella and Frank Boelaert, and to the EFSA contractor: Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta (Unit BEAR – Biostatistica Epidemiologia e Analisi del Rischio and staff: Giuseppe Ru, Francesco Ingravalle, Cristina Bona, Rosanna Desiato, Cristiana Maurella and Eleonora Aiassa).

Approved: 6 November 2018



This report presents the results of surveillance on transmissible spongiform encephalopathies (TSEs) in bovine animals, sheep, goats, cervids and other animal species, as well as genotyping in sheep, carried out in 2017 in the European Union (EU) according to Regulation (EC) 999/2001, and in Iceland, Norway and Switzerland. In total, 1,312,714 cattle were tested by the 28 EU Member States (MSs) which is a decrease of 3% compared with 2016; 18,526 were tested by the three non‐MSs. For the first time since bovine spongiform encephalopathy (BSE) has been reported, no cases of classical BSE were reported in 2017. Six atypical BSE cases were reported by three different MSs: Spain 1 H‐BSE/2 L‐BSE; France 1 H‐BSE/1 L‐BSE; and Ireland 1 L‐BSE. Over the year, 314,547 sheep and 117,268 goats were tested in the EU. In sheep, 933 cases of scrapie were reported: 839 classical and unknown (145 index cases) by eight MSs and 94 atypical (89 index cases) by 13 MSs. Fourteen ovine scrapie cases were reported by Iceland and Norway. Of all classical scrapie cases, 98.2% occurred in sheep with genotypes of susceptible groups. The genotyping of a random sample in 21 MSs showed that 26.5% of the genotyped sheep carried genotypes of the susceptible groups. In goats 567 cases of scrapie were reported: 558 classical (42 index cases) by seven MSs and nine atypical (seven index cases) by five MSs. In total, 3,585 cervids were tested for TSE by ten MSs, mostly by Romania. All results were negative. Eleven cases of chronic wasting disease (CWD) cases were reported in cervids by Norway: nine wild reindeer, one moose and, for the first time ever, one red deer. In total, 185 animals from five species other than cattle, small ruminants and cervids were tested by three MSs, with negative results.

Keywords: Prions; TSE; Mad Cow; Scrapie; Chronic Wasting Disease; Cattle; Cervids; Sheeps; EU.


Attributable #deaths and #disability-adjusted life-years caused by #infections with #antibiotic-resistant bacteria in the #EU and the #EEA in 2015: a population-level modelling analysis (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis

Alessandro Cassini, MD,  Liselotte Diaz Högberg, PhD, Diamantis Plachouras, PhD, Annalisa Quattrocchi, PhD, Ana Hoxha, MSc, Gunnar Skov Simonsen, PhD, Mélanie Colomb-Cotinat, PhD, Mirjam E Kretzschmar, PhD, Brecht Devleesschauwer, PhD, Michele Cecchini, PhD, Driss Ait Ouakrim, PhD, Tiago Cravo Oliveira, PhD, Marc J Struelens, PhD, Carl Suetens, MD, Dominique L Monnet, PhD, theBurden of AMR Collaborative Group †

Open Access / Published: November 05, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30605-4




Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).


We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.


From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.


Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.


European Centre for Disease Prevention and Control.

Keywords: Antibiotics; Drugs Resistance; EU; Excess mortality.


#Healthcare-associated #pneumonia in acute care #hospitals in #EU / #EEA countries: an analysis of data from a point prevalence survey, 2011 to 2012 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012

Jan Walter1, Sebastian Haller1, Chantal Quinten2, Tommi Kärki2, Benedikt Zacher1, Tim Eckmanns1, Muna Abu Sin1, Diamantis Plachouras2,Pete Kinross2, Carl Suetens2, ECDC PPS study group3

Affiliations: 1 Unit of Healthcare-associated Infections, Surveillance of Antibiotic Resistance and Consumption, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany; 2 Surveillance and Response Support Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; 3 The members of the ECDC PPS study group are listed at the end of the article

Correspondence:  Jan Walter

Citation style for this article: Walter Jan, Haller Sebastian, Quinten Chantal, Kärki Tommi, Zacher Benedikt, Eckmanns Tim, Abu Sin Muna, Plachouras Diamantis, Kinross Pete,Suetens Carl, ECDC PPS study group. Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012. Euro Surveill. 2018;23(32):pii=1700843. https://doi.org/10.2807/1560-7917.ES.2018.23.32.1700843

Received: 20 Dec 2017;   Accepted: 02 Jul 2018



An aim of the ECDC point prevalence survey (PPS) in European Union/European Economic Area acute care hospitals was to acquire standardised healthcare-associated infections (HAI) data. We analysed one of the most common HAIs in the ECDC PPS, healthcare-associated pneumonia (HAP). Standardised HAI case definitions were provided and countries were advised to recruit nationally representative subsets of hospitals. We calculated 95% confidence intervals (CIs) around prevalence estimates and adjusted for clustering at hospital level. Of 231,459 patients in the survey, 2,902 (1.3%; 95% CI: 1.2–1.3) fulfilled the case definition for a HAP. HAPs were most frequent in intensive care units (8.1%; 95% CI: 7.4–8.9) and among patients intubated on the day of the survey (15%; 95% CI: 14–17; n = 737 with HAP). The most frequently reported microorganism was Pseudomonas aeruginosa (17% of 1,403 isolates), followed by Staphylococcus aureus (12%) and Klebsiella spp. (12%). Antimicrobial resistance was common among isolated microorganisms. The most frequently prescribed antimicrobial group was penicillins, including combinations with beta-lactamase inhibitors. HAPs occur regularly among intubated and non-intubated patients, with marked differences between medical specialities. HAPs remain a priority for preventive interventions, including surveillance. Our data provide a reference for future prevalence of HAPs at various settings.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Antibiotics; Drugs Resistance; Pneumonia; Nosocomial Outbreaks; EU; Klebsiella spp.; Pseudomonas aeruginosa.


The #European #Virus #Archive goes #global: A growing resource for research (Antiviral Res., abstract)

[Source: Science Direct, full page: (LINK). Abstract, edited.]

Antiviral Research / Available online 29 July 2018 / In Press, Accepted Manuscript

The European Virus Archive goes global: A growing resource for research

J.L.Romette a, C.M.Prat a, E.A.Gould a, X.de Lamballerie a, R.Charrel a, B.Coutard b, A.R.Fooks c, M.Bardsley c, M.Carroll d, C.Drosten e, J.F.Drexler e, S.Günther f, B.Klempa g, D.Pinschewer h, T.Klimkait h, T.Avsic-Zupanc i, M.R.Capobianchi j, A.Dicaro j, G.Ippolito j, A.Nitsche k, M.Koopmans l, C.Reusken l, A.Gorbalenya m, H.Raoul n, H.Bourhy o, T.Mettenleiter p, S.Reiche p, C.Batten q, C.Sabeta r, J.T.Paweska s, M.Eropkin t, V.Zverev u, Z.Hu v, S.Mac Cullough w, A.Mirazimix y , F.Pradel z, P.Lieutaud a

a Unite des Virus Emergents (UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection), Marseille, France; b Architectures et Fonctions, des Macromolécules, Biologiques, Marseille, France; c Animal and Plant Health Agency, Weybridge, United Kingdom; d Department of Health-Special Pathogens Laboratory, Porton Down, United Kingdom; e Virology Laboratory, La Charité University Hospital, Germany; f Department of Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; g Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia; h Department of Pathology and Immunology, University of Bales, Switzerland; i Institute of Microbiology and Immunology, Lubljana, Slovenia; j UOC, Istituto Nazionale Malattie Infettive Roma, Italy; k Robert Koch Institut, Berlin, Germany; l ERASMUS Medical Center, Rotterdam, The Netherlands; m Leiden University Medical Center, Leiden, The Netherlands; n Laboratoire Merieux, INSERM, Lyon, France; o Institut Pasteur, Paris, France; p Friedrich Loeffler Institut, Greifswald-Insel Riems, Germany; q The Pirbright Institute, Pirbright, United Kingdom; r Onderstepoort Veterinary Institute, Praetoria, South Africa; s National Institute for Communicable Diseases, Johannesburg, South Africa; t Research Institute of Influenza, St. Petersburg, Russia; u Mechnikov Scientific Research Institute for Vaccines and Sera, Moscow, Russia; v Wuhan Institute of Virology, Wuhan, China; w Australian Animal Health Laboratory, Geelong, Australia Disease, Johannesburg, South Africa; x Folkhalsomyndigheten, Stockholm, Sweden; y China-CDC, Beijing, China; z Fondation Mérieux, réseau GABRIEL, Lyon, France

Received 10 April 2018, Revised 21 July 2018, Accepted 23 July 2018, Available online 29 July 2018.

DOI: https://doi.org/10.1016/j.antiviral.2018.07.017 / Under a Creative Commons license



  • The EVAg was created as an international organization aiming to provide a gold standard resource to the scientific community.
  • The EVAg operates as a non-profit consortium of 26 partners and 20 associated partners from EU and non-EU countries.
  • Members and associated members retain ownership of the viruses that they disseminate via the EVAg infrastructure.
  • The EVAg approach to quality management is directed by the project’s own quality standard, based upon OECD guidelines.
  • The ultimate objective is to make the EVAg a permanent archive that can provide access to viruses and reagents globally.



The European Virus Archive (EVA) was created in 2008 with funding from the FP7-EU Infrastructure Programme, in response to the need for a coordinated and readily accessible collection of viruses that could be made available to academia, public health organisations and industry. Within three years, it developed from a consortium of nine European laboratories to encompass associated partners in Africa, Russia, China, Turkey, Germany and Italy. In 2014, the H2020 Research and Innovation Framework Programme (INFRAS projects) provided support for the transformation of the EVA from a European to a global organization (EVAg). The EVAg now operates as a non-profit consortium, with 26 partners and 20 associated partners from 21 EU and non-EU countries. In this paper, we outline the structure, management and goals of the EVAg, to bring to the attention of researchers the wealth of products it can provide and to illustrate how end-users can gain access to these resources. Organizations or individuals who would like to be considered as contributors are invited to contact the EVAg coordinator, Jean-Louis Romette, at jean-louis.romette@univmed.fr.

Keywords: Virus archive – Virus collection – EU infrastructure

Keywords: EU; International Cooperation; Infectious Diseases.


Protective #Measures for #Humans against #Avian #Influenza A(#H5N8) #Outbreaks in 22 #EU/EEA Countries and #Israel, 2016–17 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 24, Number 10—October 2018 / Online Report

Protective Measures for Humans against Avian Influenza A(H5N8) Outbreaks in 22 European Union/European Economic Area Countries and Israel, 2016–17

Cornelia Adlhoch  , Gavin Dabrera, Pasi Penttinen, Richard Pebody, and on behalf of Country Experts

Author affiliations: European Centre for Disease Prevention and Control, Stockholm, Sweden (C. Adlhoch, P. Penttinen); Public Health England, London, UK (G. Dabrera, R. Pebody)



We sought to better understand national approaches for managing potential human health risks during outbreaks of infection with avian influenza A(H5N8) virus during 2017–17. Twenty-three countries in the Union/European Economic Area and Israel participated in this study. Risk to the general public was assessed as low in 18 countries and medium in 1 country. Of 524 exposed persons identified, 274 were passively monitored and 250 were actively monitored. Of 29 persons tested, all were negative for H5N8 virus. Vaccination and antiviral drug recommendations varied across countries. A high level of personal protection was recommended although a low risk was assessed. No transmission of this virus to humans was identified.

Keywords: Avian Influenza; H5N8; EU; Israel; Human; Poultry.


#Preparedness and #response against #diseases with #epidemic potential in #EU: a qualitative case study of #MERS & #poliomyelitis in 5 MS (BMC Health Serv Res., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMC Health Serv Res. 2018 Jul 6;18(1):528. doi: 10.1186/s12913-018-3326-0.

Preparedness and response against diseases with epidemic potential in the European Union: a qualitative case study of Middle East Respiratory Syndrome (MERS) and poliomyelitis in five member states.

Kinsman J1, Angrén J2, Elgh F3, Furberg M3, Mosquera PA4, Otero-García L5,6, Snacken R7, Derrough T7, Carrillo Santisteve P7, Ciotti M7, Tsolova S7.

Author information: 1 Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, 901 87, Umeå, Sweden. john.kinsman@umu.se. 2 European CBRNE Centre, Umeå University, 901 85, Umeå, Sweden. 3 Department of Clinical Microbiology, Umeå University, 901 85, Umeå, Sweden. 4 Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, 901 87, Umeå, Sweden. 5 Nursing Section, Faculty of Medicine, Autonoma de Madrid University, Madrid, Spain. 6 CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. 7 European Centre for Disease Prevention and Control, Granits väg 8, 171 65, Solna, Sweden.




EU Decision 1082/2013/EU on serious cross-border health threats provides a legal basis for collaboration between EU Member States, and between international and European level institutions on preparedness, prevention, and mitigation in the event of a public health emergency. The Decision provides a context for the present study, which aims to identify good practices and lessons learned in preparedness and response to Middle East Respiratory Syndrome (MERS) (in UK, Greece, and Spain) and poliomyelitis (in Poland and Cyprus).


Based on a documentary review, followed by five week-long country visits involving a total of 61 interviews and group discussions with experts from both the health and non-health sectors, this qualitative case study has investigated six issues related to preparedness and response to MERS and poliomyelitis: national plans and overall preparedness capacity; training and exercises; risk communication; linking policy and implementation; interoperability between the health and non-health sectors; and cross-border collaboration.


Preparedness and response plans for MERS and poliomyelitis were in place in the participating countries, with a high level of technical expertise available to implement them. Nevertheless, formal evaluation of the responses to previous public health emergencies have sometimes been limited, so lessons learned may not be reflected in updated plans, thereby risking mistakes being repeated in future. The nature and extent of inter-sectoral collaboration varied according to the sectors involved, with those sectors that have traditionally had good collaboration (e.g. animal health and food safety), as well as those that have a financial incentive for controlling infectious diseases (e.g. agriculture, tourism, and air travel) seen as most likely to have integrated public health preparedness and response plans. Although the formal protocols for inter-sectoral collaboration were not always up to date, good personal relations were reported within the relevant professional networks, which could be brought into play in the event of a public health emergency. Cross-border collaboration was greatly facilitated if the neighbouring country was a fellow EU Member State.


Infectious disease outbreaks remain as an ongoing threat. Efforts are required to ensure that core public health capacities for the full range of preparedness and response activities are sustained.

KEYWORDS: Cross-border; European Union; Inter-sectoral; Interoperability; MERS-coronavirus; Poliomyelitis; Preparedness and response; Public health; Risk communication

PMID: 29976185 DOI: 10.1186/s12913-018-3326-0

Keywords: EU; Pandemic Preparedness; Emerging Diseases; Infectious Diseases.