EUVAC.NET A surveillance network for vaccine-preventable diseases

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1 EUVAC.NET A surveillance network for vaccine-preventable diseases Mark Muscat EUVAC.NET Co-ordinator Department of Epidemiology Statens Serum Institut Denmark mmc@ssi.dk Viral Hepatitis Prevention Board Meeting November 2007 Athens, Greece 1

2 EUVAC.NET Aim To operate a Community surveillance network for vaccine-preventable infectious diseases (VPD) using epidemiological and laboratory surveillance methods 2

3 The Main Objectives To develop standardised surveillance methods To identify strengths and weaknesses in surveillance systems for VPD To disseminate and exchange information on VPD occurrence To detect and report on outbreaks in EU 3

4 EUVAC.NET s main collaborating partners Public health and surveillance institutions of all 27 EU Member States + Croatia, Iceland, Norway, Switzerland and Turkey Hub Department of Epidemiology 4

5 Historic landmarks Countries participating 15 EU member states + Iceland, Norway and Switzerland Malta Croatia 11 new EU member states + Turkey EU funding period* DG SANCO Establishment of EUVAC.NET Establishment of ECDC *Gaps funded solely by Statens Serum Institut 5

6 VPD Surveillance Varicella A Rubella Mumps A A Pertussis A Measles M Data collected Data to be collected Data being collected A = Annual data M = Monthly data 6

7 WHO European Region strategic plan The revised objectives for 2010 are: To eliminate endemic measles To eliminate endemic rubella To prevent congenital rubella syndrome (<1 per live births) 7

8 Key strategies for measles and rubella elimination 1. Achieve and sustain >95% coverage with two doses of measles through high-quality routine immunization services 2. Provide a second opportunity for measles immunization to susceptible groups 3. Provide rubella vaccination opportunities, to all susceptible children, adolescents and women of child bearing age 4. Strengthen surveillance systems 5. Improve the availability of information for health professionals and the public on the benefits and risks associated with immunization EUVAC.NET actively contributes to the measles elimination plan through its measles surveillance activities 8

9 Standardizing and harmonizing surveillance systems EUVAC.NET s collaboration with ECDC on: EU case definitions Data variables for reporting Hub 9

10 EUVAC.NET: Case definitions on website 10

11 Strengthening surveillance systems Percentage of data with known status, * (19 case-base reporting countries ) 100% 90% Hospitalisation status Importation status Outbreak status Vaccination status 80% Map: Case-base reporting countries, % % known data 60% 50% 40% 30% 20% 10% 0% * *Provisional 11

12 Strengthening surveillance systems Molecular epidemiology : a useful and a necessary component of an enhanced surveillance system required in the measles elimination phase. plays an important role in documenting the interruption of endemic measles transmission. Amplification by RT-PCR and agarose gel electrophoresis Photo source: Department of Virology, Statens Serum Institut 12

13 EUVAC.NET reporting on measles surveillance Public health and surveillance institutions of all 27 EU Member States + Croatia, Iceland, Norway, Switzerland and Turkey Data Management Graphic reports Scientific publications Annual reports 13

14 VPD outbreak notification on website 14

15 VPD outbreak information sharing in Forum site 15

16 VPD outbreak information sharing in Forum site 16

17 Reported measles cases by year, (19 case-base reporting countries ) Germany Ireland no. of reported measles cases Italy Other Total Map: Case-base reporting countries, * Data source: EUVAC.NET * Provisional data 17

18 Reported incidence of indigenous measles per 100,000 inhabitants by country, 2006 (n=7,827) No. of countries > < Germany: 2,282 cases Zero cases 11 Romania: 3,169 cases 4.34 Data source: EUVAC.NET 18

19 Changes in indigenous incidence of measles per 100,000 inhabitants from 2005 to 2006 Austria Denmark Latvia Poland Spain Germany UK Luxembourg Estonia Sweden Malta Turkey Italy Greece Italy Belgium Ireland Belgium Rest Switzerland Romania Switzerland Rest < > <0.1 19

20 Measles in Europe Highlights 2006 Still a problem in many European counties Large outbreaks at national level Anti-vaccination lobbying Identified susceptible groups: Unvaccinated persons Increasing age groups Imported cases Hard-to-reach communities 20

21 Mumps suveillance at national level Case-based data from mandatory reports Aggregated data from mandatory reports Sentinel surveillance clinician-based No national surveillance 21

22 Countries with mandatory reporting systems for mumps providing data for (n=24) All clinical, laboratory confirmed and epidemiologically- linked cases were included 24 countries 22

23 No. of reported mumps cases in 24 EUVAC.NET countries, (n=837,839) No. of reported mumps cases 220, , , , , , ,000 80,000 60,000 40,000 20,000 0 Romania Italy Other United Kingdom Poland Total

24 Pertussis data collection previous contract 19 countries participated No data provided Report is available at: 24

25 No. of reported pertussis cases in 14 EUVAC.NET participating countries, (n=77,419) The Netherlands Italy Norway Other Total No. of reported pertussis cases Note: No data from Spain and Sweden Denmark provided data only on population 0-2 years of age. Only data from former East Germany was available for this period. 25

26 No. of reported pertussis cases in 14 EUVAC.NET participating countries by country, (n=77,419) Austria Denmark Germany Greece Iceland Ireland Italy Malta The Netherlands Norway Portugal Spain Sweden United Kingdom No. of reported pertussis cases

27 Countries with mandatory reporting systems for varicella providing data for (n=14) All clinical, laboratory confirmed and epidemiologically- linked cases were included 14 countries 27

28 No. of reported varicella cases in 14 EUVAC.NET participating countries, (n=3,421,957) Poland Italy Hungary Romania Czech Republic Bulgaria Other Total No. of reported chickenpox cases 650, , , , , , , , , , , ,000 50, Year 28

29 Childhood vaccination schedules on website 29

30 MMR vaccination schedules overview on website 30

31 National Plans of Action on website Measles Measles and Rubella/congenital rubella Such national plans provide essential guidelines towards the elimination of measles and rubella and are therefore highly commendable. The "national plans" page on the euvac.net website serves as a source of information and inspiration to countries that have not yet published such a document. 31

32 References The EUVAC-NET survey: national measles surveillance systems in the EU, Switzerland, Norway, and Iceland. S. Glismann, T. Ronne, J.E. Schmidt. Eurosurveillance 2001;6: The EUVAC-NET project: creation and operation of a surveillance community network for vaccine-preventable diseases. S. Glismann, T. Rønne. Eurosurveillance 2001;6:94-8. The EUVAC-NET survey: national pertussis surveillance systems in the European Union, Switzerland, Norway, and Iceland. J.E. Schmidt, A.E. Tozzi, L. Rava, S. Glismann. Eurosurveillance 2001; 6: World Health Organization. Eliminating measles and rubella and prevention congenital rubella infection, WHO European Region strategic plan Available from: Measles surveillance annual report EUVAC.NET. Available from: Measles surveillance annual report EUVAC.NET. Available from: EUVAC.NET. Home page. 32

33 σας ευχαριστούμε Statens Serum Institut, Copenhagen, Denmark 33