Establishment of networks of human and animal virology laboratories and medical entomology

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Establishment of networks of human and animal virology laboratories and medical entomology Maria Grazia Dente, Flavia Riccardo and Silvia Declich CNESPS/Istituto Superiore di Sanità -ISS (Italy) Workshop Screening practices for infectious diseases among newly arrived migrants and Vaccine Preventable Disease (VPD): strategies and coverage - Istituto Superiore di Sanità, 28-29 May 2015

Outline Origins and aims of the MediLabSecure project Overview of activities Focus on the Public Health Work-Package Who could be our Contact Points?

Set up of a Mediterranean Laboratory Network priorities : Biosafety, West Nile and Dengue

4 Year Program 2014-2017 19 Target countries Albania, Algeria, Armenia, Bosnia and Herzegovina, Egypt, Georgia, Jordan, Kosovo, Lebanon, Libya, Moldova, Montenegro, Morocco, Palestine, Serbia, The former Yugoslav Republic of Macedonia, Tunisia, Turkey, Ukraine. 4 Partner Institutions

General Objective Create a framework for collaboration to improve surveillance and monitoring of emerging vector borne viral diseases (arboviruses). Provide training for public health experts in participating countries to increase the communicable disease control in the Mediterranean and Black Sea region. Promote knowledge development and transfer of biosafety best laboratory practices 5

Specific work First cluster for awareness, risk assessment, monitoring and control of emerging or re-emerging viruses with vector transmission. Interaction of several work packages, one for human health, one for animal health, one for entomology and one for public health reinforcement. Promote integrated surveillance (animal, human, entomological) Second cluster for awareness, monitoring and control of emerging respiratory viruses Capacity building of national laboratories in preparedness and response to emerging zoonotic viruses and respiratory viruses.

WP1 Coordination, Communication and dissemination Cluster 1: Emerging viruses with vector transmission Cluster 2: Emerging respiratory viruses with possible animal transmission WP4 Medical Entomology WP2 Animal virology WP3 Human Virology and Biosafety WP 5 Public Health Biosafety Steering Team MediLabSecure Member Laboratories and units/ Fpoints in MoH - CoE Advisory Board (external including OIE, WHO, ECDC, other Network respresentatives)

Focus of the current phase Zoonotic viruses transmitted by mosquitoes with an existing identified or potential risk in the region: West Nile, Dengue, Chikungunya, Yellow Fever, Rift valley fever

Focus on the Public Health Work-Package General objective To facilitate the integration of surveillance, risk assessment and early case detection across the different project s areas of activity: animal virology, human virology and medical entomology and the national surveillance system (NSS) for communicable diseases.

http://www.fao.org/docrep/019/i3440e/i3440e.pdf

Specific objectives Assessing the national level of integration of surveillance systems and describing how the exchange of information is organized between data flows in the Project s Areas of activities and the national surveillance system (NSS) for communicable diseases. Identifying formal procedures and informal processes in depth in selected countries. Identifying success stories in establishing a functional integration of surveillance in the region.

How? Literature Review Survey Collection of evidence 2015 2016 Situation analysis In 3 Countries successfully integrating surveillance across sectors that will agree to participate in the study (Workshop). Workshop Sharing and discussion of results 2017

Criteria to describe existing levels of integration between human/animal/entomological surveillance for a specific exposure Level of integration Sublevels of integration Criteria Policy and institutional level Policy level 1. Existence of a National policy addressing integrated surveillance for this specific exposure 2. Existence of a policy addressing integrated surveillance for this specific exposure at subnational level Institutional level 1. Existence of agreements among the institutions involved in human/animal/entomological surveillance for the specific exposure, 2. Existence of a coordination mechanisms among the institutions involved, 3. Existence of identified focal points for each of human/animal/entomological surveillance for the specific exposure Data collection and analysis level Interoperability mechanisms at data collection level Interoperability mechanisms at data analysis level 1. Existence of integrated data collection tools 2. Existence of activation mechanisms of human surveillance based on signals from animal/entomological surveillance 3. Other interoperability mechanisms at data collection level 1. Presence of DB exchange/merging/other mechanisms to facilitate joint analysis among sectors. 2. Performance of joint/integrated data analysis among the different surveillance sectors 3. Other interoperability mechanisms at data analysis level Dissemination level - 1. Existence of joint result dissemination mechanisms (e.g. bulletins, reports, papers, media reports, websites )

Literature Review (ongoing) Task: assessing the level of integration between the animal virology, human virology and medical entomology entities with the central national surveillance system. In order to do this, there is the need to clearly define what is integrated surveillance in the field of arboviral diseases. Criteria are needed to describe and define this integration in a consistent way. Study question: Which criteria can be used to define integrated surveillance (human, animal, entomological) in the field of autochthonous vector borne viral diseases in countries of the Mediterranean, Black sea and EU regions? General Aim: To identify criteria able to consistently describe integrated surveillance of autochthonous arboviral diseases to be used for studies in the context of MediLabSecure WP5. Specific objectives: - To analyse studies describing existing surveillance systems of autochthonous vector borne viral diseases, including systems successfully integrating human, animal virology and/or medical entomology surveillance. - To identify those elements that should be present in order to defined a surveillance system as integrated

Literature Review (ongoing) Given the specificity of integrated surveillance activities to the different pathogens, there is a need to define the search strategy of this review in a way to analyse surveillance integration by disease. There is therefore the need to identify which VBD should be considered in this review on the basis of those most relevant to the geographical area of interest of the MediLabSecure Project. The following viral vector borne diseases have caused autochthonous cases (endemic/sporadic) in the EU, Mediterranean and Black Sea regions: West Nile Virus, Chickungunya, Dengue, Rift Valley Fever, Crimean Congo Haemorrhagic Fever, Tick Borne Encephalitis. As the current priority of the MediLabSecure Project has been narrowed down to mosquito transmitted VBD, this review will consider the following diseases: WNV, Chickungunya, Dengue and RVF.

Survey (ongoing) Based on the criteria shown three questions with conditional branching to maximum two «child questions» were inserted in a wider survey. The survey was circulated among national focal points in laboratories of animal and human virology and of medical entomology in the countries involved in the project. Now the same questions should be sent to public health officials to complete the study

Who should we contact? Public Health officials at national level (MoH/IPH) personally involved in the surveillance of vector-borne diseases.

Able to comment on: Policy and Institutional level Data collection and analysis level Dissemination level Existence of a National policy addressing integrated surveillance for each disease Existence of a coordination mechanisms among the institutions involved Existence of integrated data collection tools Presence of DB exchange/merging/other mechanisms to facilitate joint analysis among sectors. Performance of joint/integrated data analysis among the different surveillance sectors Existence of joint result dissemination mechanisms (e.g. bulletins, reports, papers, media reports, websites )

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