Heymann 4/2/09 12:23 pm Page 107
Prevention and Control of Infectious Disease Epidemics within Europe
Changes made to the environment in relation to human activities have strengthen pandemic influenza preparedness in the EU and, more
a major influence on the emergence, re-emergence and spread of broadly, to support every country in maintaining and developing
epidemics of infectious diseases. Alteration of ecological zones prevention, preparedness and control measures. At a global level, an
increases the frequency with which infectious agents, usually confined international safety net of global surveillance has been developed to
to animals, cross the species barrier to infect humans. The disruption of detect and respond to epidemics.
21
In this context, the newly
the natural habitats of animals can force them into closer contact with implemented (2007) International Health Regulations (IHR) – adhered
humans. Climate extremes, whether involving excessive rainfall or to by all Member States of WHO – provides a legal framework for the
drought, can displace animal species and bring them into closer contact management of public health events that may constitute an
with human settlements, or increase vector-breeding sites. emergency of international concern and for the improvement of the
However, the consequences of the environment and interspecies
transmission of infectious agents are most clearly demonstrated in the The future of European health
case of the influenza virus. It is only a matter of time until an animal
security will continue to rely on a
influenza virus undergoes adaptive mutation or recombines with a
human influenza virus and causes the next influenza pandemic.
18
In regional approach with active support
1997 in the Hong Kong Special Administrative Region of China,
from ECDC and WHO working within
crowded conditions and live poultry markets adjacent to residential
areas facilitated the emergence of the avian influenza A virus (H5N1),
the framework of the International
previously thought to be confined to birds.
19
A re-emergence of this
Health Regulations.
same virus in poultry throughout Asia, Africa and Europe during the
period 2003–2008 has resulted in increasing numbers of sporadic
human zoonotic infections. By September 2008, 387 incidences of capacity of all countries to detect, assess, notify and respond to all
human infection and 245 deaths had been reported from 15 countries public health threats.
22
IHR requires close collaboration among
worldwide. In Europe, the spread of avian influenza to poultry resulted Member States and between WHO and the Member States, as well as
in sporadic human cases being reported in Azerbaijan and Turkey in collaboration among members of regional economic organisations or
2006. These were rapidly controlled, and since these initial cases H5N1 other regional groups. This is particularly relevant for the EU.
23
has been isolated from wild migratory birds several times in various
European countries.
20
Prompt reaction has contained the threat and International and European initiatives in the future will maintain and
prevented avian influenza from becoming entrenched in any country develop new co-ordinated efforts to cope with the challenges of
of the region. preventing and controlling epidemics of infectious diseases that will
continue to threaten European populations, despite a high disparity in
The response to the cluster of human cases of avian influenza in the approaches and resources among the various countries. In today’s
Turkey in early 2006 is a good example of an immediate, international, globalised and highly mobile world, where infectious agents travel in
multisectoral and co-ordinated response to an infectious disease food, animals, insects and humans, the best defence against the
epidemic threat to Europe by European countries, international development and spread of infectious diseases rests with strong national
organisations, non-governmental organisations and others. Although public health actions, including strong disease surveillance and response
the prevention and control of infectious diseases remains a national systems and public health infrastructures that provide equitable access
responsibility, the increased risk and spread of epidemics of infectious to healthcare and facilitate co-ordinated multisectoral collaboration with
diseases in Europe calls for a co-ordinated approach. The World Health international partners. The future of European health security will
Organization (WHO) is often at the head of such a response, with the continue to rely on a regional approach with active support from ECDC
support of ECDC. This is clearly illustrated by the work carried out to and WHO working within the framework of the IHR. ■
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EUROPEAN INFECTIOUS DISEASE 107
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