Abstract
Globalization and environmental change, social and demographic determinants and health system capacity are significant drivers of infectious diseases which can also act as epidemic precursors. Thus, monitoring changes in these drivers can help anticipate, or even forecast, an upsurge of infectious diseases. The European Environment and Epidemiology (E3) Network has been built for this purpose and applied to three early warning case studies: (1) The environmental suitability of malaria transmission in Greece was mapped in order to target epidemiological and entomological surveillance and vector control activities. Malaria transmission in these areas was interrupted in 2013 through such integrated preparedness and response activities. (2) Since 2010, recurrent West Nile fever outbreaks have ensued in South/eastern Europe. Temperature deviations from a thirty year average proved to be associated with the 2010 outbreak. Drivers of subsequent outbreaks were computed through multivariate logistic regression models and included monthly temperature anomalies for July and a normalized water index. (3) Dengue is a tropical disease but sustained transmission has recently emerged in Madeira. Autochthonous transmission has also occurred repeatedly in France and in Croatia mainly due to travel importation. The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats.
Highlights
The emergence and spread of vector-borne diseases (VBD) in Europe is a function of biotic, abiotic and socioeconomic drivers of disease
The risk of dengue importation into Europe in 2010 was computed with the volume of international travelers from dengue affected areas worldwide.These prototype early warning systems indicate that monitoring drivers of infectious diseases can help predict vector-borne disease threats
The most significant infectious disease drivers for Europe were grouped into three broad categories: globalization and environmental change; social and demographic change; and public health system
Summary
The emergence and spread of vector-borne diseases (VBD) in Europe is a function of biotic (living organisms in an ecosystem), abiotic (non-living elements in an ecosystem) and socioeconomic drivers of disease. The VBD scenario considered a threat from the introduction of new disease vectors, which creates new opportunities for disease transmission; expanded ability of vectors to transmit pathogens (e.g., by mutation); and a shift in the transmission range of diseases, hosts, and vectors due to socio-economic factors and climate change This VBD scenario from the foresight study had some similarities with actual VBD outbreaks in Europe that occurred subsequently: The large dengue outbreak in Madeira in 2012 was sparked by the importation of viremic air traffic passengers in an environment where the vector Aedes aegypti had recently been introduced [22]. The processing of these data sets, and those continuously assembled from other sources, with regular outputs from advanced scientific analysis, serve as a reference point [29] It supports data exchanges and scientific collaborations between member states, researchers, ECDC experts and other authorised users across geographical and political boundaries in the European Community, with particular interest in the area of climatic change adaptation, landscape epidemiology and emerging disease threats. The data of the E3 Network have been used in a number of case studies, three of which are briefly described below
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