Case studies on preparedness planning for polio in Poland and Cyprus

​The last cases of poliomyelitis due to wild poliovirus in Poland and Cyprus were registered in 1984 and 1995, respectively. Current efforts against polio are therefore aimed at maintaining the two countries’ polio-free status. The overall objective of this report is to support these two EU Member States in updating their polio preparedness planning. The specific aims of the case study were to: critically review implemented actions and identify gaps in order to propose approaches for strengthening the national polio plans; identify health system elements that are important in polio preparedness planning; and provide examples of collaborative efforts between these sectors in planning measures for outbreak response to polio as a cross-border health threat.Katalognummer: TQ-07-16-086-EN-N</p

Synergies in community and institutional public health emergency preparedness for tick-borne diseases in Spain : a case study on Crimean-Congo haemorrhagic fever

Within the broad context of EU Decision 1082/2013/EU on serious cross-border health threats, the European Centre for Disease Prevention and Control (ECDC) has initiated a case study project to investigate the synergies between communities affected by serious public health threats and the institutions (both health- and non-healthrelated) that are mandated to prepare for and respond to them. The premise for the project is that affected communities are increasingly being recognised as key resources that can be used during public health emergencies, and that the concerns, understanding and experience of ordinary people should be harnessed as an important part of the response. The aim of this case study project is to identify good practices related to community preparedness for tick-borne diseases. This report focuses on two cases of Crimean-Congo Haemorrhagic Fever (CCHF) that emerged in Spain in August– September 2016, the first autochthonous clinical cases of CCHF in south-western Europe. Specifically, the study aims: - to identify good practices and patterns of cooperation between affected communities and the official institutions mandated to address tick-borne diseases such as CCHF; - to identify inter-sectoral collaboration between health and non-health-related sectors with regard to tickborne diseases, such as CCHF; - to identify actions that could be taken by other EU countries

Synergies in community and institutional public health emergency preparedness for tick-borne diseases in Spain and the Netherlands

Within the broad context of EU Decision 1082/2013/EU on serious cross-border threats to health, the European Centre for Disease Prevention and Control (ECDC) has initiated a case study project to investigate the synergies between communities affected by serious public health threats and the institutions (both health- and non-healthrelated) mandated to prepare for and respond to them. The premise for the project is that affected communities are increasingly recognised as key resources that can be used during public health emergencies, and that the concerns and experience of ordinary people should be harnessed as an important part of the response. The aim of this qualitative comparative case study project is to identify good practices related to community preparedness for tick-borne diseases. Two EU countries, Spain and the Netherlands, were selected for inclusion. Work in Spain focused around two cases of autochthonous infection with Crimean-Congo haemorrhagic fever (CCHF) virus that emerged in the Autonomous Community of Castilla y León in August 2016. Work in the Netherlands focussed on the first two endemic cases of tick-borne encephalitis (TBE) in the country, appearing in July 2016 in the Utrecht and Twente regions. The response to the TBE cases was undertaken within the wider context of prevention work on lyme borreliosis (LB) in the country. Specifically, the study aims to: - Identify good practices and patterns of cooperation between affected communities and the official institutions mandated to address tick-borne diseases; - Identify inter-sectoral collaboration between health and non-health-related sectors with regard to tick-borne diseases; - Identify practices that could be of use for other EU countries in the area of public health preparedness

Public Health Preparedness and Response Synergies Between Institutional Authorities and the Community: A Qualitative Case Study of Emerging Tick-Borne Diseases in Spain and the Netherlands

Background: Communities affected by infectious disease outbreaks are increasingly recognised as partners with a significant role to play during public health emergencies. This paper reports on a qualitative case study of the interactions between affected communities and public health institutions prior to, during, and after two emerging tick-borne disease events in 2016: Crimean-Congo Haemorrhagic Fever in Spain, and Tick-Borne Encephalitis in the Netherlands. The aim of the paper is to identify pre-existing and emergent synergies between communities and authorities, and to highlight areas where synergies could be facilitated and enhanced in future outbreaks. Methods: Documentary material provided background for a set of semi-structured interviews with experts working in both health and relevant non-health official institutions (13 and 21 individuals respectively in Spain and the Netherlands), and focus group discussions with representatives of affected communities (15 and 10 individuals respectively). Data from all sources were combined and analysed thematically, initially independently for each country and then for both countries together. Results: Strong synergies were identified in tick surveillance activities in both countries, and the value of pre-existing networks of interest groups for preparedness and response activities was recognised. However, authorities also noted that there were hard-to-reach and potentially vulnerable groups, such as hikers, foreign tourists, and volunteers working in green areas. While the general population received preventive information about the two events, risk communication or other community engagement efforts were not seen as necessary specifically for these sub-groups. Post-event evaluations of community engagement activities during the two events were limited, so lessons learned were not well documented. Conclusions: A set of good practices emerged from this study, that could be applied in these and other settings. They included the potential value of conducting stakeholder analyses of community actors with a stake in tick-borne or other zoonotic diseases; of utilising pre-existing stakeholder networks for information dissemination; and of monitoring community perceptions of any public health incident, including through social media. Efforts in the two countries to build on the community engagement activities that are already in place could contribute to better preparedness planning and more efficient and timely responses in future outbreaks

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

BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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