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Tommi Asikainen, Tubingen, 22 October 2008

FUTURE DISEASE CHALLENGES IN EUROPE – where modelling is needed. European Centre for Disease Prevention and Control. Tommi Asikainen, Tubingen, 22 October 2008. ECDC modelling activities. Expert meeting: Now-Casting and short-term forecasting Realtime modelling during an influenza pandemic

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Tommi Asikainen, Tubingen, 22 October 2008

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  1. FUTURE DISEASE CHALLENGES IN EUROPE – where modelling is needed European Centre for Disease Prevention and Control Tommi Asikainen, Tubingen, 22 October 2008

  2. ECDC modelling activities • Expert meeting: Now-Casting and short-term forecasting • Realtime modelling during an influenza pandemic • Expert meeting: Chikungunya modelling • Seminars • HIV (open) • Prevalence estimations • Varicella (open) • Introduction into national child vaccination schedules

  3. Upcoming ECDC modelling activities • Surveillance in an influenza pandemic meeting • 60 participants, 20 modellers • Pandemic influenza planning assumptions meeting • 30 participants, 15 modellers • HIV prevalence estimation meeting

  4. Upcoming ECDC modelling activities • Curriculum for providing modelling training meeting • TB modelling in low prevalence countries meeting • Use of synthetic populations meeting • Upon budget availability • Modelling call for tenders • Upon budget availability

  5. How will this meeting benefit you? • Meetings • Specialized • With other expertise involved • Project proposals • DG Research (European Commission) • EAHC Executive Agency for Health and Consumers (former PHEA) • ECDC • Ways to influence • Meeting report • Shared with partners • ECDC ”lobbying” • Time frame

  6. Will ECDC only rely on your opinion?

  7. Top 10 future disease threatsExcellent meeting

  8. Antimicrobial resistance • Production line on developing new drugs • Today new treatments are available after 7-10 years • Effect on the spread by reducing this time • Community acquired MRSA

  9. Antimicrobial resistance Some other strategies, of varying cost effectiveness depending on how resistant and how prevalent a particular pathogen is, would include: • Developing vaccines against completely resistant pathogens. • Increasing effectiveness of infection control methods and technologies in the healthcare setting. • Developing and implementing screening and cohorting methods to prevent exposure and transmission.

  10. Antimicrobial resistance Some other strategies, of varying cost effectiveness depending on how resistant and how prevalent a particular pathogen is, would include: • Developing effective methods for eliminating carriage of resistant pathogens. • Developing and using point of care tests that detect antibiotic susceptibility patterns to ensure appropriate treatment. • Developing and using point of care tests that have high sensitivity and specificity for distinguishing viral from bacterial infections to ensure appropriate treatment.

  11. Vaccine preventable diseases • Measles • Can we eliminate the disease within a five year period in EU countries? • What happens with the groups in seventies who were not affected and did not get a measles vaccine • Rubella • What is the situation within a five year period? • Varicella • New quadrivalent measles-mumps-rubella-varicella available in EU • Data from US (effectiveness, impact on herpes zoster) • Member States need help

  12. Tuberculosis • Forecasting of impact on the epidemic in low incidence countries of cohorts from high burden countries and the relative impact of control measures (i.e. screening) • Ongoing ECDC work, but in need of better modelling work • Modelling future progress towards elimination given current trends of transmissions and burden distribution in low incidence countries

  13. Tuberculosis • Modelling impact of new tools on control effectiveness • Diagnostics • Interferon Gamma Release Assays (IGRA) • Line probe assays (rapid molecular testing) • Liquid media culture, Moxifloxacin, Gatofloxacin • Drugs reducing treatment period

  14. Influenza • School closures, closing bordures, reduced travel..... • School closures (Simon Cauchemez et al 2008) • Border closures, reduced travel But......... • Operational modelling • Decision makers want to know optimal distribution of antivirals and anticipated hospital occupancy • Seasonal influenza • Prevalence • Vaccine effectiveness

  15. Vector borne / emerging infections • ”Climate change” • Effect of extreme heatwaves • MoMo (Mortality Monitoring) network • Introduction of new pathogens • Risk Mapping • Risk maps of Aedes Albopictus (unpublished) • TBE Swedish data used to predict the situation in Finland • Linking epidemiological and environmental data • E3 network

  16. Burden of Disease • ECDC has launched a huge tender • Total burden for ”all” infectious diseases

  17. ”ECDC wish list” • More work on vaccine effectiveness definitions • Advice on how to measure and analyse contact patterns • Build on the POLYMOD project • Model comparisons • Methodology for modelling mortality of diseases • Baseline • Bayesian based

  18. ”Top 10” future modelling challenges

  19. Example 1 ECDC expert meeting on Chikungunya modelling • Entomological data • ”Biased” traps • Effects of interventions • Need to know how the surveillance system works

  20. Example 2 Expert meeting on pandemic influenza realtime modelling • What data to collect • Modellers <-> Surveillance <-> Decision maker • Which models to use • What does the decision maker want to know?

  21. .........the floor is now open for discussion on what YOU think is important.

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