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Overview of surveillance of water related diseases in the UNECE region

Overview of surveillance of water related diseases in the UNECE region. Monica Francesca Blasi Unit of Quality of Aquatic Environments and Bathing Water National Institute of Health Rome, Italy.

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Overview of surveillance of water related diseases in the UNECE region

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  1. Overview of surveillance of water related diseases in the UNECE region Monica Francesca Blasi Unit of Quality of Aquatic Environments and Bathing Water National Institute of Health Rome, Italy ------------------------------------------------------------------------------------------------------------------- Workshop on Water and Health, Bucharest 14th -16th of May 2008 5th Meeting of the Capacity for Water Cooperation, UNECE Capacity Building events

  2. Plan of the activities Task Force on surveillance and early warning systems, contingency plans and response capacity (2007-2009) • Questionnaire to assess the current capacity of water-related disease surveillance, and elaboration and publication of replies • Guidance materials (technical and policy guidelines) • Scientific workshop • Assistance and in-country support

  3. QUESTIONNAIRE The Task Force developed a questionnaire in order to assess: • The state-of-the-art on the surveillance systems of water-related diseases in the UNECE region • Critical areas and situations • The burden of WRDs in the region • Assistance programmes and training activities

  4. QUESTIONNAIRE STRUCTURE • General section: priority, emerging and locally important diseases • Organization of the surveillance systems structure, coordination and reporting • Case confirmation and laboratory capabilities to detect pathogenic microorganisms • Public information • Data characteristics • Outbreaks detection • Epidemic preparedness • Capacity of response • Training • Databases and mapping/GIS resources

  5. The questionnaire, as well as information on registration, access and compiling, have been sent to the Protocol’s national focal points by the end of February The questionnaire is available in the online version at the link: http://cms2.iss.it/ Info: monicafrancesca.blasi@iss.it

  6. …the questionnaire is also hosted in electronic format on a protected site of the Italian National Institute of Health (http://cms2.iss.it/)

  7. 6 4 3 2 1 5 8 QUESTIONNAIRE REPLIES • At the moment only 8 countries sent back the questionnaire’s answers Andorra 1 Czech Republic 2 Estonia 3 Finland 4 Hungary 5 Norway 6 Slovakia 7 Turkey 8 7

  8. 1. General information • 1.1 Is there a mandatory surveillance and reporting system for any diseases in the country?: YES=8 • 1.2...and the surveillance systems cover the following WRDs... PRIORITY DISEASES EMERGING DISEASES

  9. 1.3. Are there additional surveillance programmes for specific water-related diseases that are locally important such as… Blue baby syndrome: 2 Arsenicosis: 1 Viral infections particularly norovirus: 5 Parasitic diseases: 6

  10. 2. Surveillance: structure, coordination and reporting • 2.1. Is there a mandatory surveillance and reporting system for water-related disease (WRD) in your country? YES=8

  11. 2.2. If yes, please provide a short textual description of the operation of the mandatory surveillance system composition, function and links to various sectors including the laboratories:6 countriesrepliedtothisquestion Hospitals or Laboratories:responsible persons, reference laboratories in the country or in others countries, clinicians Local authorities:Municipal Health Protection Authorities, Departments of Epidemiology of Regional Public Health Authorities, Health protection Institutes regional Offices, local or regional medical Officers Service Central authorities:Health protection Inspectorates, National public Health Authorities, Ministry of Health or Social Affairs, National Epidemiological Information System, National public health and medical officers service Surveillance System

  12. 2.3. Is there a surveillance coordination body at the national level? Yes= 8 • 2.4. Is there a standardized surveillance form provided by the central level collecting communicable disease surveillance data? Yes= 8 • 2.5. Is the possible vehicle of infection (water, foods, etc) considered on the notification form? Yes=4 • 2.7. Are potential environmental sources responsible for water contamination investigated or reported in the notification form?Yes= 5

  13. 2.6. Is there a specific reporting form for the following water-related diseases, which allows later confirmation of the exposure route? Emerging less then priority diseases

  14. 3. Case confirmation • 3.1. Is case confirmation mandatory by laboratory analysis for the following water-related diseases?

  15. Priority diseases Yes No Cholera 7 1 Enterohaemorrhagic 7 1 E. coli Shigellosis/bacillary dysentery 7 1 Typhoid fever 7 1 Viral hepatitis A 8 0 • 3.2.a. Is there a national laboratory capability to confirm the etiological agents of the following water-related diseases? The most of countries are able to confirme the etiological agents

  16. 3.2.b. If yes, list etiological agents detected by routine laboratory analysis: Emerging less then priority diseases

  17. 4. Public information • 4.1Is there a public awareness programme on the importance of water-related diseases and the relationship between water hygiene and health. YES=4 • 4.2 Is there an integrated information system, accessible to the public, about long-term trends, current concerns and successfully handled past problems in water and health? YES=2 • 4.3 Is there an information system on rights and entitlements to water? YES=4 • 4.4 If yes, list the web site, databases or other forms of communication -Web-pages=4 -School education system activities for the public such as World water day, annually reports=1 -No responses= 3

  18. 5. Data characteristics • 5.1. Please provide information on the level of detail available at the central level on data concerning water-related diseases. • DESCRIPTIVE INFORMATION • STATISTICAL INFORMATION

  19. DESCRIPTIVE INFORMATION priority diseases

  20. DESCRIPTIVE INFORMATION emerging diseases

  21. STATISTICAL DATA TREATMENT Basic statistics: YES=7 for all the priority and emerging WRDs Trend analysis: YES=7 for all the priority and emerging WRDs

  22. 5.1.c. Action threshold – has an action threshold been defined for the following diseases and, if so, what is the threshold value? PRIORITY EMERGING

  23. 6. Outbreak detection • 6.1. Are you able to identify the exposure routes of water – related diseases by source of drinking water? PRIORITY

  24. 6. Outbreak detection • 6.1. Are you able to identify the exposure routes of water – related diseases by source of drinking water? EMERGING

  25. 6.2. Are you able to identify the exposure route of water-related diseases by food source?

  26. 6.3. Are you able to identify the exposure route of water-related diseases by type of recreational water?

  27. 7. Epidemic preparedness

  28. 7. Epidemic preparedness

  29. 7.2. Is information related to the emergency adequately provided to the people? Yes= 4 No=3 No response=1

  30. 8. Capacity of response • 8.1. Has the central level or local authority the ability to start intervention measures within 48 hours of notification? Yes=7 Unknown=1

  31. 9. Training • 1. Has your Country foreseen periodic training courses on surveillance systems? YES= 6 • 2. Are WRD addressed by the training courses? YES= 5 • 3. Is international support needed for the design and/or implementation of such training courses? No=3 Elaborated methods and financial support would be necessary=1 Would be helpful=1 Yes=1 WRD training is needed=1 No response=1

  32. 10. Databases and Mapping/GIS Resources • 10.1. Is the central computerized database available for the cases and outbreaks of WRD? YES=5 • 10.2. Is Geographical Information System (GIS) used within your sector? YES= 1 Partially= 4 • 10.3. Has your country foreseen periodic training courses on GIS? YES= 1

  33. CONCLUSIONS On the basis of these limited replies is possible to reach some preliminary conclusions: The current WRDs Surveillance Systems are generally able in detecting and reporting priority, emerging and locally important diseases These countries use different organization in reporting WRDs There is a lack of information expecially for rural areas (unregulated water-systems) There is also a lack of information on the possible diseases due to bathing water, shell-fish and crops consumption Lack of adequate information to the public Weakness in the capacity of response (vaccines, medical supplies and water tratment available at all times) Scarse use of database and mapping Request of training

  34. RECOMMENDATIONS • It is crucial to receive replies from the focal points and to facilitate such replies; it is also fundamentalto translate the questionnaire into Russian, in order to overcame the language barrier.

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