SAFE SAtellites F or Epidemiology

1. SAFESAtellites For Epidemiology A satellite based application for health early warning 1

2. ESA context: telemedicine via satellite transition phase • ESA wants to create a telemedicine programme in partnership with WHO. • Creation of a European expert group to advise ESA on the actions to be promoted in the telemedicine field. • Identifications of 3 activities by the expert group • Health Early Warning -> SAFE project • Management of Medical Emergency for commercial aviation • Interconnectivity for Healthcare Services and Professional Medical Education bridging communities in Eastern and Western Europe • Approach: User driven, user co-funding for sustainability, promotion of a transition phase SAFE

3. Context (Source WHO, InVS) • Among current biological threats • Avian Influenza • Since 2003: 235 cases, 137 deaths (WHO, 8/08/2006) • Increasing geographical spread in animals, increasing number of species affected… • Current or emerging and re-emerging diseases • Global challenges for AIDS, Tuberculosis, Malaria, and many others • Environmental/climate changes influence microbial geographical distribution, persistence and transmission mode and can cause spread of local or species-specific diseases • On average, one new human disease per year, of which 75% is from animal origin • Diseases can re-emerge after containment if the reservoir of thevirus still exists (Ebola, SARS) • Chikungunya in La Réunion island: • since March 2005 - More than 266 000 cases (InVS, 3/08/2006). • Bioterrorism • Anthrax (US, 2001) • + Risk of epidemiological crises after natural or man-made disasters SAFE

4. Context (Source WHO) SAFE

5. Needs • Need for an Outbreak Management System to prevent, predict and organize an optimized response. • Network of experts, decision-makers • Tools: • To prevent or predict the outbreak • To issue early warning • To optimize the resources and the intervention to limit the extension of the crisis • Added value of satellite communications for health early warning in remote, isolate or prone to natural or man-made disaster areas. SAFE

6. SATCOM in biological crises • Access to communication from any place in the world especially remote areas or areas with difficult access. • Data collection for electronic surveillance and early alert • Geolocalisation of events related to the outbreak of epidemics (monitoring of movement of birds, localization of areas at risks…) • Communication for management of biological crisis. • Satellite connectivity between experts, decision-making centers and coordination centers on the site of the crisis. • Access to Internet from remote areas or mobile field units • Satellite communications for mobile field units. • Post disaster monitoring for data collection. SAFE

7. SAFE objectives To develop and demonstrate the added value of various satellite communication services for all the phases of a biological crisis including prevention, early warning and crisis management. • Specifications based on a close collaboration with end-users, in particular WHO and ECDC. • Development of a European Outbreak management system: • Interoperable • Implementing existing standards • Based on well recognized open source technologies. • To provide a standard tool usable by the maximum number of end-users. SAFE

8. SAFE demonstrator (1) SAFE

9. SAFE demonstrator (2) • A network of expert centers and hospitals able to communicate by satellites and interoperable with other networks • A coordination van • DVB-RCS capability • Deployable Wi-Fi network • Portable terminals, satellite phones for mobile teams • A field laboratory or lab.van • In-situ analyses • An information system • Data collection • GIS for geolocalisation and visualization of epidemics evolution SAFE

10. Network of expert centers • Satellite link to restore the communicationbetween the field and the overall network of epidemiological surveillance through Internet. • For SAFE demonstrations: • DVB-RCS access • Access through a communication platform offering: • Broadband satellite connectivity for high quality point to point and multipoint videoconference or broadcasting applications. • Access to a network of already satellite powered sites (35 hospitals in various countries) SAFE

11. Coordination van • Link with expert and decision makers: • DVB-RCS connection • Access to Internet • Link with mobile teams on the field: • Local Wi-Fi network • Satellite phones for areas outside Wi-Fi coverage • handheld terminals for data collection by the mobile teams. • Equipped with • Satcom antenna for DVB-RCS connection (2Mb/s) • Application server with SAFE information system (data collection + GIS) • Mobile terminals for the field agents: Tablet PC, PDA, GlobalStar Phones • + for the purpose of SAFE demonstrations: a lab. Kit. SAFE

12. Lab van (Field laboratory) • To obtain and analyze: • Environmental samples to evaluate the diffusion of the biological agent and the sources of contamination • Biological samples from asymptomatic people and for people demonstrating local or general symptoms of infection or intoxication • Series of preliminary tests • Advices and expertise from remote expert centers (Possibility to send images and data) • Rapid and preliminary information provided to hospitals and public health experts (care of potentially infected/intoxicated people) • Link with the coordination van, remote expert centers • Equipped with • Instruments and material to obtain biological and environmental samples • Basic microbiological kits to detect and presumptively identify the biological agent • SAFE information system • Link withlaboratories, hospitals, epidemiological centers, military and civil protection groups for the crisis management. • Structures and instrumentation to protect people working in fromthe contaminating agent To limit the costs, the lab van will be replaced by a lab kit included in the coordination van for most of SAFE demonstrations. SAFE

13. Data management system - MEDANY • Based on open source technologies (Eclipse eRCP namely supported by IBM, Nokia, Motorola) • Solution adapted to any type of situation, easy deployment, easy maintenance • Quick and easy configuration of collection forms • Easy application deployment (concept of rich client) as easy as calling a URL • eUpdate -> very easy maintenance • Configuration: • Remote and local application servers for collecting, consolidating, storing an analyzing information • Rich client deployed on mobile equipment • Maintenance facilitated (eUpdates). • High portability on a great number of handheld devices (PDA, Smart Phones) • Website for data consultation • Interface with laboratory equipment for the lab van. • Security: secured access with user profiles. • Interoperability • Export via web services for inter-system communication • Export to files (spreadsheet, Epi Info format…) • Database with standard interfaces - integration of adata modeldefined in accordance with PHIN guidelines. SAFE

14. GIS • Integration of information essential for the evaluation of the situation • Vegetation map • Land cover • Water resources, water quality • Wind blow and dust maps • Land surface temperature • Meteorological information layer. • Integration of geopolitical information • In-situ information all along the crisis • Points of sample collection • Situation of the different components/people of the in-situ units • Areas covered by mobile teams. • Satellite images: Global analysis of the situation: • Historical information and new acquired one to evaluate damage. • Digital elevation maps SAFE

15. Demontrations • Objective: • To validate SAFE approach with end-users. • Different types of demonstrations: • End-to-end case of early warning at the onset of an epidemic based on a post disaster scenario. • Itinerant and On-demand demonstrations • Inclusion of a scenario on the avian flu risk defined with experts from WHO. • Evaluation of SAFE solution for radiological risks. • Others to be defined, all over Europe, on demand of users. SAFE

16. Sustainability • Objective of the consortium: • To provide a sustainable system for Health Early Warning, using international standards and relying on advanced satcom services. • Promotion towards end-users • Participation to workshops • Promotion of a users group • Organization of the itinerant on demand demonstrations SAFE

17. Other perspectives and recommendations • Conditions for acceptability of space based products by the users • Legal aspects of sharing health related data • Access and property rights on transnational data • Rules for publishing transnational sensitive data • Standardization of health data for efficient exchanges in the European region. • Discussion with decision makers: • Possibility to issue an open source version of a basic SAFE information system for data collection in collaboration with decision makers. • Initial investment to be defined. SAFE

18. Schedule • Duration: 18 months (07/2006 - 12/2007) • July 2006 - December 2006: • Definition of users and requirements • Functional analysis, system design • November 2006 - June 2007: • Development and integration • July 2007-December 2007: • Demonstrations • Cost benefit and sustainability analysis • Perspectives and recommendations. SAFE

19. Partners Microbiology UNIVERSITY of VERONA FORTH Institute for Computer Science SAFE

20. Why becoming part of the users group • Participate in the specifications of the system. • Contribute to evaluate SAFE solution, for instance by including SAFE solution in one of your exercises • Get a prior access to SAFE results • Become a partner for the dissemination and the exploitation SAFE