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A European Centre for Infectious Disease?

1998; Elsevier BV; Volume: 352; Issue: 9136 Linguagem: Inglês

10.1016/s0140-6736(98)00042-7

1474-547X

Johan Giesecke, Julius Weinberg,

Data-Driven Disease Surveillance

Jane Bradbury's Sept 19 news item (p 969)1European infectious disease centre takes shape.Lancet. 1998; 352: 969Google Scholar reports on a meeting between a group of scientists in Montpellier in September, during which the implementation of a European Centre for Infectious Disease was discussed. Even earlier, this concept had been advanced by one of its chief proponents, Michael Tibayrenc, for example in a letter to Nature last year.2Tibayrenc M European centres for disease control.Nature. 1997; 389: 433-434Crossref PubMed Scopus (4) Google Scholar It will also be the subject of a workshop at the meeting of the European Society for Clinical Microbiology and Infectious Diseases in Berlin next year. Whereas scientists should be free to entertain any idea, this particular one has little substance. Reference is frequently made to the Centers for Disease Control and Prevention (CDC) in the USA. One should not forget, however, that the CDC was founded on, and maintains, a clear public-health perspective. The development of any similar structure in Europe must recognise that surveillance is primarily about information for action—whilst research is important it is not the prime reason for collaboration.3Giesecke J Surveillance or infectious disease in the European Union.Lancet. 1996; 318: 1534Summary Full Text Full Text PDF Scopus (8) Google Scholar There has been an ongoing discussion about the surveillance and control of infectious diseases within the European Union. There are two views: one, which has much support in the European Parliament, maintains that a central structure is needed; the other, advocated by the Commission, proposes a network between the Member States, in which the national surveillance institutes would be the principal nodes. In a reconciliation in June, the latter view prevailed, and it is agreed to set up a network for the Epidemiological Surveillance and Control of Communicable Diseases in the Community. The idea of a central edifice seems to be politically dead. This development has been anticipated by the national centres with responsibilities in communicable disease surveillance, and the heads of these centres already meet regularly. Their group has become known as the Charter Group, after its production of a draft Charter for Communicable Disease Surveillance in the European Community 2 years ago. Under their direction, and in collaboration with the Commission unit responsible for public health, several successful European collaborations have developed. These collaborations have produced appropriate European datasets and delivered information for effective international public-health action.4Shohat T Green M Merom D Gill O Reisfeld A Matas A International epidemiological and microbiological study of an outbreak of Salmonella agena infection from a ready to eat savoury snack-2: Israel.BMJ. 1995; 313: 1107-1109Crossref Scopus (61) Google Scholar, 5Joseph C Morgan D Birtles R An international investigation of an outbreak of Legionnaire's disease among UK and French tourists.Eur J Epidemiol. 1996; 12: 1-5Crossref PubMed Google Scholar The Charter Group has also assisted the European Commission to prioritise future European surveillance activities, to develop the telematics infrastructure for effective communication on outbreaks, and to produce an inventory of facilities for communicable disease surveillance in Europe. All these developments have been without a centre. Collaboration can build around disease-specific networks, and around infrastructure projects, training, information technology, quality control, &c. Building and supporting the network of networks— the virtual European CDC—and funding the coordination of those networks is more likely to deliver public-health action and benefit than building with bricks and mortar. Not another European institutionThe early days of medicine in Europe saw the necessary (given the diverse countries and cultures involved) building of national institutes dedicated to research and treatment. Names such as the Pasteur, Karolinska, and Jules Bordet institutes spring to mind in their fields of infection, medicine, and oncology, respectively. There is a temptation for this pattern to continue, this time at the international level, in a more communal Europe minded to respond to or mimic enterprises elsewhere. An example here is the European Molecular Biology Laboratory, which started in Heidelberg in 1974. Full-Text PDF