Objective
This paper reviews current idea on surveillance and studies in a pandemic in Europe and the experience in 2009 (influenza). WHO and ECDC (European Centre for Disease Control and Prevention) divided surveillance and studies in a pandemic into 4 component: early detection and investigation; comprehensive early assessment; monitoring and investigations concerning the effectiveness, safety and impact of pharmaceutical interventions. Pandemics represent exceptional challenges for surveillance because it has been stressful for those in the health sector, especially the essential contributors to surveillance: laboratories, clinicians and the public health workforce. Other challenges concerned the heterogeneity of pandemics.
Component 1. Early detection and investigation
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Events occur regularly that might represent the start of a pandemic, so early detection and investigation is a continuous process, even if true pandemic strains only occur a few times each century.
Component 2. Comprehensive early assessment: the strategic parameters
To characterize the important characters of the new virus, its infection and the disease it causes, including virological, epidemiological and clinical features. The key objective is to guide effective countermeasures. This is basically determining the ‘known unknowns’ of the pandemic; the features that are known to differ from one pandemic to another. The most important features are those that lead to specific and differing public health actions according to the findings. These are known as ‘strategic parameters’ by ECDC.
What can and cannot be assumed for the next pandemic.
What probably can be assumed: the ‘known knowns’ What cannot be assumed: the ‘known unknowns’
Modes of transmission (droplet, direct and indirect