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      Comparing Findings from Syndromic Surveillance Systems at a European Level

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          Objective To present a proposal for coordinating syndromic surveillance (SyS) systems operated by European countries and for comparing findings from these systems. Introduction Co-financed by the European Commission through the Executive Agency for Health and Consumers, the European Triple-S project (Syndromic Surveillance Survey, Assessment towards Guidelines for Europe) was launched in 2010 for a 3-year period [1] and includes 24 organizations in 13 countries. Numerous European countries have created SyS systems [2,3]. These systems analyze and report their SyS findings to local, regional or national public-health authorities in accordance with their national priorities. But the country outputs are not systematically reported and compared at the EU level, hindering a global overview and interpretation of the health situations observed in different regions or countries in Europe. The Triple-S project has thus proposed a strategy for coordinating the comparison and interpretation of SyS information across Europe to produce a Europe-wide epidemiological picture of a given health event in a timely manner, and thereby support coordinated public- health action. Methods Based on Triple-S outputs (including human and veterinary inventories and a survey of users’ expectations) and expert advice, Triple- S discussed different models for ensuring the comparison and reporting of findings from EU countries. Triple-S detailed the main characteristics, strengths, drawbacks and minimum requirements for implementing each model. The project discussed the roles of potential stakeholders in coordinating SyS in Europe. Results Triple-S identified three models suitable for different syndromes or health threats for organising SyS at the European level. For the sustainability of three suggested models, a SyS coordinating group is needed to coordinate SyS activities in Europe. This group would centralize and analyze health information provided by countries or regions, interpret this information and produce a European summary report usable by the regional, national and European authorities. The three models are: EU countries create their own protocols for data collection, analysis, reporting and dissemination. No data or report on SyS is compiled at the EU level for this model. The SyS coordinating Group would mainly support the setup and improvement of SyS systems in MS and would provide advice on SyS to EU institutions. In the second model, data analysis would still be performed by countries and regions, but they would provide standardized reporting of their findings to the SyS coordinating group using common protocols with a minimum level of information to report. In the third model, the SyS coordinating group would centralize and analyse standardised data provided by the different countries and regions. The collected data should comply with a common protocol that defines the format of the data, the groups for data aggregation, common definitions of syndromes, geographical levels, etc. The SyS coordinating group would work with all players in local/ regional/national SyS systems, with EU bodies and international organizations, in particular the European Commission, ECDC, ISDS and with other public-health surveillance systems and networks. Conclusions Currently, although there is no systematic sharing of reports, Triple-S has developed an informal network allowing contacts and sharing that has strengthened SyS links and practices across Europe. Triple-S proposes gradual implementation of the different European models suited to several different situations, starting with centralizing outputs for one or two prioritized syndromes and assessing the usefulness of such centralisation.

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          Inventory of veterinary syndromic surveillance initiatives in Europe (Triple-S project): current situation and perspectives.

          Within the current context that favours the emergence of new diseases, syndromic surveillance (SyS) appears increasingly more relevant tool for the early detection of unexpected health events. The Triple-S project (Syndromic Surveillance Systems in Europe), co-financed by the European Commission, was launched in September 2010 for a three year period to promote both human and animal health SyS in European countries. Objectives of the project included performing an inventory of current and planned European animal health SyS systems and promoting knowledge transfer between SyS experts. This study presents and discusses the results of the Triple-S inventory of European veterinary SyS initiatives. European SyS systems were identified through an active process based on a questionnaire sent to animal health experts involved in SyS in Europe. Results were analyzed through a descriptive analysis and a multiple factor analysis (MFA) in order to establish a typology of the European SyS initiatives. Twenty seven European SyS systems were identified from twelve countries, at different levels of development, from project phase to active systems. Results of this inventory showed a real interest of European countries for SyS but also highlighted the novelty of this field. This survey highlighted the diversity of SyS systems in Europe in terms of objectives, population targeted, data providers, indicators monitored. For most SyS initiatives, statistical analysis of surveillance results was identified as a limitation in using the data. MFA results distinguished two types of systems. The first one belonged to the private sector, focused on companion animals and had reached a higher degree of achievement. The second one was based on mandatory collected data, targeted livestock species and is still in an early project phase. The exchange of knowledge between human and animal health sectors was considered useful to enhance SyS. In the same way that SyS is complementary to traditional surveillance, synergies between human and animal health SyS could be an added value, most notably to enhance timeliness, sensitivity and help interpreting non-specific signals. Copyright © 2013 Elsevier B.V. All rights reserved.
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            Author and article information

            Journal
            Online J Public Health Inform
            Online J Public Health Inform
            OJPHI
            Online Journal of Public Health Informatics
            University of Illinois at Chicago Library
            1947-2579
            29 April 2014
            2014
            : 6
            : 1
            : e124
            Affiliations
            [1 ]French Institute for Public Health Surveillance (InVS), Saint Maurice, France;
            [2 ]Dept. of International Health, School of Public Health and Primary Care (Caphri), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands;
            [3 ]French Agency for Food, Environmental and Occupational Health Safety, Lyon, France;
            [4 ]Smittskyddsinstitutet, Stockholm, Sweden;
            [5 ]Statens Serum Institut, Copenhagen, Denmark
            Author notes
            [* ]Anne Fouillet, E-mail: a.fouillet@ 123456invs.sante.fr
            Article
            ojphi-06-e124
            10.5210/ojphi.v6i1.5061
            4050903
            d9b00a04-8a1a-4b8b-9215-7263937c68dc
            ISDS Annual Conference Proceedings 2013. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License ( http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
            History
            Categories
            ISDS 2013 Conference Abstracts

            european strategy,triple-s project,syndromic surveillance,comparability

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