Transcript EPIET slideshow 2008 web - ECDC

Update on the EPIET programme
Marion Muehlen and Katharina Alpers
EPIET and PAE scientific coordinators
EPIET
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European Programme for Intervention Epidemiology Training
Started 1996, funded by EU Commission and Member States
From Nov 07 funded by ECDC/EU Member States
Coordinators:
 Viviane Bremer, based at ECDC in Stockholm, Sweden (100%,
leading coordinator)
 Alicia Barrasa, based at Carlos III in Madrid, Spain (100%)
 Marion Muehlen, based at HPA-CfI in London, UK (60%)
 Brigitte Helynck, based at INVS in Paris (50%)
 Marie-Anne Botrel, based at INVS in Paris (50%)
 Doris Radun, based at RKI in Berln (80%)
 Katharina Alpers (100% PAE-Coordinator)
• Administration:
 Anna Bohlin, Claudia Metz-Ruffer, ECDC staff
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EPIET programme objectives
To:
• Strengthen CD surveillance & control in EU
• Develop a European network of intervention
epidemiologists
 Training fellows and externals together
 Training of trainers
 Sustaining and strengthening a network of training sites
• Develop a response capacity inside & beyond EU:
 surveillance
 outbreak investigations
 applied research
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Training objectives
• Plan, implement, evaluate a surveillance system
• Perform outbreak investigations
• Develop a research project on a relevant public
health issue
• Acquire oral and written scientific
communication skills
• Acquire teaching skills
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Training format
• Theoretical training
An introductory course (3 weeks), open to
external participants
At least 6 one-week training modules rotating in
EU Member States
• Learning by doing practical training
23 months
At a European public health institute
On site supervision by senior epidemiologists and
from EPIET coordinators
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Modules
• Compulsory
 Introductory course
 Computer tools in outbreak investigations
 Vaccinology
 Project review
 Multivariate analysis
• Optional
 Scientific writing
 Time series analysis
 Lab and epi
 Rapid assessment of complex emergency
situations
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Introductory course, content
• Lectures from field
epidemiologists
• Interactive case studies
based on real
investigations
• Development of a study
protocol based on real
PH issue
• Surveillance exercise
• Communication exercises
Since 2004 in Menorca, Spain
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Course Modules in 2002-2007
• Biostatistics (Porto, Rome)
• Communication (London, Berlin)
• Rapid assessment techniques in
emergency situations (Veyrier, Berlin)
• Time series analysis and Geographic
Information System (Athens, Madrid,
Veyrier, Bilthoven)
• Vaccines (Glasgow, Helsinki, Stockholm,
London, Bilthoven)
• Data management (Bilthoven)
• Computer & outbreak investigations
(Heraklion, Paris, Athens, Prague,
Budapest, Malta, Vienna, Sesimbra)
• Bioterrorism (Berlin)
• Logistic Regression (Bordeaux, Madrid)
• Scientific Writing (Berlin)
• Multivariable Analysis (Stockholm)
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Outbreak investigations (examples)
• Campylobacter and norovirus linked to communal water in
Sweden, 2002
• Q-Fever associated with sheep market in Germany, 2002
• Avian influenza in poultry cullers in NL, 2003
• Legionella associated with cooling towers in France, 2003
• Hepatitis A in homosexual men in Denmark, 2004
• Tuberculosis linked to supermarket in NL, 2005
• S. Hadar associated with roasted chicken in Spain, 2005
• Giardia linked to communal water in Norway, 2005
• S. DT 104 associated with pork meat in NL, 2005/6
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Choice of modules
• Skills assessment form at start of training
• Depending on
 Previous skills
 Local training opportunities
 Future needs
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EU Cross-border Investigations
1999-2007
• Salmonella paratyphi B among EU tourists returning
from Turkey, 1999
• Clostridium infection and deaths among intravenous
drug users, England, Scotland, Ireland, 2000
• EU-wide outbreak of
Salmonella typhimurium 204b, 2000
• Meningitis W135 in pilgrims returning from the Haj, 2000,
2001
• Hepatitis A in Ibiza and German tourists, 2001
• An outbreak of gastroenteritis in holiday-makers
travelling to Andorra, January-February 2002
• Hepatitis A among returning travellers from Egypt, 2004
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Research Projects (examples)
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Risk factors (RF) for Hantavirus in France and Belgium
RF for meningococcal meningitis in day care centers, Ireland
RF for Q fever in Germany
RF for sporadic cases of Listeriosis in France
RF for MRSA in nursing homes, Germany
RF for Hep C in hemodialysis Unit, France
Seroprevalence of WNV among German and
Austrian bird-ringers
RF for sporadic campylobacteriosis, Ireland
RF for CA-MRSA, Switzerland
RF for syphilis, Sweden
Influenza vaccine effectiveness, Denmark
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Surveillance Projects (Examples)
• Establishment of new surveillance
 Norovirus in Sweden
 Congenital toxoplasmosis in France
 CA-MRSA in Switzerland
 Heat and cold-related mortality in Spain
 Winter mortality in the UK
 Sales of flu medicine in Northern Ireland
• Evaluation of surveillance systems
 EHEC in France
 STI in Finnland
 Syphilis and Influenza in Germany
 Tuberculosis in Spain
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EPIET international missions (1)
Outbreak investigations
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Infant deaths following immunisation (Egypt)
Tularaemia (Kosovo)
Suspected anthrax (Ethiopia)
Ebola (Uganda, Gabon, Sudan)
Hepatitis E (Sudan)
Marburg fever (Angola)
Measles (Nigeria, Niger, DRC, Serbia, Kosovo)
SARS (Hong Kong)
Meningitis (Sri Lanka)
Avian influenza (Vietnam, Turkey, Azerbaijan)
Mumps (Moldovia)
Meningitis (Burkina Faso)
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EPIET international missions (2)
Surveillance projects and surveys
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Cholera Surveillance (Mozambique)
Unsafe Injection Practices survey (Burkina Faso)
Assessment of neonatal tetanus status (Zimbabwe)
Vaccine coverage (Côte d’Ivoire, Republic of Guinea,
East-Timor, Pakistan)
SARS (Hong Kong)
Retrospective Mortality Survey (Darfur, Sudan)
Nutritional survey (Niger, East-Timor)
Early warning system (Pakistan after Earthquake)
Avian influenza (Georgia, Azerbaijan)
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Scientific Conference
• ESCAIDE annually in fall
 co-organized ECDC, EPIET, EAN, TEPHINET-Euro
• Slots for EPIET fellows
 500 persons from European and international
field epidemiology
• EPIET fellows, alumni, FETPs Europe, supervisors
and colleagues from training sites
 EPIET Fellows prepared by “project review” module
• Review of methods and presentations during a
whole week, this year in September
• Satellite workshops: training the trainers
organized by EPIET, Tephinet, EAN, PAE and FETPCanada
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Time frame
modules
outbreak
investigation
surveillanceproject
research
project
teaching
ESCAIDE
SeptOkt Nov Dez Jan Feb Mrz Apr Mai Jun Jul Aug Sep Okt Nov Dez Jan Feb Mrz Apr Mai Jun Jul Aug Sep Okt Nov
Year 1
Year 2
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Practical Training
“learning by doing”
• 27 Nations
+ Norway
+ Switzerland
+ WHO
+ EpiCentre / MSF
+ ECDC
• 27 Training sites
(23 for cohort 11-13)
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Who does What?
• ECDC
 Pays grants and expenses for modules and international
missions
• Training sites
 Host fellow, offer supervision, activities and projects
• Supervisors
 First responsible for training the fellow
 Teaching
• Coordinators
 Overall responsible for training
 Review all work of fellows
 Advise supervisors on questions
 Organise training modules / courses
 Supervise international missions
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Supervision of fellows
• Supervision on site by at least 1 senior
epidemiologist (4 hours/week)
• Draft protocols/reports/manuscripts sent to all
coordinators
• Viadesk as virtual office
• Final work uploaded to folder on viadesk
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Time frame per cohort
Each cohort begins with an
introductory course, and ends
with a scientific seminar, where
each fellow presents his/her
work.
Cohort 12: 13 fellows
Sept-Oct 06
Sept-Oct 08
Cohort 13: 13 fellows
Sept-Oct 07
Sept-Oct 09
Cohort 14: 19 fellows
Sept-Oct 08
Sept-Oct 10
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Selection process
• 1st stage
 Check eligibility (ECDC human resources)
 ECDC Selection Panel goes through all applications and
selects eligible candidates
 MS rank 2 best candidates - for this year’s selection process
this had NO effect on eligibility for ECDC selection panel!
• 2nd stage
 Candidates choose 3 preferred training sites
 Face to face interview with ECDC selection panel
• 3rd stage
 Training site market
 Interviews with training sites
• 4th stage
 Final selection meeting between panel and host site
representatives and placement of candidates
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Output of EPIET 1995-2007
• Cohort 1-12:
 124 fellows trained in EPIET
 39 in EU FETP’s (Germany, Norway, Sweden)
• 149 (93%) graduated (diploma)
• Network of trainers (until 2007)
 12 different modules
 252 individual trainers
 55 organisations
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Number of graduated EPIET Fellows
1995-2008 by Country of Origin/Training
33 30 27 24 21 18 15 12
(nr=146)
Hosted
Sent
Austria
Belgium
Czech republic
Denmark
Finland
France
Germany EPIET
Germany FETP
Greece
Hungary
Ireland
Italy
Latvia
Lithuania
Luxembourg
Malta
Norway EPIET
Norway FETP
Portugal
Slovenia
Spain
Sweden
Switzerland
The Netherlands
United Kingdom
WHO
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6
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12 15 18 21 24 27 30 33
Number of EPIET fellows
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EPIET graduates working in MS (1998-2007)
Place of work
EU Member States
Number
89
ECDC
6
Norway
4
Switzerland
1
Ouside Europe
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Global level
(WHO, NGO's, UN etc)
Unknown
Total
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130
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Next challenges for EPIET
• Training seats
 Equity of access
 Number of salaries
• Trainers
 Expand training sites to all EU member states
 Increase number of trainers
• National field epidemiology training programmes
 Increase synergy with national FETP’s
 Create new FETPs
• Training material
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European added value
• Promotion of field epidemiology in EU
• Contribution to the European Network for
surveillance and control of CD
• Training of trainers in EPIET host institutes
• Promotion of national training programmes
• Increased mobility of epidemiologists
• Cross border investigations in EU
• International missions
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More information
More information is available on the web at:
 http://www.epiet.org
Or writing an e-mail to:
[email protected]
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Thank you
European
Programme for
Intervention
Epidemiology
Training
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