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In 1994, the Instituto de Salud Carlos III (ISCIII; Carlos III Health
Institute) of the Spanish Ministry of Health and the Consumer (MSC)
created the Programa de Epidemiología Aplicada de Campo (PEAC; Applied
Field Epidemiology Programme). The programme is managed by the Centro
Nacional de Epidemiología (National Epidemiological Centre) in
collaboration with the Escuela Nacional de Sanidad (National School of
Health), and supported by General Direction for Health and Consumer of MSC
and the Health Councils (Consejerías de Sanidad) of the autonomous
regions.
The PEAC runs a masters degree programme in applied field epidemiology,
in which degrees are conferred by the National School of Health. As PEAC
is a national programme, it forms a part of the European Program for
Intervention Epidemiology Training (EPIET) and is a member of the Network
Training for Epidemiology Public Health Intervention (TEPHINET), the
association of 27 regional and national programmes of the acting
Intervention Epidemiology Training Programs.
The PEAC shares the same purpose and aims as the Epidemic Intelligence
Service (EIS) of the Centers for Disease Control and Prevention (CDC) in
the United States, EPIET, and other similar programmes being carried out
in countries that are part of TEPHINET. These programmes aim to develop
skills in epidemiological procedures, in public health communication, and
a culture of serving the population in health activities. Skills are
developed through hands-on training, which emphasises practical experience
more than theory. The programme works within the framework of Servicios de
Salud Pública (Public Health Services) and focuses on the application of
disease control measures.
The PEAC trains and certifies people who work in the practical
application of public health measures at different levels in Spain. Such
people may work in research (mainly in infectious diseases but also health
diagnosis and environmental studies) or service. The programme follows
current trends in training for public health epidemiology.
Since 1994, 35 people have graduated from the programme and 13 are
currently being trained. The programme is one of the strategic components
in the reform process underway in disease control in Spain. It has trained
and contributed to the improvement of people working at national and
regional administrative levels. Applications from people who work in
public health control departments, at any level, are given priority.
The programme receives funding from two sources: the ISCIII and the
Dirección General de Salud Pública y Consumo, both of which are part of
the Ministry of Health and Consumption. Funding terms are set down in an
agreement signed by both institutions. From the outset, the programme has
trained students from EPIET (Holland, Portugal, and now Germany) and from
Latin America (Cuba, Argentina, and the Dominican Republic), priorities
among the cooperation activities laid down by the ISCIII.
The training program lasts two years and is a full time activity. The
first year of training takes place at the Centro Nacional de
Epidemiología (CNE) and the second at the Servicios de Vigilancia
Epidemiológica (Public Health Surveillance) of the various autonomous
regions and at the CNE. Training is divided into two major sections:
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Theory (510 hours) – course on major principles, a workshop
entitled ‘An Introduction to Public Health Surveillance’, various
modules on advanced methods (epidemiological surveillance, specialised
epidemiology, advanced statistics, public health planning, and
communication), seminars, and work sessions.
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Practice – this section is aimed at developing skills and
aptitudes through practical experience in epidemiological surveillance
and through other types of training carried out in the field (evaluating
the level of surveillance, the ecology, the breakout of epidemics,
evaluating health operations). This section also focuses on the
development of communication skills - both scientific (publishing
epidemiological reports in the Boletín Epidemiológico Semanal
[weekly epidemiological bulletin] and writing and presenting a
scientific paper) and social.
In six years of existence, the PEAC has been credited with noteworthy
accomplishments: 75 epidemic outbreaks have been studied, 67 studies have
been carried out on how to evaluate various infectious diseases and how to
analyse health conditions in different zones. Sixty-seven articles written
by students of the PEAC have been published in various journals,
bulletins, and on the internet. Some of the PEAC action programmes have
had a direct impact on public health, such as studies of the efficacy of
certain vaccines, food poisoning, an infant formula contaminated with
lactosa-fermenting Salmonella Virchow
and outbreaks of brucellosis in slaughterhouses.
In the past six years the programme has received two awards. One was
CDC’s John Snow Award (for best investigative work) in 1997, for case
control studies on acute gastroenteritis induced by Campylobacter jejuni
in Mallorca. The other was the Merieux Foundation Award, which was awarded
for the first time at the first international conference of TEPHINET in
Ottawa, Canada, in 2000, for a study of two outbreaks of parotitis and the
Rubini strain vaccine, incorporating an evaluation of vaccine efficacy.
When they leave the programme, half of our graduates change their
professional activities within the field epidemiological service and are
promoted to new positions in fields related to health surveillance or
teaching. Seven of our graduates now hold posts within health systems,
either in health surveillance or teaching. |