The European Centre for Disease Prevention and Control (ECDC) has a mandate to identify, assess and communicate current and emerging threats to human health from communicable diseases in the European Union (EU) [1]. The identification of threats is undertaken through the use of ‘epidemic intelligence’, the systematic collection and collation of information from a variety of sources, usually in real-time, which is then verified and analysed and, if necessary, activates response.

The implementation of the new International Health Regulations (IHR) in June 2007 has led to a need for more sensitive and specific public health event detection tools. Upon request, the ECDC can support EU Member States to assess and strengthen their threat detection and response capacity. Following the establishment of its Emergency Operations Centre (EOC) in May 2007, the ECDC developed a plan, defining epidemic intelligence activities in times of “peace” and times of crisis, and the necessary resources (human and material) to deal with both. The epidemic intelligence team, working full-time in the EOC, uses a set of advanced information technology tools to detect potential threats, paying special attention to events threatening more than one EU Member State. The team’s activities are divided into four main components:

• The maintenance of a database (the Threat Tracking Tool) to store, process and report potential health threats for Europe;
• The holding of a daily morning briefing, where all threats are discussed, and the ECDC’s actions decided based on the team’s risk assessment;
• A 24-hour on-duty system to ensure continuous epidemic intelligence operations;
• The production and distribution of reports on a daily and weekly basis.

The ECDC’s long-term strategy includes supporting EU Member States in developing and/or strengthening epidemic intelligence activities and related facilities [2]. In line with this strategy, an expert from Portugal’s Directorate-General of Health spent one week in July 2007 working in the ECDC’s epidemic intelligence team. The agenda was organised in order to facilitate the integration and familiarisation of the expert in the Centre’s daily and weekly epidemic intelligence activities and to acquire a broader perspective of public health signals, alerts and threats that, recognised at Member State level, may correspond to a threat to other Member States. The expert joined the ECDC’s epidemic intelligence team in screening and filtering news sources; followed messages from the Early Warning and Response System and other alert mechanisms; took part in the daily briefings; inputted the information into the database and circulated the resulting reports; tested the ECDC’s teleconference and videoconference systems with Portugal; and took part in videoconferences with both Portugal and the European Commission.

All involved recognised that the integration of expertise from Member States in the ECDC’s epidemic intelligence work contributes to a better understanding of the main needs and priorities regarding personnel, facilities, tools, equipments and products at Member State level. For Portugal, the main priorities were to identify areas of work needing greater organisation and coordination; to increase the collaboration between departments and units performing indicator-based and event-based surveillance at national, regional and local levels, and potentially at European and international level; and to facilitate communication between the risk assessment and the risk management levels.

The experience helped ECDC identify a model to support Member States with epidemic intelligence activities, and acted as the first operational step toward promoting networking in this field, and a better understanding of procedures, equipment and tools among Member States.

Based on the needs and priorities identified, the specific learning objectives, targets, and methods for a training-of-trainers epidemic intelligence workshop to take place in Portugal in the spring of 2008 were defined. This will be supervised by experts from the ECDC.

The findings and lessons learned from this initiative were shared with all EU Member States during the 3rd ECDC Consultation on Epidemic Intelligence in Europe, which took place in Stockholm on 5-6 December 2007. Several delegates expressed their interest in the initiative, and it was suggested that representatives from Member States could be placed at the ECDC for a period to participate in the Centre’s daily activities and that Member States could also join in the Centre’s daily epidemic intelligence briefings via teleconference.