The European Centre for Disease Prevention and Control (ECDC) is an agency of the European Union (EU) whose mission is to strengthen Europe's defences against infectious diseases. It covers a wide spectrum of activities, such as: surveillance, epidemic intelligence, response, scientific advice, microbiology, preparedness, public health training, international relations, health communication, and the scientific journal Eurosurveillance.The centre was established in 2004 and is headquartered in Solna, Sweden.
In 2023 the European Centre for Disease Prevention and Control (ECDC) launched RespiCast, the first European Respiratory Diseases Forecasting Hub, to provide probabilistic forecasts for influenza-like illness (ILI) and acute respiratory infection (ARI) incidence across 26 European countries. During the 2023/24 and 2024/25 winter seasons, RespiCast collected one- to four-week-ahead forecasts from multiple models contributed by different international teams and combined them into an ensemble. Our analysis shows that, when evaluated using the weighted interval score (WIS) and the absolute error (AE), the ensemble consistently outperformed the baseline model (defined as a persistence model that projects the last observed value forward) as well as individual models across most countries and forecasting rounds for both ILI and ARI incidence in the two seasons. Analysis of ensemble coverage (defined as the proportion of times observed values fall within the specified prediction intervals) indicated that forecast prediction intervals were reliable, although a general overconfidence trend (i.e., prediction intervals that are too narrow) was observed, particularly in specific countries. The relative performance of the ensemble declined in certain weeks, likely due to reduced participation from modelling teams, epidemic dynamics, higher data noise, and reporting delays. Forecast scores varied across countries, with some exhibiting consistently higher relative errors than others. Overall, the findings highlight the strengths of ensemble approaches in improving the accuracy and reliability of epidemiological forecasts while identifying areas for improvement, such as managing overconfidence and addressing variability in performance across countries and over time.
Background: Resources to respond to emerging and re-emerging infectious disease emergencies are limited. Aim: To support preparedness planning and resource allocation, a prioritisation methodology was applied to rank epidemic-prone diseases in Eastern Africa. Setting: The study took place in the eastern region of Africa representing 14 member states. Methods: A multi-criteria decision analysis (MCDA) combined with a modified Delphi approach, adapted from the Africa Centres for Disease Control and Prevention (CDC’s) continental prioritisation framework was employed. A planning team of epidemiologists and infectious disease experts designed the exercise, implemented through a three-day workshop in Comoros from 9 May 2023 to 11 May 2023. The workshop convened 43 experts from Eastern Africa member states and partner organisations to rank diseases. Participants assessed each disease against 19 predefined criteria, grouped into four overarching domains: risk trajectory, epidemic potential, disease severity, and preparedness and medical countermeasures. Overall risk was calculated as the product of risk trajectory, epidemic potential, and disease severity. Results: Twenty-eight experts (88%, 28 of the eligible participants, n = 32) prioritised 22 potential epidemic-prone diseases. The top 10 were Ebola virus disease (risk = 12.7), Marburg virus disease (11.8), cholera (11.1), coronavirus disease 2019 (COVID-19) (9.9), influenza (8.9), measles (8.6), yellow fever (8.5), Crimean-Congo haemorrhagic fever (8.2), malaria (8.0) and Rift Valley fever (7.9). The unknown disease, defined as one caused by a hypothetical novel pathogen (often referred to as ‘Disease X’), Crimean-Congo haemorrhagic fever, Rift Valley fever and mpox received the lowest preparedness rating. Conclusion: Ebola virus disease (EVD), Marburg virus disease (MVD) and cholera ranked highest in risk, while unknown disease and zoonoses showed the lowest preparedness. Contribution: Amid current funding constraints, these findings provide evidence to guide Africa CDC and partners in strengthening emergency preparedness and response in Eastern Africa, highlighting priority diseases while underscoring the need for further analysis of capacity gaps.
IntroductionCarbapenem-resistant (CR)-Enterobacterales are a serious threat to public health worldwide. However, there are limited surveillance data on the molecular epidemiology of CR-Escherichia coli. To address this need, the European Centre for Disease Prevention and Control (ECDC) investigated the molecular epidemiology of CR-E. coli in the carbapenem- and/or colistin-resistant Enterobacterales (CCRE) survey launched in 2019, involving 37 European countries, including Italy.MethodsIn 2019, 46 acute-care hospitals in Italy were enrolled to collect the first 10 non-duplicated consecutive isolates of carbapenem non-susceptible Klebsiella pneumoniae specie complex or E. coli isolates and 10 carbapenem-susceptible comparator isolates of the same species. Each isolate was subjected to antibiotic susceptibility testing. WGS analysis was performed using Illumina technology to determine the ST and to detect resistance genes, virulence factors, and plasmid content.ResultsA total of 61 E. coli isolates were collected from 17 hospitals: 17 CR-E. coli isolates (from urine, 41.2%, and blood, 23.5%) and 44 carbapenem-susceptible (CS)-isolates (from blood, 43.2%, and urine, 38.6%). All the CR-E. coli isolates were resistant to amoxicillin/clavulanic acid, cefepime, ceftazidime and piperacillin/tazobactam; three were resistant to ceftazidime/avibactam and all were susceptible to amikacin and tigecycline. MLST analysis showed the presence of unrelated lineages: CR-E. coli isolates belonged to 8 different STs, with ST131 predominant (58.8%). All the CR-E. coli isolates carried one carbapenemase: KPC-3 (10 isolates), KPC-2 (three), NDM-5 (two), VIM-1 and OXA-181 (one each). Among CS-E. coli isolates, the highest resistance rates were observed for amoxicillin/clavulanic acid (36.4%) followed by ciprofloxacin, and trimethoprim/sulfamethoxazole, and ST131, carrying CTX-M-15, was the predominant clone.DiscussionCR-E. coli clones from infection showed a heterogeneous genetic background, ST131 being the most frequent. KPC was the most common carbapenemase but the presence of E. coli isolates carrying NDM-5 is worrisome, as it results in resistance to several novel beta-lactam-beta-lactamase combinations. Our study underlines the importance of genomic surveillance to monitor and prevent the spread of high-risk clones causing difficult-to-treat infections.
BACKGROUND AND AIMS:Reliable data on viral hepatitis-related deaths remain limited, challenging assessment of progress towards the WHO elimination targets for mortality. To address this gap, we estimated hepatitis B- and C-attributable mortality in Italy, Romania, and Spain for 2022. METHODS:Retrospective hospital data on decompensated cirrhosis and hepatocellular carcinoma cases were collected from sentinel sites in each of three countries using standard WHO protocol. The data were used to calculate fractions of these diseases attributable to hepatitis B and C. Adjusted and weighted attributable fractions were applied to national vital statistics data on deaths from cirrhosis and hepatocellular carcinoma from Eurostat to produce national hepatitis mortality estimates. RESULTS:A total of 1733 cases of decompensated cirrhosis and hepatocellular carcinoma cases were enrolled into the study from sentinel sites across Italy, Romania, and Spain. We estimated that the share of decompensated cirrhosis deaths attributed to hepatitis B was: 8.7% in Italy, 16.8% in Romania and 1.8% in Spain. The respective share of hepatocellular carcinoma deaths attributed to hepatitis B was 19.0% in Italy, 31.2% in Romania and 4.9% in Spain. Hepatitis C accounted for 61.6% of hepatocellular carcinoma deaths in Italy, 36.5% in Romania, and 31.1% in Spain, as well as 32.9% of decompensated cirrhosis deaths in Italy, 18.8% in Romania and 12.7% in Spain. Overall, hepatitis B-related mortality per 100 000 population was 3.1 in Italy, 12.0 in Romania and 0.6 in Spain. Hepatitis C-related mortality was 11.4 per 100 000 population in Italy, 13.8 in Romania and 3.7 in Spain. CONCLUSIONS:Our study yielded empirical data needed to estimate hepatitis mortality for assessing the impact of hepatitis strategies. Whilst our results indicate a reduction in deaths related to hepatitis B and C in Italy and Spain, none of the three countries was meeting the WHO's 2025 target for hepatitis C-related mortality, although the hepatitis B-related mortality target was met by Italy and Spain. Our findings highlight the need for countries to continue strengthening efforts to prevent and control viral hepatitis and to integrate such assessments into national surveillance to guide effective targeting of interventions and monitoring of progress towards the elimination targets.
Background Insecticide-treated nets (ITNs) are assumed to remain functional for three-years. However, products within the same class differ in fabric durability and persistence of bioavailable insecticide. Understanding the relative contributions of both factors to ITN efficacy under real-use conditions is essential for optimising product design. Methods Physical and chemical decay were assessed using pyrethroid ITNs collected from a three-year longitudinal field trial in Tanzania. The effects of insecticide content, hole location, and holed surface area on 24h-mortality and blood-feeding of laboratory-reared pyrethroid-susceptible Anopheles gambiae sensu stricto mosquitoes were evaluated using the Ifakara Ambient Chamber Test (I-ACT) bioassay. Entomological effects were analysed using a differential equation model for mosquito mortality and feeding, with a hyperbolic function for holed area and a saturating function for insecticide content, allowing separation of barrier and insecticidal effects. Results Fabric integrity and insecticide content declined over time, with marked variation between brands. Approximately 50% of fabric damage occurred in the bottom quadrant that was typically tucked under mattresses and contributed minimally to mosquito entry. As nets aged, increasing holed area led to higher blood-feeding success among attacking mosquitoes, driven primarily by large holes in lower side panels above the mattress, representing 27% of holed surface area accessible to mosquitoes. Despite this, residual insecticidal activity remained sufficient to maintain low mosquito survival. The model showed excellent fit and enabled independent estimation of barrier and insecticidal effects. Differences in mosquito mortality between brands were largely explained by linear scaling of insecticide concentration, with a shared parameter describing the concentration required to achieve half-maximal effect. Overall, estimated entomological effectiveness declined only modestly with net age. Conclusion Functional durability of ITNs can be understood as the outcome of two analytically separable processes: physical degradation of the fabric and loss of bioavailable insecticide. I-ACT enabled precise measurement of both effects. Even heavily damaged nets retained substantial effectiveness when insecticidal activity remained high and nets continued to be used. This framework provides a practical means for comparing ITN products and strengthening durability monitoring. Future ITN design should prioritise insecticidal performance to kill mosquitoes, while recognising that fabric construction influences both fabric durability and user acceptability. These fabric related characteristics are important to maximise retention, sustained use and ensure cost-effective public health impact.
