Towards an integrated approach in surveillance of vector-borne diseases in Europe

Abstract

Vector borne disease (VBD) emergence is a complex and dynamic process. Interactions between multiple disciplines and responsible health and environmental authorities are often needed for an effective early warning, surveillance and control of vectors and the diseases they transmit. To fully appreciate this complexity, integrated knowledge about the human and the vector population is desirable. In the current paper, important parameters and terms of both public health and medical entomology are defined in order to establish a common language that facilitates collaboration between the two disciplines. Special focus is put on the different VBD contexts with respect to the current presence or absence of the disease, the pathogen and the vector in a given location. Depending on the context, whether a VBD is endemic or not, surveillance activities are required to assess disease burden or threat, respectively. Following a decision for action, surveillance activities continue to assess trends.

Figure 1

Simplified scheme for VBD surveillance feedback system. Vertical yellow cylinders represent the categorical collections of data (monitoring). Horizontal arrows represent the use of selective set of data from monitoring activities for surveillance purposes for a specific VBD context or VBD. The diamonds points at the responsible health agency/decision makers and the triangles represent the input of research and developmental studies. The EU could play a pro-active role in the activities indicated in purple. Other signals indicate signals that are not included in disease burden or threat assessments but that affect decision-making.

Figure 2

Intervention and surveillance pyramid for vector-borne diseases.

Figure 3

Outcome tree for estimating disease burden of Lyme borreliosis (LB). R: recovered. GP: general practitioner. An outcome tree for estimating economic costs of LB is presented in [21].

Figure 4

Outcome tree of human exposure to ticks. ^†total tick bites is GP visits for tick bites times 15 (x) in the Netherlands [23].