Wastewater surveillance and quantitative analysis of SARS-CoV-2 RNA are increasingly used to monitor the spread of COVID-19 in the community. We studied the feasibility of applying the surveillance data for early detection of local outbreaks. A Monte Carlo simulation model was constructed, applying data on reported variation in RNA gene copy concentration in faeces and faecal masses shed. It showed that, even with a constant number of SARS-CoV-2 RNA shedders, the variation in concentrations found in wastewater samples will be large, and that it will be challenging to translate viral concentrations into incidence estimates, especially when the number of shedders is low. Potential signals for early detection of hypothetical outbreaks were analysed for their performance in terms of sensitivity and specificity of the signals. The results suggest that a sudden increase in incidence is not easily identified on the basis of wastewater surveillance data, especially in small sampling areas and in low-incidence situations. However, with a high number of shedders and when combining data from multiple consecutive tests, the performance of wastewater sampling is expected to improve considerably. The developed modelling approach can increase our understanding of the results from wastewater surveillance of SARS-CoV-2.

Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged <5 and 5–14 years, and adults over 65 years were modelled separately as were time lags of up to 4 weeks between calls and laboratory specimen dates. Associations with respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for ‘cold/flu’, whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

Puumala virus (PUUV) causes many human infections in large parts of Europe and can lead to mild to moderate disease. The bank vole (Myodes glareolus) is the only reservoir of PUUV in Central Europe. A commercial PUUV rapid field test for rodents was validated for bank-vole blood samples collected in two PUUV-endemic regions in Germany (North Rhine-Westphalia and Baden-Württemberg). A comparison of the results of the rapid field test and standard ELISAs indicated a test efficacy of 93–95%, largely independent of the origin of the antigens used in the ELISA. In ELISAs, reactivity for the German PUUV strain was higher compared to the Swedish strain but not compared to the Finnish strain, which was used for the rapid field test. In conclusion, the use of the rapid field test can facilitate short-term estimation of PUUV seroprevalence in bank-vole populations in Germany and can aid in assessing human PUUV infection risk.

Objectives: EUnetHTA WP 7 (Strand B) aimed to promote sharing information on new and emerging technologies. The task was to develop a prototype of a newsletter and pilot the processes of production.

Methods: The EuroScan database served as information source on pertinent technologies. To prioritize, a set of criteria for scoring the potential impact and for selecting the technologies for articles was applied and a pilot newsletter was produced.

Results: Being objective and transparent about the content of a newsletter required a method for prioritizing health technologies. Using significance criteria, members of the prioritization panel selected twelve technologies for articles of different length and depth. Potential recipients, surveyed on relevance, content, timeliness, and readability responded mostly positive, but requested more information on cost effectiveness and criticized timeliness.

Conclusions: Dissemination of an EU-wide newsletter would be feasible, but time-consuming. Although a newsletter appears to fulfill a need for information on emerging and new health technologies, it is not considered the right tool to avoid duplication of effort in the present international constellation of horizon scanning for new health technologies. Other options will be pursued as part of future collaborative actions, for example, a core set of early awareness information, or an on-demand electronic information system.

One of the features of the sub-prime crisis, that began in August 2007, was its unexpected nature. It came as a surprise not only to most financial market participants but also in some degree to the policy community. In this context, we seek to assess whether early warning systems based on the logit and binomial tree approaches on the UK and US economies could have helped to warn about the crisis. We also consider a ‘check list approach’ of indicators based on history. Although not all of the complementary approaches are successful, we contend that our work suggests that a broadening of approaches to macroprudential analysis is appropriate.

In the past few decades, vector-borne diseases have been spreading into countries previously free of these agents. It is necessary for a surveillance method to be tailored to the biology of these agents in order to detect their incursion. Using a sentinel herd system, it is possible to target high-risk areas where occurrence is most probably due to vector presence. Since the 1970s, diseases such as Akabane, vesicular stomatitis and Bluetongue disease have successfully been monitored using cattle herds as sentinels in many countries such as Saudi Arabia, Australia, China, Indonesia, Sultanate of Oman and most recently in countries in Western Europe. This paper reviews the strengths and weaknesses of sentinel herd surveillance systems in general. In order to determine their efficacy, the following criteria were found to be essential: the choice of sentinel locations, sentinel animal, seasonality of sampling and diagnostic testing methods. We conclude that due to its ability to focus on a specific disease, sentinel herd systems have been successful in the early detection of the spread of a targeted agent. This review is used as a basis for recommendations for the development of future sentinel herd systems.

This is a summary of the presentations and discussion of Surveillance, Early Warning Alert and Response at the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO)in Phuket, Thailand, 04–06 May 2005. The topics discussed included issues related to the surveillance, early warning alert, and response to communicable and vector-borne diseases as pertaining to the responses to the damage created bythe Tsunami. It is presented in the following major sections: (1) key questions; (2) needs assessment; (3) coordination(4) gap filling; and (5) capacity building. The key questions section is presented in six sub-sections: (1) communicable diseases; (2) early warning; (3) laboratory capacity and referral networking; (4) coordination of disease surveillance, early warning, and response; (5) health infrastructure rebuilding; and (6) using existing national surveillance plans toenhance disease surveillance and early warning systems.

Octachlorostyrene (OCS) and trans-nonachlor (TNC) were detected in cape petrels (Daption capense) of King George Island, which tallies with their presence in samples of gentoo penguins (Pygoscelis papua) of the Falkland Islands. The detection of TNC in a sample of the Antarctic southern fulmar (Fulmarus glacialoides) implies that the Antarctic region has been contaminated by this compound. Mirex and photomirex were also detected in samples of the cape petrels and southern fulmar, as well as in Adélie penguins (Pygoscelis adeliae) from Hop Island. The ratios of the mirex and photomirex concentrations in the truly Antarctic species from different locations are similar, which suggests that these compounds are diffusely distributed over the continent. The detection of organochlorine pollutants in Antarctic seabirds is an indication that these compounds have a global distribution. Screening of subcutaneous fat of Antarctic seabirds for organochlorines provides an excellent indication of the occurrence of organochlorine pollutants in Antarctica, and as such an ‘early warning’ for the global dispersion of these compounds.

Mr. Chairman, Ladies and Gentlemen, first let me thank you for coming to this meeting that has been organized by us in close collaboration with UYDP, OCHA, UNIGEF and IDNOR with generous support from the Canadian, UK, and USA development agencies. It always is a pleasure to recognize our partners.

We have with us here today representatives of a large number of agencies, institutions, NGOs, and private individuals. This cross section of interests is a manifestation of a growing and irreversible trend. The important issues of our time cannot be dealt with solely by nations, agencies, or individuals, even the most powerful ones. The phenomenon of globalization no longer is restricted to economic or financial matters: it is now evoking the wide participation of ranges and numbers of actors that would have been unthinkable a few decades ago. In almost all aspects of our work, we are looking to find the partners and interests that can bring value to the management of the issue or the search for solutions, if definitive solutions ever can be found to the really important human challenges.