In PAHO, Epidemic Intelligence is carried out by the Health Emergency Information and Risk Assessment (HIM) Unit at the Health Emergencies Department (PHE).
Through the HIM Unit, PAHO works in providing timely and authoritative situation analysis, risk assessment, and response monitoring for acute public health events and emergencies in the Americas, continuously coordinating the strengthening of the systematic detection, verification, and risk assessment of events, including training, coordination, and dissemination of accurate and timely information for all potential public health emergencies of international concern (PHEIC) and acute public health events under the International Health Regulations (IHR).
Also, the HIM Unit serves as the main liaison for National IHR Focal Points communications under the IHR, as the designated WHO IHR Contact Point for the Region of the America.
24/7 Detection, Verification and Risk Assessment of Public Health Events under the IHR.
Collection, management, analysis and reporting on data related to public health events, emergencies, and disasters.
Development of basic operational tools and risk mapping.
Definition of minimal standardized information required for different emergency related activities/topics.
Development of prediction tools and modeling.
Production of country risk profiles and their periodic updating.
The PAHO Mapping team is part of the PAHO Health Emergencies Department, under the Health Emergency Information & Risk Assessment Unit (HIM), along with the Detection, Verification, and Risk Assessment (DVA) team and the Epidemiological Analytics team.
The mapping team gathers and systematizes epidemiological data on epidemic-prone diseases in the region.
Data gathered by DVA, as well as the Epidemiological Analytics team, and other contributors in the Organization, is analyzed with a spatial-temporal lens utilizing Geographic Information System (GIS) to generate maps, dashboards, and other products that help national authorities understand the dynamics of outbreaks and guide the Organization’s response. Many of these products are available through these public interactive dashboards.
The PAHO Detection, Verification, and Risk Assessment team (DVA) is part of the PAHO Health Emergencies Department, under the Health Emergency Information & Risk Assessment Unit (HIM), along with the Mapping team and the Epidemiological Analytics team. The PAHO DVA team collaborates with WHO headquarters, Regional Offices, PAHO Country Offices and Member States in carrying out event surveillance, risk assessment, and information management and disseminates. It also serves as the WHO International Health Regulations Regional Contact Point, providing support for Member States in establishing and implementing functional integrated early warning and response systems in order to improve early detection and rapid response to epidemic-prone diseases with pandemic potential and other public health emergencies.
In addition to directly receiving information from Member States, the Detection, Verification and Risk Assessment (DVA) team continuously screens informal or unofficial information sources to detect events or situations that may threaten international public health and for which Member States may require assistance. The DVA team gathers official reports and identifies rumors of suspected public health events from a wide range of sources.
Information obtained from unofficial or informal sources undergoes an initial screening, referred to as the initial risk assessment. A risk assessment is not considered complete until the event is verified by the Member State.
After the initial detection of an event is made from informal or extraofficial sources DVA verifies the information with the Member State. Requests for verification are sent to the National IHR Focal Point (NFP) of the respective Member State.
Risk assessment is the process of evaluating the probability and consequences of injury or an event arising from exposure to identified risks.
It is an interactive process that is initiated upon the detection of an event and continues until such event is under control. Risk assessment requires an interdisciplinary approach and the participation of PAHO/WHO technical experts, PAHO/WHO Country Offices and IHR National Focal Points.
Following a risk assessment, the IHR Annex 2 decision instrument for the assessment and notification of events is used by Member States to decide whether an acute public heath event requires notification to the WHO. The effective use of Annex 2 depends on the national authorities of each country and their respective IHR National Focal Point (NFP) who carry out the risk assessments of public health events occurring within their territories.
WHO has published guidelines describing when and how to apply Annex 2 to real situations.
To determine if an event must be notified to the WHO Contact Point, Member States must use the following criteria:
Any event that meets any two out of the four criteria must be reported. The notification must be made within 24 hours of the assessment made in accordance with the decision instrument of the IHR (2005) Annex 2.
Following notification, communication must continue with accurate and sufficiently detailed public health information on the notified event, where possible including case definitions, laboratory results, source and type of the risk, number of cases and deaths, conditions affecting the spread of the disease and the health measures employed.
In addition, four conditions (smallpox, poliomyelitis due to wild-type poliovirus, human influenza caused by a new subtype, and severe acute respiratory syndrome (SARS)) must be reported to the WHO as they are inherently considered unusual or unexpected and may have serious public health impact.
Risk assessment is an ongoing process that can support one or more of the following actions at any point in time:
The Detection, Verification and Risk Assessment (DVA) team disseminates information about international public health events through the publication of epidemiological alerts, interactive maps and reports available to the public.
Epidemiological Alerts provide information about international public health events which have implications or could have implications for the countries and territories of the Americas; as well as recommendations issued by the Pan American Health Organization related to the event in question.
All alerts are archived here.
The Detection, Verification and Risk Assessment team uses the WHO developed "Event Management System" to manage information on events in the Region of the Americas. This system makes it possible to disseminate critical event-related information between international public health professionals, including the PAHO/WHO Country Offices, specialized centers and other WHO Regional Offices.
The following types of information are stored in the system:
To support event management at the national level, PAHO/WHO in collaboration with the Brazil and Chile Ministries of Health has developed a tool called the "System of Monitoring Events (SIME)."
SIME is a computer application designed for the registry and monitoring of national level public health events. Since its creation it has been modified and updated for compatibility with the registration and analysis of data requirements within the International Health Regulations (2005) framework. The current version is 184.108.40.206.
Information about disease outbreaks, surveillance, alert and response activities from the WHO Headquarters and Regional Offices may be accessed through the following sites:
The PAHO Epidemiological Analytics team is part of the PAHO Health Emergencies Department, under the Health Emergency Information & Risk Assessment Unit (HIM), along with the Detection, Verification, and Risk Assessment team and the Mapping team. The epidemiological analytics team works closely with the DVA and Mapping teams.
Epidemiological information on known epidemic-prone diseases in the region of the Americas is collected on a regular basis to maintain updated databases. With the information collected, the team is ready to provide epidemiological analysis when an outbreak occurs. This information is the basis for internal analytics and reports which inform executive management on decision-making.
Many of the products generated by this team are for internal consumption. The team is also involved in helping countries implement early warning and alert response systems (EWARS) and thus has provided in-country technical assistance to the Ministry of Health and similar national authority counterparts in the region.
In addition, the team generates tools on modeling for forecasting/nowcasting for COVID-19 and others through user-friendly interfaces. This facilitates one on one training with countries to improve their response capacities to outbreaks.
Other links you may be interested: Caribbean Disaster Emergency Management Agency (CDEMA)