What is known as Epidemic Intelligence (EI) is the cycle of organized and systematic collection, analysis and interpretation of information from all sources to detect, verify and investigate potential health risks.
In the Americas region, epidemic intelligence is a shared responsibility carried out by both PAHO/WHO and its Member States. PAHO, WHO, public health authorities, and researchers collect data from many sources including Ministries of health, national institutes of public health, WHO collaborating centers, civilian and military laboratories, academic institutes, and non-governmental organizations (NGOs), and analyze them together to detect, assess, characterize, monitor and respond to health conditions, as well as related risk factors.
To ensure a comprehensive picture of threats and risks to global health security, WHO gathers information from a variety of sources, both formal and informal. Therefore, PAHO’s capacity to provide actionable information and technical advice to national authorities about public health events that could pose a threat to global health security depends on the timely notification by, and transparency of, Member States in sharing information with PAHO as well as on PAHO’s capacity to maintain communication 24/7 with the National Focal Points (NFPs).
Throughout the process of gathering data and disseminating information, risk assessments are routinely carried out to establish the potential impact of an event on human health, the risk of spread, and the related resource implications for mitigation. Risk assessments are essential for characterizing the data/information collected.
Once a public health risk has been detected, an effective management process is essential to continuously monitor and assess its status, share information, and support response activities when and where needed. WHO’s Event Management System (EMS) is the central electronic system for entering, accessing, and managing information for all potential and substantiated events. The EMS records each event’s details, official communications, WHO assessments and risk analysis, and decisions.
- Annually, approximately 24,000 signals of potential events are screened by PAHO, with 5,000 of these further analyzed and 160 followed upon (3 per week on average).
The EMS recorded 1,613 events for LAC from 2001 to 2016. In 2017 only, out of 404 events registered by WHO, 119 (27%) were monitored and reported by PAHO, making the Americas the region with the second highest number of events registered behind the African Region (142 events).
Of the 119 events recorded in 2017 in the Americas, 58 substantiated events were registered in 22 State Parties and 2 territories in 2017. Of that number, 46 (79%) were due to infectious diseases, 4 (7%) were zoonotic/animal disease-related, 3 (5) were food safety-related, 2 (3%) were product-related, 1 (2%) was chemical-related, 1 (2%) was radionuclear, and 1 (2%) was undetermined.
Epidemic intelligence is a resource-intensive activity (24/7/365) that requires highly qualified and dedicated staff to implement an efficient global early warning system and network. In PAHO, it is carried out by the Health Emergency Information and Risk Assessment (HIM) Unit at the Health Emergencies (PHE) Department.
The HIM Unit works in providing timely and authoritative situation analysis, risk assessment, and response monitoring for acute public health events and emergencies in the Americas. It also continuously coordinates 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). The designated WHO IHR Contact Point for the Region of the Americas is under the HIM Unit, serving as the main liaison for National IHR Focal Points communications under the IHR.
Additional areas of work under the scope of HIM include:
- 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
- Supporting Member States in the Americas Region 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
- Definition of minimal standardized information required for different emergency-related activities/topics
- Development of basic operational tools and risk mapping
- Development of prediction tools and modeling
- Production of country risk profiles and their periodic updating