Identification of a problem, e.g., an outbreak Surveilance Intervention Effect

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1 EPIDEMIOLOGY

2 EPIDEMIOLOGY Epidemiology is a cornerstone of the control of infectious diseases. Statens Serum Institut s epidemiological activities cover a wide field, from surveillance of diseases and control of outbreaks via preparedness against biological terrorism to epidemiological frontline research and international health. The epidemiological activities supported by the preparedness activities in our other business areas (diagnostics, vaccines and diagnostic media and reagents) constitute the Institute s overall efforts to prevent and control infectious diseases, congenital disorders and biological threats. PREVENTION AND CONTROL OF INFECTIOUS DISEASES AS A CYCLE Statens Serum Institut s control of infectious diseases is part of a cycle in which the infectious diseases are continuously under surveillance, and outbreaks are detected and combated. Surveillance Surveillance is crucial for detecting current outbreaks and for effective prevention, as they provide valuable knowledge about the incidence and development of specific diseases. Statens Serum Institut is responsible for the surveillance of reportable infectious diseases through various kinds of reporting systems. The Danish childhood vaccination program is also under surveillance, and data are collected from various vo-luntary reporting systems. Surveillance covers continuous registration, analysis and interpretation of outcome of specific data, e.g. changes in disease frequency, outbreaks of diseases, appearance of new microorganisms and forms of resistance or more virulent types of familiar vira. A modern surveillance system includes both the collection and registration of disease data, and timely and regular communication of knowledge to the people and authorities responsible for treatment of diseases, prevention and control. Investigation and outbreak control of infectious diseases In connection with outbreaks of diseases, SSI takes part in the detection of potential sources of infection, often concerning food products. In other cases, although the source of infection may be familiar, there may be several ways to effectively control the outbreak. Then the options must be carefully analyzed to find the best means of preventing further infection. Ongoing advice and communication Identification of a problem, e.g., an outbreak Epidemiology Molecular typing Coordination Communication Advice and guidance Diagnostics Notifications Registres Surveilance Intervention Effect

3 EPIDEMIOLOGY IS A CORNERSTONE OF THE CONTROL OF INFECTIOUS DISEASES Evidence-based investigation and outbreak control of infectious diseases require multidisciplinary cooperation between several players and authorities. Modern analytical epidemiology and microbiological methods are often used hand in hand to investigate diseases. Advice The Institute gives highly qualified advice and guidance to stakeholders in the Danish health service, citizens, decisionmakers etc. Advice is given both on intervention against current outbreaks and on a wider scale, for example: which is for both the general public and health professionals, e.g.: Citizens: information on travel and infectious diseases as well as general descriptions of diseases Health professionals: information on surveillance, diagnostics, vaccination, diagnostic media and reagents News on the Institute s activities Hotline for health professionals Newsletters: EPI-NEWS, a weekly newsletter on infectious diseases, CAS-NEWS covering hospital hygiene, SSI-NEWS and News on microbiology. Electronic subscription for all newsletters is available via Expert opinions and investigations for the central healthcare and food authorities Training, lectures, publications etc. EPIDEMIOLOGICAL RESEARCH Denmark is a leading light in frontline epidemiological research, particularly due to the extensive Danish registers, which provide unique research opportunities and enable us to often achieve very precise research results. Then there are also the many years of productive cooperation between epidemiologists, statisticians and experts in the clinical and basic scientific subjects. Basic epidemiological research at Statens Serum Institut is primarily causal and covers mainly risk factors and prognostic factors of importance for diseases. The core elements lie within infectious, allergy and cancer diseases, genetic epidemiology as well as diseases arising in the fetal stage or shortly after birth, with research based on data from population-based health and demographic registers, for example. Other projects are based on information gathered through direct contact with the population, often in the form of cohort or case control studies. BIOLOGICAL SAFETY PREPAREDNESS Through the Center for Biological Defense (CBB), SSI manages the Danish prevention and control of unconventional safety threats. CBB is the point of contact for domestic as well as foreign alerts and enquiries, sampling and incident response in the biological field. CBB s tasks are to: Assist relevant authorities with expert knowledge and decision support Ensure collection of relevant investigation specimens in case of suspected biological attacks in order to detect or reject biological weapons Establish twenty-four-hour preparedness Participate in international collaboration, e.g. with NATO and EU countries as well as WHO Research preparedness against biological weapons as well as prevention and combating the consequences Follow international developments Offer education and training to relevant players INTERNATIONAL HEALTH Infectious diseases are currently playing a part in one third of all deaths worldwide nearly half of all deaths in developing countries. Most new infection problems are caused by man and can be prevented and treated if recognized in time. Due to growing globalization, comprising increased mobility, international tourism, growing trade and refugees, local occurrences of infectious diseases are becoming a global problem and therefore a national problem in Denmark. Today, infectious diseases can spread faster than ever before and with fatal consequences. SSI therefore actively takes part in international work in a range of areas, e.g. in the EU, where the Institute is hosting EUVAC-NET, covering European surveillance of infections prevented by vaccines. We are a domestic point of contact for the European Early Warning and Response System (EWRS). SSI houses seven WHO reference centers and takes part in WHO s IHR network (International Health Regulations).

4 THE INSTITUTE GIVES HIGHLY QUALIFIED ADVICE AND GUIDANCE TO STAKEHOLDERS IN THE DANISH HEALTH SERVICE, CITIZENS, DECISION MAKERS ETC. Statens Serum Institut operates a research station in Guinea-Bissau, West Africa. One of its main tasks is to help improve WHO s standard programs by assessing the longterm consequences of specific interventions, e.g. vaccination. The research station represents the longest continuous demographic surveillance in Africa.

5 STATENS SERUM INSTITUT FACTS ABOUT STATENS SERUM INSTITUT Statens Serum Institut is a state-owned enterprise under the Danish Ministry of Health and Prevention. For more than a century, the Institute s main task has been to control infectious diseases. However, our tasks have been continuously broadened, and today the Institute is an international research, production and service enterprise with approx. 1,200 employees. A considerable part of our annual revenue of approx. DKK 1bn is generated by exports. NATIONAL PREVENTION AND CONTROL IN A GLOBALIZED WORLD Levels and types of infection are constantly changing. Due to globalization from increased mobility, tourism and growing trade in e.g. food products, infectious diseases can spread more rapidly than ever before. It is the Institute s task to ensure research-based prevention and control that can deal with current infection-related problems and anticipate and prevent new threats. We achieve this in close national and international cooperation through, for example, the WHO and the EU. The core elements are: Epidemiology: surveillance, advice and investigation in the area of infectious diseases Specialized diagnosis: development and performance of specialized diagnosis of infectious and congenital diseases Biological safety preparedness: Operational and researchbased preparedness against biological weapons, including biological terrorism Vaccines supply: Ensuring the supply of vaccines etc. through production and procurement. The Institute produces e.g. several of the vaccines in the Danish Childhood Vaccination program MODERN BIOTECHNOLOGICAL ENTERPRISE Our business-oriented, biotechnological enterprise sells high-quality products and services at home and abroad. Our main business areas comprise: Diagnostics: Quality-assured diagnostic studies within microbiology, biochemistry, genetics and immunology Vaccines: Production and exports of vaccines against diphtheria, tetanus, polio, pertussis and tuberculosis (BCG), etc. Contract work: As a producer of vaccines, the Institute offers a number of services from research into products for contract customers Diagnostic media and reagents etc.: Production covering plate substrates, sampling materials, biological indicators, antibodies and antisera, etc. for use in the health sector, food sector, etc. SYNERGIES = BETTER CONTROL OF INFECTIOUS DISEASES The combination of Statens Serum Institut as a preparedness organization and a producer of vaccines, routine diagnostics as well as diagnostic media and reagents creates synergies that strengthen our preparedness. Our knowledge basis is broader and our flexibility greater both in daily work and when new and unexpected threats like SARS and avian influenza occur. RESEARCH AND DEVELOPMENT Research and development at a high international level are important for ensuring effective prevention and control of infectious diseases and for further developing the Institute s business activities. That is why Statens Serum Institut spends approx. 20% of its revenue on research and development. A significant share comprises grants from foundations such as the EU, the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation. Our efforts focus on: Diagnosis and surveillance of infectious diseases including gastrointestinal infections, respiratory infections, resist ance to antibiotics, hospital infections and antiviral resistance Diagnosis and prevention of congenital diseases including biochemical, chemical and genetic disease markers Vaccines including tuberculosis, Chlamydia and HIV as well as adjuvant systems Epidemiological research focusing on infectious diseases, the effect of vaccines, causes of cancer diseases and diseases related to pre-natal or neo-natal life

6 MISSION STATEMENT: STATENS SERUM INSTITUT PREVENTS AND CONTROLS INFECTIOUS DISEASES, BIOLOGICAL THREATS AND CONGENITAL DISORDERS Contact Statens Serum Institut 5, Artillerivej DK-2300 Copenhagen S T F serum@ssi.dk W ssi.dk The Danish Ministry of Health and Prevention Statens Serum Institut Epidemiology Diagnostics Vaccines Diagnostic media and reagents Surveillance Development and Production of Ensuring the supply Preparedness Smitteudredning Advice Research performance of specialized diagnosis Laboratory based childhood vaccines Ensuring the supply of other vaccines etc. and special develop- ment of reagents, sera etc. for diagnos- tics Biological safety surveilance Research into new preparedness Advice vaccines Sales of qualityas- Exports of vaccines Sales to the Danish sured diagnostics and other biological health sector to the health sector products Business activities License Sales to the food agreements industry etc. Contract work Exports