Prevention and Control of Infectious Diseases with Pandemic Potential: The EU-Project SARSControl

Introduction: The influenza pandemics of the 20(th) century, the SARS epidemic in 2002/03 and the growing number of human cases infected with the H5N1 avian influenza virus clearly demonstrate that the threat of new pandemics is very real. These events have intensified pandemic prevention and control activities worldwide. "SARSControl" is a three-year project funded by the European Commission with the objective to aid European member states in the public health management of new emerging infections. This article summarises the main research results and recommendations arising from this project. Method: The reports and papers published in the SARSControl project form the basis of this article. In addition, a literature search for SARS and pandemic influenza was conducted and information on pandemic planning and management guidelines obtained from the WHO and EU websites. The project results are discussed in this context. Results: A lack of knowledge and delayed international communication resulted in the rapid spread of SARS, highlighting the importance of a global system for rapid and transparent information transfer. Epidemiological and economic modelling studies have shown that, in comparison to travel restrictions, applying intervention measures to interrupt local transmission within a Country and investing into vaccine research and anti-viral stockpiling, is a more cost-effective and efficient use of resources for the containment of pandemics. A study investigating the perceived threat associated with pandemics showed that the subjective risk perception of people varies among countries. This influences human behaviour and should hence be considered during risk communication and implementation of pandemic control measures. Discussion: The basic prerequistes of an efficient pandemic management are operationalisable pandemic plans, subjected to regular exercises, backed by adequate resources and a sound health-care infrastructure. At international level cross-border co-operation and information exchange on infection control is the key to pandemic mitigation and containment. Strengthening a surveillance systems at the international level, to allow the timely monitoring of infectious agents and outbreaks is essential. Transferring such outbreak information in real time into mathematical models and the resulting essential epidemiological information to policy makers would facilitate a more efficient use of scarce resources. Involvement of the public in decisions regarding the implementation of restrictive control measures which often curtail individual liberty is necessary for the acceptance and ultimate success of pandemic control.