Research project P4S/251/be-Prepared (Research action P4S)
During the COVID-19 crisis, information from clinical and epidemiological data, as well as from microbial genomic analyses, were combined in order to inform policy and the public. The integration of data from different sources is thus crucial for proposing and evaluating public health responses. However, no robust architecture has been created to enable integrated surveillance beyond the pandemic. Rigorous observations from both genomics and cross-sectoral data are needed, following a One Health perspective; integrating human, animal, and environmental health. Current infectious disease surveillance in Belgium is sectoral, and the exchange of data is slow and cumbersome. For example, an outbreak of Salmonella-contaminated chocolate products produced in Belgium was noticed with delay by our own systems after other countries had already noticed. To avoid such occurrences in the future, Sciensano has developed an innovative Belgian Preparedness Architecture for Infectious Diseases (be.Prepared) that aims precisely to ensure the integration and coupling of pathogen and health data. This national framework can support infectious disease investigations both in routine and in crisis situations, where scaling up data collection systems and linking data to a unique national identification number will be crucial. In addition to make observations, it is necessary to share data on routine surveillance and emerging threats with regional, community and federal (health) authorities, the scientific community and citizens. This was also demonstrated during the 2020-2021 SARS-CoV-2 pandemic, when dashboards were made accessible via a single website. More recently, during the avian influenza epidemic (2021-2023),
Sciensano took the initiative of implementing a dashboard to geographically represent avian influenza outbreaks across Belgian territory. In the be.Prepared AHEADD project, we will use be.Prepared as a novel methodology for cross-sectoral outbreaks, with two applications presenting a One Health perspective: (i) identification of foodborne outbreaks (i.e. human Salmonella- and Listeria isolates from food samples) and (ii) identification of zoonotic influenza events (i.e. human cases of avian influenza complemented with environmental data and risk estimates). Specifically, the National Reference Laboratory for Foodborne Pathogens will analyse samples from controls by the FAVV-AFSCA, thereby building a genomic indicator database for foodborne pathogens with automated genomic cluster detection among human and food isolates. A public cross-sectoral visualisation for avian influenza on a genomic-epidemiological level will be implemented as a collaboration of multiple services within Sciensano and the service of Atmospheric Composition, Measurements and Modelling within the Royal Meteorological Institute as a partner. Upon expert analysis, a set of relevant metadata on risk estimates on introduction and spread of a pathogen will be collected. The inclusion of these metadata into a public cartographic display will be evaluated. During the process, quantitative indicators will be used to map the progress and outcome of the implementations, e.g. number of isolates, number of links, number of prevented outbreaks, explicit phylogeographic reconstruction, etc. The be.Prepared AHEADD initiative will, in an interdisciplinary One-Health collaboration, facilitate the rapid cross-sectoral detection of outbreaks. Additionally, it will support the identification of antimicrobial resistance patterns coming from genomic data, the intuitive geographic visualisation of the epidemiological situation in Belgium and the risk assessment of zoonotic events in the framework of genomic-epidemiological surveillance.
