EFSA expert: We need to think out of the box on infectious diseases

The European Food Safety Authority (EFSA) is launching a new initiative on infectious diseases after a series of recent outbreaks in the EU, such as the Bluetongue (in Northern Europe in 2006), Schmallenberg (in 2011) and Q fever (in the Netherlands, 2007-2010), explains Franck Berthe.

Franck Berthe is the head of the European Food Safety Authority's (EFSA) Animal Health and Welfare Unit. He spoke to EURACTIV's Henriette Jacobsen.

Which infectious diseases is EFSA worried we’d potentially see an outbreak of in the future? 

I guess we don’t have a shortlist of big diseases we worry about. I think we are very open about those diseases and the main ones we want to see covered in our exercises and activities are the ones being directed back to animals. It’s important to remember that EFSA is a food safety agency, but obviously consumers are also citizens; they have a job, they travel and they have leisure activities during which they can be directly or indirectly interacting with animals. In that light, and if we remember that 70% of infectious diseases in humans have their origins in animals, it’s very important for us to keep an eye on that.

What are the characteristics that these diseases have in common? 

This is what we are trying to break down. When we look at the recent past, we have seen a number of incidents for example Bluetongue, being outside its geographical range, and the emergence of a brand-new virus, Schmallenberg, but also the outbreaks of Q fever in the Netherlands between 2007-2010… that one was really serious from a public health point of view with several thousand human cases.

When you look at these events, all of them caught us by surprise, and if you try to categorise them, you would have difficulties because there are vector-borne and non-vector-borne diseases and they are potentially food-borne or non-food-borne diseases. What we are trying to do is to really think out of the box.

What is EFSA’s response to combat these diseases? 

When we look at those events, they raise questions and we are not the only ones asking those questions. It’s not just EFSA thinking along those lines, but we have been thinking about those events and they bring us to one big question which is about our capacity to assess risk at the human-animal interface. This is why we have launched this initiative which we call the workshop series.

What are you trying to do with these workshops?

We thought that it’s too big of an issue to address in one shot. We have decided to go through a more distilled approach. Throughout 2013, we are holding a series of events; sometimes workshops, roundtables and discussions. We do that with a wide range of experts from various scientific disciplines. It involves our staff, our experts, the panel members, but we also engage with other EU agencies for example ECDC (European Centre for Disease Control) and sister agencies in the member states and with the risk managers themselves, the decision-makers in the Commission.

Why are you launching this initiative now? 

After Bluetongue and Schmallenberg, everybody is thinking ‘what’s next?’ We try not to go into that direction. We try not to predict the future. We try to learn from the past. The reason why we are doing this now is because we are finishing with Schmallenberg. There have been a lot of efforts from our side. We have seen that it was a success story so we want to build on that success. In terms of timing, we are mid-way through the current panel so we think it’s a good time to think about the future as well. For the panel on animal health and welfare, it’s a strategic timing to have this type of exercise.

How well is the EU prepared for new disease outbreaks? 

This is where the Schmallenberg outbreak gives a positive feedback. Obviously, we have been successful between the time the first signs in the farms were noticed and the time of the description of the virus. The timeline was only between a few weeks and a few months. We were very fast in developing diagnostics and cooperating between member states and different agencies to monitor the situation. That’s a success story.

What we don’t want is to be complacent about that. We want to know if we were lucky or if we were really prepared. In the EU, we have clearly a high level of expertise. We have excellent networks. We have good collaboration between the member states and we also have a good collaboration between what we usually call the risk assessor and the risk managers. What we could see also with Schmallenberg is that the efforts we put into building transdisciplinarity at EU level is paying back. In a matter of a few days, we were able to ask simple teams of biologists, epidemiologists, mathematical modelers, people in academia… all these people were working together so in terms of preparedness, we are very well prepared.

The point is that when we use the word ‘preparedness’ at EFSA, we are not talking about early response. We’re talking about providing the science and the advice needed for the risk managers to respond.

What are the signs and factors we should look for that could lead to a disease outbreak? 

This is one of the major outcomes of the workshop series. One of the starting points was emerging risks and the drivers of emerging risks. What we have seen is that usually those drivers are not playing alone, but they come as a mix of different drivers, leading to a certain condition. Now we are using the word ‘context’. It’s the combination of drivers that creates that context. We see that it’s not so much about pointing the finger at anyone or anything, but trying to understand the context and what the drivers are that form the context.

One of the things that we see for example is the social unrest in Syria for a few months now. We have seen on TV and in newspapers all those refugees moving away from their homes, taking with them their families and belongings. They don’t carry a fridge with them. They take their animals with them. By doing so, we believe that we’re creating pathways. It’s something to take into account in the view of emergence in that region of diseases what we’re seeing now.

Is the EU prepared for potential outbreaks that are outside its borders, but still very close such as in Syria, Ukraine or Belarus? 

This is something we are working on and we have produced pieces of advice on a couple of relevant diseases from that point of view. We have for example been working with experts from Sub-Saharan Africa and North Africa to better understand the dynamic of diseases from that part of the globe to better understand what would be the potential risks for Europe. A few years ago, when we had the African Swine Fever, we came to the conclusion that there should be some cross-regional cooperation on issues such as the African Swine Fever because that was the scale of the problem.

What is your advice for consumers in terms of what they should and should not do? 

I guess there are many things that you should do or not do from washing your hands… but again I believe we will stay away from making top 5 or top 10 lists and try to understand the overall trends. Since the Second World War, we have gradually moved from the concept of food security to food safety and many people believe now that we are entering a new era. It’s now more about food acceptability. People have questions like ‘Should I eat local food?’, ‘Should I eat organic food?’ and they have questions about gene-modified organisms (GMOs). We believe this is changing the demand and the way we produce and bring food to people. These things we want to integrate in our risk assessments.

Besides these EFSA initiatives, what else would you like to see the EU do? 

The EU is doing a lot of things already. The key word is cooperation, not to work in isolation. Over the years, the ties with the national agencies and member states have been reinforced. We have worked more and more with the ECDC and with the European Medicines Agency (EMA) in London. We have just issued on Influenza H32 which is a joint opinion with the three of us. These are the things we are doing that we want to do more and more.