title: Determinants and Drivers of Infectious Disease Threat Events in Europe.
abstract: Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008-2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Semenza
authors.forename: Elisabet
authors.initials: E
authors.lastname: Lindgren
authors.forename: Laszlo
authors.initials: L
authors.lastname: Balkanyi
authors.forename: Laura
authors.initials: L
authors.lastname: Espinosa
authors.forename: My S
authors.initials: MS
authors.lastname: Almqvist
authors.forename: Pasi
authors.initials: P
authors.lastname: Penttinen
authors.forename: Joacim
authors.initials: J
authors.lastname: Rocklöv
mesh_terms: D002980:Climate; D016000:Cluster Analysis; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases / Q000453:epidemiology*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D004777:Environment; D062665:Epidemiological Monitoring; D005060:Europe / Q000453:epidemiology; D006801:Humans; D038622:Internationality; D015233:Models, Statistical; D011634:Public Health / Q000706:statistics & numerical data; D014195:Travel
keywords: Europe; antimicrobial resistance; climate change; demographic; determinants; drivers; environment; food and water; global trade; globalization; infectious diseases; natural environment; public health systems; social; tourism; travel