Enhancing Epidemic Intelligence in Tunisia: Early signal detection and coordinated response during the first Quadrimester of 2025
1
1 National Observatory of Emerging and Reemerging Diseases, Tunis, Tunisia
2
2 University of Tunis El Manar, Faculty of medicine of Tunis, Tunis, Tunisia
Popul. Med. 2026;8(Supplement Supplement 1):A3112
ABSTRACT
BACKGROUND:
Timely detection and verification of public health threats are essential for outbreak preparedness and control. In February 2024, Tunisia reinforced its epidemic intelligence (EI) system by reactivating the weekly videoconference EpiTec, integrating indicator-based surveillance (IBS) from mandatory notifiable diseases and event-based surveillance (EBS). This effort was supported by international collaboration and digital surveillance tools.¹,² We aimed to analyze the EpiTec reports.
METHODS:
Between January and April 2025, Tunisia’s 24 Regional Health Directorates submitted weekly EI reports to the National Observatory of New and Emerging Diseases (ONMNE). For influenza, the national alert threshold was set at 7.13%. Weekly EpiTec videoconferences ensured real-time coordination among regional focal points, national programs, and rapid response teams. For national and international event monitoring, ONMNE accessed the WHO/EMRO-supported Epidemic Intelligence from Open Sources (EIOS) platform, complemented by official updates from Africa CDC, ECDC, CDC, and WHO.
RESULTS:
Between ISO weeks 1–17 of 2025, over 100 national signals were reported, 82 of which met verification criteria. Key alerts included influenza-like illness exceedances in Kairouan (10.4%, S02), Nabeul (14%, S03), Bizerte (S03, S05, S11), Gabes (S05, S06), and Sfax (S11, S15, S16). There were 118 cutaneous leishmaniasis cases (S02–S08) and 129 mumps cases in Gafsa, Sidi Bouzid, and Tozeur (S02–S09). Brucellosis was recurrent in ≥10 regions. Fourteen acute flaccid paralysis and nine meningitis cases (three fatal) were reported. Foodborne outbreaks occurred in Gafsa, Siliana, Monastir, and Medenine. Animal rabies was reported almost weekly in >10 governorates, with two suspected human cases (Sfax, Zaghouan). International alerts via EIOS included measles (USA, France, Morocco), avian influenza H5N1 (Cambodia), mpox (Central Africa), cholera (Angola), dengue (Mali), and a Marburg outbreak (Tanzania).
CONCLUSIONS:
Integrating EBS with national coordination via EpiTec and global monitoring through EIOS strengthened Tunisia’s early warning capacity and multisectoral collaboration, offering a model for enhancing epidemic intelligence systems.
Timely detection and verification of public health threats are essential for outbreak preparedness and control. In February 2024, Tunisia reinforced its epidemic intelligence (EI) system by reactivating the weekly videoconference EpiTec, integrating indicator-based surveillance (IBS) from mandatory notifiable diseases and event-based surveillance (EBS). This effort was supported by international collaboration and digital surveillance tools.¹,² We aimed to analyze the EpiTec reports.
METHODS:
Between January and April 2025, Tunisia’s 24 Regional Health Directorates submitted weekly EI reports to the National Observatory of New and Emerging Diseases (ONMNE). For influenza, the national alert threshold was set at 7.13%. Weekly EpiTec videoconferences ensured real-time coordination among regional focal points, national programs, and rapid response teams. For national and international event monitoring, ONMNE accessed the WHO/EMRO-supported Epidemic Intelligence from Open Sources (EIOS) platform, complemented by official updates from Africa CDC, ECDC, CDC, and WHO.
RESULTS:
Between ISO weeks 1–17 of 2025, over 100 national signals were reported, 82 of which met verification criteria. Key alerts included influenza-like illness exceedances in Kairouan (10.4%, S02), Nabeul (14%, S03), Bizerte (S03, S05, S11), Gabes (S05, S06), and Sfax (S11, S15, S16). There were 118 cutaneous leishmaniasis cases (S02–S08) and 129 mumps cases in Gafsa, Sidi Bouzid, and Tozeur (S02–S09). Brucellosis was recurrent in ≥10 regions. Fourteen acute flaccid paralysis and nine meningitis cases (three fatal) were reported. Foodborne outbreaks occurred in Gafsa, Siliana, Monastir, and Medenine. Animal rabies was reported almost weekly in >10 governorates, with two suspected human cases (Sfax, Zaghouan). International alerts via EIOS included measles (USA, France, Morocco), avian influenza H5N1 (Cambodia), mpox (Central Africa), cholera (Angola), dengue (Mali), and a Marburg outbreak (Tanzania).
CONCLUSIONS:
Integrating EBS with national coordination via EpiTec and global monitoring through EIOS strengthened Tunisia’s early warning capacity and multisectoral collaboration, offering a model for enhancing epidemic intelligence systems.
| eISSN: | 2654-1459 |
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