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The 27th of December has been designated by the United Nations as the “International Day of Epidemic Preparedness”. Since the COVID-19 pandemic, everybody is aware of the crucial need to prevent, detect and control large outbreaks of infectious diseases. But what can an academic hospital with a name and a location that an international audience can hardly pronounce (the ‘Redboet’ hospital in ‘Naimegan’) do to contribute to global epidemic preparedness? Spoiler: it’s more than you might think!
Many ‘disease detectives’ work at the Radboudumc to prevent, detect and control the spread of infectious diseases. One of them is Alma Tostmann, hospital epidemiologist and deputy head of the Infection Prevention and Control (IPC) Unit, who will guide us through the world of epidemic preparedness: from local practice to global collaboration.
Local epidemic preparedness: vigilance and a good network
While epidemics are outbreaks of infectious disease at a large scale, epidemic preparedness starts at the local level. Alma explains: ‘Every large outbreak begins small. The first patient of something big will show up somewhere. Preparedness means vigilance and awareness at every level of the healthcare system. One of the actions that we take at Radboudumc is that all patients with a confirmed influenza A infection are asked whether they had recent contact with sick or dead animals, in order to timely detect a possible human avian influenza case.’
Local epidemic preparedness in Nijmegen alone is, of course, not enough. Highly trained epidemiologists and infectious disease experts are required everywhere in the world to keep an eye out for potential disease outbreaks. Alma became a trained ‘disease detective’ through the fellowship program of the European Centre for Disease Prevention and Control (ECDC). She worked for two years at a UK Public Health institute and followed trainings with a European group of “fellows”. ‘Having this strong and committed international epidemiology network was very helpful during the COVID-19 pandemic, when an answer to any epidemiological question I had was at hand 24/7.’
Training on disease prevention and control as well as establishing professional networks is vital for epidemic preparedness. Since 2023, Alma is co-director of a two-year postgraduate diploma course in infection prevention and control within the Infection Control Africa Network (ICAN), which provides advanced IPC-training to healthcare workers in Africa. ‘Each year a new group of 20-30 healthcare workers start this program and they form a close and collaborative group. They help each other with practical and strategic IPC-related questions: ranging from a local healthcare associated infection outbreak, to setting up the response to the current Marburg outbreak in Ethiopia.’
(Inter)national epidemic preparedness: surveillance and management
Prevention of infectious diseases happens at the local level, but equally requires coordinated actions at (inter)national level. ‘It is not always possible to prevent the start of an outbreak, but early detection and an adequate coordinated response can prevent small outbreaks from evolving into large epidemics’, Alma explains. To improve these processes, Radboudumc is part of a national project since 2024 that aims to improve Severe Acute Respiratory Infection (SARI) surveillance in the Netherlands. A reliable SARI surveillance system is vital for monitoring trends of respiratory infections, detecting possible outbreaks, and monitoring the impact of national vaccination programs. ‘Having a feasible and robust SARI surveillance system in place is important for pandemic preparedness. This new system is an improvement compared to the system we had for monitoring COVID-19 hospital admissions, as that included a lot of manual data collection, which is not sustainable in the longer run.’
Internationally, Radboudumc researchers also contribute to improving epidemic preparedness. This happens for example by research on improving the medical care that we provide in our high-level isolation unit, coordinated by Prof. Chantal Rovers. Furthermore, healthcare systems include the primary care and public health domain, which is the main focus of Prof. Aura Timen, who coordinates the RAPIDE project, which aims to improve healthcare during cross-border health emergencies.
Epidemic preparedness also means being prepared to give sound advice and recommendations, about the infection prevention and public health measures needed to prevent further infections, that are rightly balanced in a wider societal context. In general, biomedical experts in the Outbreak Management Team (OMT) and socioeconomic experts in the Societal Impact Team (MIT) provide their expert views on the situation. Integrating these viewpoints is challenging, which is why the Pandemic and Disaster Preparedness Center organizes simulation exercises to rehearse real-life scenarios. Alma, as well as colleagues Prof. Heiman Wertheim and Prof. Chantal Rovers, has taken part in these scenario exercises several times: ‘It was very interesting to take part as you notice how much you are used to your own way of thinking. Having to explain your implicit thought processes to the other “team” was very informative. Integrating such advice is not easy, especially under time pressure, but we all felt these simulations have gained valuable insights that can be used for improving national outbreak response.’
Looking ahead: Epidemic Preparedness in 2026
It is clear that Radboudumc’s disease detectives contribute to epidemic preparedness at all levels: local, regional, national and international. Which New Year’s resolution will keep us on the path toward epidemic preparedness? Alma: ‘Think globally, act locally. By conducting our role in IPC and outbreak detection and response properly at Radboudumc, while we connect with our regional, national and international partners, we will be ready for the next pandemic.’
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A blog by Laura Akkerman (PhD candidate @ Dep. Medical Microbiology)
Jr. editor for Radboudumc Research Institute for Medical Innovation
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