In this game, the players face unusual infections with particularly resistant microorganisms (HRMO) in a nursing home.

How do you detect an unusual number of BRMO infections, and what role does the resistance mechanism play? What measures are taken at the patient and institutional levels? And how do you discuss the different roles within the outbreak team?

SO BRMO can be played with geriatric specialists (SO), but also well with the members of the infection prevention committee. SO BRMO is a scenario game. The game is a tool to reflect as a team on the specific challenges that scenarios in which BRMO play the leading role entail. Explore relevant challenges and perspectives together!

Information about the game:

Game time: 60 minutes
Number of players: 4-6
Guided Play: Yes

This game can be ordered at our webshop.

(C) Copyright Pandemos BV - 2023

Board Game Strengthens Antibiotic Awareness

Knowledge about antibiotic resistance and infection prevention is essential in the fight against ABR. So get started with infection prevention in different scenarios! The games Resistance and SO BRMO are specially made for this. It is a fun way of learning, and the increased knowledge improves insight into specific antibiotic resistance challenges.


In this board game, a team of healthcare professionals (the players) takes on highly resistant micro-organisms (HRMO). The game takes place in a ward in a nursing home. Several consecutive infections have been discovered in this department. Is there an epidemic? How does HRMO spread? What actions should be taken to stop the spread? The players work together to answer these questions. This is done in three stages:

The first discovery of infections caused by HRMOs.
Research into the transmission route of HRMOs.
They are reporting an unusual number of infections, who are reporting what?
The game master manages the game. The players analyze and discuss the situation in each phase from their role in the department. National protocols, department protocols, medical devices and the division of a department are discussed. The rounding-off takes place based on a point count of the number of infections that can be traced. Whoever can explain the most infections wins. Do you manage to explain most of the infections, or will the HRMOs continue to spread? Watch the explainer video of the game.

Information about the game:

Game time 30 min.
Game Guidance: Yes
Number of players 6-8
Players: healthcare professionals working in nursing homes, small-scale living and institutions for people with an intellectual disability.

The game is currently available in Dutch and can be ordered via the webshop.

(C) Copyright Pandemos BV - 2023

FluFighters™ at University College London

We took the train from Houten (NL) to London (UK) to play FluFighters™ with the Global Digital Health students at UCL. This Outbreak Learning Game lets students step into the shoes of epidemic responders at different levels. The scenario is set in the Netherlands, though the narrative was translated into English. The story starts with an unusually severe Influenza outbreak at an elementary school in the center of the Netherlands. The players are local outbreak investigators and have to make smart choices. They must ask the right questions to figure out what is going on and who is most at risk. And they discover the challenges of getting the right resources together to enable the investigation.

Group of students playing the FluFighter card game

The game is collaborative, so players have to make all decisions together. But the clock ticks, as it does in real life when an outbreak hits a population.

Once the players have determined the most important questions to investigate, they must gather the necessary resources in time to allow the investigation to take off.

FluFighters™ was developed by Transmissible and Grumpy Owl Games and is distributed through Pandemos.

Can you count to 386…?

That’s how many multidisciplinary experts we have from 112 countries & territories on the @Nature global #COVIDconsensus which I am proud to announce that I am a part of. This paper focuses on how to end the #COVID19 pandemic as a public health threat, and officially launched TODAY at!

Specific actions are required to end #COVID19 as a public health threat & our new #COVIDconsensus paper provides actionable recommendations with a whole-of-society and whole-of-government approach to make that possible in the months, not years, to come.

As a result of the large number of experts, wide geographical representation & Delphi study design, this may prove to be a model for developing responses to future global health emergencies.!

Transmissible Director co-authors  COVID-19 vaccine safety study

Arnold Bosman, M.D., participated in the observational study published in Frontiers in Public Health showing low rates of reported severe adverse events after immunization

Selangor Public Health Advisory Council Visit

Transmissible hosted the Selangor Public Health Advisory Council Visit on Friday, 14 October 2022, at our office in Houten.

Step into my Shoes- An Exciting Simulation Game

Arnold Bosman moderated the Pandemos game 'Step into my shoes at the European Health Forum Conference in Gastein, 2022. MSD and ESIP organised the session.

"This was indeed a very interesting game!"
(Dimitra Pantelli, European Observatory on Health Systems and Policies)

Health Managers and Gaming: Stakeholders put Spotlight on Ecosystem

At the European Health Managers Association (EHMA) Conference in Brussels, it was all about Health Managers and Gaming. Commissioned by MSD / Sanofi, Transmissible supported Pandemos to moderate a Vaccination Stakeholder Engagement Game at the EHMA Conference in Brussels.

Health Managers and Gaming

Pandemos developed the Vaccination Ecosystem game to engage stakeholders in an interactive debate about the European Vaccination Action Plan. Ten stakeholders each receive a specific assignment to take actions that will improve two Key Performance Indicators (KPIs) of the Vaccination Ecosystem. The more support their chosen action receives from other stakeholders, the more effective it will have. However, different stakeholders will focus on different KPIs, so you need to choose well.

Five players form one stakeholder team: the Ministry of Health, Regulators, Vaccine Manufacturers, Health Care Professionals, EU Agencies, Media, Procurement Bodies, NITAG, Civil Societies and R&D Partners. And once the actions are implemented, the Ecosystem changes. And though an action may promote some KPI, it will undermine others. So, all stakeholders must work together to identify the best actions to heal the Ecosystem again.

Curious? Check out the Pandemos website.

Webinar on field epidemiology

Ashis Brahma hosts a weekly webinar on the topic "Good care in healthcare and public health". Recently, he interviewed Arnold Bosman of Transmissible on the topics of Field Epidemiology, Trans-Disciplinary work, and Creativity. View this, and more interviews on

Ashis and Arnold speak Dutch (so, be warned)

Ashis Brahma interviews Arnold Bosman, 9 May 2022, on

New Field Epidemiology Competencies - the ultimate guide

ECDC publishes revised Epidemiology Competencies.

On April 8, 2022, the European Centre for Disease Prevention and Control (ECDC) published the revised  Competency Framework for Public Health Epidemiology. Transmissible participated in this revision process. The Association of Schools for Public Health in the European Region (ASPHER) led the revision process.

Lastly, based on this work, ECDC developed a self-assessment tool for these competencies in their EVA platform.

Why is this impactful? What is at stake? Firstly, competency frameworks are essential for the harmonization of public health capacities between countries. Next, these frameworks provide valuable guidance for future curricula of educational institutions. Lastly, they offer a repository of functional descriptions that can be used for job profiles and performance monitoring.

The European Centre for Disease Prevention and Control expressed appreciation to the team involved in this revision.

I take this opportunity to thank and to congratulate the whole team on the work accomplished
(Jeanine Pommier, ECDC)

ECDC publishes revised Field Epidemiology Competencies. 

ECDC publishes revised Field Epidemiology Competencies. 

Pandemic? Vaccines are not enough

The COVID19 pandemic is still with us after 22 months. And globally, there is no sign of stopping. The World Health Organization provides expert guidance to all countries on the best-known response to this public health threat. Still, we see large variations in national approaches. In The Netherlands, for example, the government has put most emphasis on vaccination, while releasing most of the non-pharmacological interventions that were in place to keep the virus transmission in check. Even when the baseline rate of infections was still high (over 2000 cases daily).

Unfortunately, soon after releasing these control measures, numbers started rising again in September, despite a vaccination coverage of 85% of the population over 12 years of age.

News Channel EenVandaag invited Arnold Bosman (Transmissible) to comment on the situation and the need for specific measures. The below fragment is in Dutch.

The key message is that vaccines are important, but will not be sufficient to control the pandemic alone. Additional control measures will always be needed. The challenge is to find the right mix of baseline measures, that will allow society to remain open at most levels. The key is to adopt a strategy of containment. This would be the biggest step forward for The Netherlands, where the government still maintains a mitigation strategy, allowing significant virus circulation up to levels that are just under the healthcare capacity threshold. As the World Health Organization and the European Centre for Disease Prevention and Control have stated regularly: mitigation strategies are not advisable, as the risk of uncontrollable outbreaks, that require stringent lockdown measures, is very high.

URGE - but still, they come....

Gameplay in progress at NSPOH

We designed the learning game URGE with Grumpy Owl Games as a multidisciplinary public health challenge in three rounds. The game is produced and distributed by Pandemos - the public health gaming company. URGE forces specialists out of their professional silos to team up against the greatest challenge of their careers. The team must race against time and develop scenarios to protect the population. For this, they must come out of their comfort zone and start making decisions as a team.

The Netherlands School of Public Health (NSPOH) commissioned Pandemos to create this game as part of their curriculum.

We tried out the game on July 14, 2021, to test the first reactions at the school for public health. This helped us to finalise the game and launch it on September 2 at the NSPOH.

EPIET Anniversary Interviews

ECDC Report: STI Control Strategies

On 4 September 2019, ECDC published the report "Developing a national strategy for the prevention and control of sexually transmitted infections". The European Centre for Disease Prevention and Control (ECDC) commissioned this contract through contract ECD.8353, coordinated by Otilia Mardh and Andrew J Amato-Gauci, and produced by Transmissible B.V., represented by Arnold Bosman, Marita van de Laar and Jurgita Pakalniskiene.

A strategy should be evidence-based and take into account national STI epidemiological data. Prevention and control activities should consider the determinants of sexual transmission, for example, factors such as transmissibility of pathogens, contact rates, and duration of infectiousness. A combination of primary, secondary and tertiary prevention activities may be used, based on their proven effectiveness; equally relevant when selecting prevention activities are strategy objectives and the characteristics of the epidemic in question.

The development of a new national strategy and action plan should consider alignment with other policies, strategies and action plans – both national and international – in order to create synergies between related policy areas.

The report proposes a seven-step approach for the development, implementation and monitoring of a national strategy and action plan:
- Establish a national coordination mechanism
- Engage stakeholders in the process
- Perform a situation analysis
- Develop the strategy document
- Develop an action plan
- Coordinate and manage the action plan implementation
- Establish a monitoring and evaluation plan

Simulation Exercise Flu

On 11 and 12 September 2019, we supported Trimension in coordinating a regional Simulation Exercise for severe seasonal influenza. The exercise was held in the east of the Netherlands and involved public health services, hospitals, general practitioners, crisis coordination teams, and other healthcare partners. The exercise aimed to test the preparedness and the functions at a tactical crisis response level.

Transmissible supported the exercise with epidemiological and public health scenario content and counter-play in the exercise response cell.

Micro-learning for busy professionals

Professional life is demanding. At the technical expert level, you are faced with rapid new developments in your field. As an executive manager, you face demands and priorities 360 degrees around you. Even if you are motivated to learn, where will you find the time?

Microlearning offers added value when learners are busy managing many priorities. Microlearning gives learners bite-sized programs that fit into their workday more easily than traditional training. Video lectures of 3-4 minutes are more attractive than those taking 30-40 minutes. But there is a catch! You must resist the temptation to take the easy road, and simply chop up a lecture in 10 smaller parts, without modifying the storyline. Because doing that forces the learner to follow all lectures in a fixed sequence. Plus you risk that a single short video raises more questions than it answers.

Recently, a corporate client approached us with the request to create training for senior managers within the organisation. The topic had technical aspects, as well as tactical and strategic elements. The purpose of the training would require the managers to update knowledge and to align with the global corporate policy. Knowledge and experience varied within the group and as a consequence, so would the individual learning objectives.

Microlearning offered a solution. We categorised the field of knowledge into 6 domains. For each of the domains, we identified six to ten concepts that managers had to know. Each of these concepts could be explained briefly, which is what we did. Together with Vetpot Video productions, we created bite-sized video lectures, varying in length from 3 to 9 minutes. The micro-lectured were designed such, that they could be viewed in any sequence. The lectures could be viewed on a desktop, tablet or smartphone, to optimize the access.

But very short lectures alone are not enough to make micro-learning successful. Motivation to engage with the training is not a matter of course (no pun intended). To achieve this, we introduced three online problem-based debating events, each one around a specific topic. Pegbarians created cartoon invitations, which we sent around to introduce the topics for debate. Also, we distributed a syllabus with an overview of all micro-learning. This included provocative comic book stories created by Jordan Collver, to jumpstart the debate.

This combination of micro-learning and problem-based awareness-raising proved to be very popular and successful. Participants agreed or disagreed with the comic-book narrative. Either way, this filled the online events with lively discussions about perceptions, values and expectations around the three topics. It also helped to separate knowledge from opinions. To share knowledge, we referred to the microlearning videos. This allowed focussing the discussions on opinions and strategic directions.

An additional benefit of microlearning is improved accessibility to the learning content. The short lectures easily fill idle time, for example, while travelling.

Thanks to the ubiquitous mobile devises and connectivity, microlearning can be enjoyed on your own conditions, anytime, anyplace, anywhere.

Our project on HIV Drug Resistance Surveillance

In 2017, Transmissible started a project for ECDC to pilot surveillance of HIV Drug Resistance (HIVDR) in 9 European countries. Marita van de Laar and Arnold Bosman worked with a team of experts from ECDC and 9 pilot countries to design, perform and analyse the pilot.

The article reporting on the outcome of this pilot was published in Eurosurveillance on 9 May 2019. (See below)

Vaccine hesitant mother learned about value of vaccination. The hard way.

When we think about declining vaccination coverage, the first that probably comes to mind is the shouting match on social media between Antivaxxers and ProVaxxers. As often in life, the ones with the loudest mouths do not represent the majority voice.

Antivaccination messages are scary, use false arguments and present falsehoods as facts. They frighten a much larger group of responsible, caring parents into hesitating about vaccination. Vaccine hesitancy has grown, not because the hesitant are stupid, but mainly because they care. They care about their children; some believe there may be truth in the Antivaxx claims that vaccines are bad for a child.

All parents have to weigh the risks for their children. Do I breast-feed, or bottle-feed? Can I let her cycle to school each day, or should she take the bus? Every choice has a risk. Not choosing also has a risk. The question is: which risk do you want to avoid?

If someone says: "Vaccines are completely safe, you will never be hurt", then that simply is not true. There is an extremely small risk attached to any medicine (even preventive) that you take. The important question is: how big is the risk when I do NOT vaccinate?

Well, this we know for as long as medicine exists. Measles kills, Whooping cough kills, Polio kills and paralyses, Rubella kills or cripples your unborn baby. These risks are at least thousands of times larger than the risk of taking the vaccines. It is an established, widely accepted scientific fact that not vaccinating presents a hugely bigger risk than vaccinating. Yes, it is true that a bridge may collapse. But do you really believe it is safer to let your kids swim across the river?

The safest choice you have as a parent is to vaccinate your children. It is a simple as that.

Better than I can ever explain, this Canadian mother tells you her story:

What will you give your Valentine this year?

Valentine's Day. We celebrate love. In anticipation of this wonderful day, we have a message prepared for all you lovers out there.

Mass Game Event

On 23 January 2019, 150 bachelor students at Utrecht University played our educational game 'Greep op Griep' (FluFighters). Students play the game in groups of 5-6 players. This afternoon, five groups played in the same room and got familiar with the roles in outbreak response. During the game, players step in the shoes of four local, national and international organisations and try to solve the problems they face.


In the theme of the Chinese 'Year of the Pig' (5 February 2019 - 24 January 2020), we thought you'd like this jigsaw puzzle. After solving it, we will be most interested in receiving your comprehensive risk assessment for this situation. You can leave it in the comments section below (only for logged in users: registration is free))

Days to Christmas

Our Transmissible Advent Calendar counts down the days to Christmas. Each day, a new post is unveiled. You probably already see the full image that is behind each of the days. No? Just come back tomorrow, and a new part is shown.

[adventcalendar calendar="mindful"]


Click on each day to read the post

World AIDS Day 2018


End isolation
End stigma
End HIV transmission

You’ve helped to fight HIV. Now, let’s end it. This World AIDS Day join the fight to end the negative impact of HIV. World AIDS Day is on December 1, each year. Let's all contribute in our own way.


Mark World AIDS Day in your school by using our free teaching resources. Your students will learn about what life is like with HIV, how to protect themselves and about HIV history with our assembly PowerPoint and illustrated timeline, which you can download here.

ESCAIDE 2018 Interactions

From 21-23 November 2018, the ECDC and network partners organised the annual European Scientific Conference on Applied Infectious Disease Epidemiology: ESCAIDE. This year, the conference was hosted by Malta, at the Hilton Hotel in St. Julian's. The program offered inspiring speakers with a range of perspectives on communicable disease prevention and control.

The conference is coordinated by ECDC since 2007, when it was transformed from the annual EPIET Scientific Seminar (organised by EPIET since 1996) into ESCAIDE.

Among the Keynote speakers opening ESCAIDE were Dr. John Nkengasong (director at the Africa Centres for Disease Control and Prevention, Ethiopia) and Prof. Dr. Christian Drosten (virologist at the Institute of Virology, Campus Charité Mitte, Germany). ECDC Director Andrea Ammon opened the first day by reminding the audience of the conference aims (see picture).


Career Compass

The EPIET Alumni Network (EAN) has been a key partner in co-organising ESCAIDE since the very beginning. On the first day, EAN organised the 'Career Compass', an interactive session where the audience can ask a panel questions on career choices. This year, the panel (see picture on the right) included a wide range of public health experts. Behind the table (from right to left), you see Dr. Chris Barbara (Chairman of the Pathology Department at Mater Dei Hospital in Malta), Dr. Grazia Caleo (Public Health Advisor for the Manson Unit in Medecins Sans Frontieres), Dr. Emilie Perron (Pharmaco-epidemiologist at WHO), Dr. Jane Wheelan (senior epidemiologist at GSK vaccines), Thibaut Jombart (Associate Professor outbreak response analytics, Imperial College London, UK), and Dr. Alastair Donachie (graduating EPIET fellow cohort 2016).

Arnold Bosman (Transmissible) moderated the Career Compass session.



Poster Session 22 on Vaccine Effectiveness (see picture left) included 4 presentations on effectiveness of Pneumococcal Vaccines and one on seasonal influenza.

Sebastian Cortaredona presented how likely it is that vaccinated people with diabetes will re-vaccinate next year. Lukas Richter presented the impact of PCV-10 on children and adults in Austria. Camelia Savulescu (EpiConcept) gave a summary of the effectiveness studies of SpidNet for PCV-13. Larisa Savrasova discussed outcomes six years after the introduction of PCV-10 in Latvia. And Anna Alari gave an overview of geographical analysis of vaccine coverage and pneumococcal meningitis in France.

The session was moderated by Arnold Bosman (Transmissible).



Games for Health 2018

Vincent, Tom and Arnold ready for the first keynote speech.

On 1 and 2 October 2018, the 'Greep op Griep-team' joined the Games for Health Europe conference in Eindhoven. Grumpy Owl Games (formerly known as: Jade Owl Studios) and Transmissible designed and developed the educational game 'Influencing Influenza' (Greep op Griep) for the Utrecht University and presented their work at this international meeting.

The Temporary Art Centre (TAC) in Eindhoven hosted the conference. Located opposite the PSV- Philips Stadium. TAC contains 80 workspaces for starting professional artists and has a cultural program with exhibitions, readings, workshops and music. During the first two days of October 2018, this old industrial building hosted the GFHEU conference in a unique, creative atmosphere.

Jeremy explaining the game to Ting Jiang from the Centre for Advanced Hindsight.

Tom and Arnold spent the two days listening to presentations, interacting with health workers and game professionals. Vincent joined the first day, and Jeremy the second. Arnold presented the creation and performance of the game on the first afternoon.

We had two tables in the main room to exhibit the game and that proved a great position. During the breaks, there were always interested participants around our tables, curious to get info or play a round.

Keynote speeches were awesome, on thought provoking topics and state of the art game development.


Training the Communicable Disease Team

On 28 June we organised a table top training with the Regional Public Health Services 'Hollands Midden', in Leiden, the Netherlands. The Communicable Disease Control team engaged in a challenging scenario, dealing with a biosecurity breach in the region. The scenario unfolded real time, and had started the evening before, when the director of public health called the duty officer with an assignment for support.

Transmissible prepared and executed the training together with collaborative partner Trimension. The training has been accredited for Continuous Professional Development (CPD).


Masterclass Digital Disaster Response

 On 21 June 2018, University College London (UCL) organised a Masterclass on Digital Disaster Response. Participants brought a rich and wide range of professional backgrounds, a majority of which in public health and disaster response. Dr. Patty Kostkova had convened the event, and invited Arnold Bosman from Transmissible (NL) and professor Carlos Castillo from Pompeu University (ES) to present.

In the morning, Arnold started with an overview of public health emergency response, and rapid assessment priorities in complex emergencies. This was followed by an exercise, where participants viewed a video about the earthquake in Haiti (2010) and had to discuss priorities for in that context. With the experience that participants brought in, including Tsunami relief in Banda Aceh (2004/5) and Haiti Earthquake relief (2010), this exercise provided a rich discussion.

In the afternoon, professor Castillo presented datamining from social media streams such as Twitter and Facebook, to achieve rapid assessment of geographical area affected, casualty counts, and severity of impact.


Happy Schuman Day !

On the 9th of May 2018, we celebrate the European Union. On this day, it was 68 years ago that Robert Schuman, the Luxembourg-borne French foreign minister presented a declaration that would become one of the foundations of the European Union. Together with Jean Monnet, he would draw up the Schuman-Plan for a United Europe with lasting peace.

In 1950, the nations of Europe were still struggling to overcome the devastation wrought by World War II, which had ended 5 years earlier. Determined to prevent another such terrible war, European governments concluded that pooling coal and steel production would – in the words of the Declaration – make war between historic rivals France and Germany "not merely unthinkable, but materially impossible".


It was thought – correctly – that merging of economic interests would help raise standards of living and be the first step towards a more united Europe.  The European Coal and Steel Community (founding members: France, West Germany, Italy, the Netherlands, Belgium and Luxembourg) was the first of a series of supranational European institutions that would ultimately become today's "European Union". Membership of the ECSC was open to other countries.

The contribution which an organized and living Europe can bring to civilization is indispensable to the maintenance of peaceful relations. In taking upon herself for more than 20 years the role of champion of a united Europe, France has always had as her essential aim the service of peace.


Life-course Immunisation Report Published

The Confederation of Meningitis Organisations (CoMO), the Coalition for Life-Course Immunisation (CLCI), along with Transmissible and other key stakeholders, have co-authored and contributed to a document that was initiated and funded by MSD and produced by the Health Policy Partnership. The report discusses what a life-course approach to vaccination could look like and how it could be implemented into future vaccination policies.

The report highlights that adopting a life-course approach to vaccination could positively impact individuals, the wider community, and socioeconomic factors. For example:

  • The individual: taking a life-course approach to vaccination may help boost the individuals’ immunity over their lifetime, which may make them more resistant to other diseases
  • Public Health: vaccinating individuals helps to stop the spread of infectious disease to vulnerable, unvaccinated populations.
  • Socioeconomic impact: through preventing illness, vaccinating individuals at all ages can reduce hospitalisation rates and increase productivity in the workplace.

Research suggests that shifting to a life-course approach to vaccination will require policymakers to make several changes.

These changes fall into 5 categories:

  • Involving global, EU and public health leaders
  • Changing the public’s perception of vaccination
  • Engaging healthcare professionals
  • Integrating vaccination into non-healthcare settings, such as schools or workplaces
  • Improving vaccine surveillance, data and research.

Read the full report to find out more:

[aesop_document type="pdf" src="" caption="A life-course approach to vaccination:
adapting European policies"]



Some of the co-authors of the report have also penned an open letter to key members of DG-Santé. In the letter, they call on all stakeholders to adopt a life-course approach to vaccination. Read the open letter here:

[aesop_document type="pdf" src="" caption="Open Letter on Lifelong Vaccination"]


The Health Policy Partnership have created an infographic for members of the general public and policymakers detailing the importance of a life-course approach to vaccination:

[aesop_gallery id="4214" revealfx="off" overlay_revealfx="off"]

Digital Health - The Lyon Conference 2018

The Digital Health community is growing. And it is thanks to conferences like #DH2018 in Lyon, that experts from related disciplines can exchange results, experience and ideas for future developments. Computer scientists, clinicians, nurses, public health specialists, behavioral scientists, epidemiologists, microbiologists and, yes, also philosophers, ethicists and legal experts have a stake in the field of Digital Health.

One of the first invitations that I accepted after staring up Transmissible in June 2016, is to become co-chair of the Digital Health Conference, and join the team of Patty Kostkova, who has been promoting the field of digital health for over a decade. Starting with the eHealth conferences held in London (2008), Istanbul (2009), Casablanca (2010) and Malaga (2011), a next step was made to set up the Public Health in Digital Age Workshop. This workshop was held with WWW conference in Rio de Janeiro (2013) and Seoul (2014). In 2015, this was transformed to a full subconference on Digital Health, held under the WWW Conference in Florence (2015), in Montreal (2016) and independently in London (2017).

The aim of the Digital Health Conference is to bring together public health agencies (WHO, ECDC, CDC, PHE) and computer science and IT and MedTech industry to cross-fertilize ideas and drive this growing interdisciplinary field.

This year, in Lyon, we have set up a program around the theme "Emergency and Humanitarian Medicine". Addressing acute needs of natural and manmade disasters will leverage opportunities created by geo-located big data, mobile technology and crowdsourcing for improving resilience, early warning and response to disasters and emergencies.

Curious for a glimpse in the conference?

New vlog series on Flu Preparedness (Dutch)

To support the Trimension simulation exercise on seasonal influenza, we have created a series of video briefs to explain some key aspects of preparedness for Seasonal Influenza. Below is one example (in Dutch) on hygiene measures.

The series can be found at our Vimeo channel 'Korte Uitleg'.


Playful Introduction to Outbreak Response

The University of Utrecht innovates the medical curriculum and asked Transmissible to develop a game to get students acquainted with outbreak response. In partnership with Jade Owl Studios, we designed 'Influencing Flu', a hybrid game combining an adrenalin raising card-round with a branching online narrative. The scenario starts with a local outbreak of severe influenza at an elementary school. In groups of 5-6 players, the students decide on the information they want to collect for the investigation file. Through a high-paced card game, they have 2 minutes to spend the right resources to gain access to the information. In five rounds, they play roles in the key outbreak response organisations.

The game was beta tested in November 2017, and launched for first play on February 6, 2018.

Digital Health Conference 2018

Digital Health 2018

From 23-26 April 2018 the Digital Health Conference will be held in Lyon, France. It is only appropriate to host this event in Europe's City of Health Innovation: the event is focused more and more on public health and digital innovations, so it was only a matter of time for it to be in proximity of so many other health innovations. Lyon is the 1st Smart City in France, the 2nd Digital Cluster, and the place of the 1st European Bike System 'Velo-V'.

The previous Digital Health Conference was the first with a specific public health track. In 2018, we continue this direction, with a focus on vaccine preventable diseases. Below is a glance at this year's programme. Don't miss the opportunity to submit an abstract! The deadline has been extended to 29 January 2018.


[aesop_document type="pdf" src=""]

Join me in my efforts to support Save the Children Federation, Inc.

For the past six years, Syria’s children have been bombed, shot at and starved to death. They’ve seen loved ones killed or injured, right before their eyes. Their homes and schools reduced to rubble. Their families torn apart.

We, the rest of the world, are so far away. In fact, we live in fully different worlds. It is easy to feel powerless, hopeless, and defeated, when thinking of the horrors that Syria's children have to go through, day by day.

Still, great things can start with small gestures.

Save the Children helps us to get organised. With my company Transmissible, I want to motivate people in the network to support this fundraiser, to join the activities this month, and donate to help Syria's Children.

There is lots of space to join our team: the more members, the more funds we can raise.

Donate on our Fundraiser Page on Save the Children.

Thank you for supporting Save the Children Federation, Inc.

Your contribution is greatly appreciated!

Thanks ++,  Arnold


Days to Christmas

Our Transmissible Advent Calendar counts down the days to Christmas. Each day, a new post is unveiled. You probably already see the full image that is behind each of the days. No? Just come back tomorrow, and a new part is shown.

[adventcalendar calendar="transmissible17"]


Click on each day to read the post

Regional Simulation Exercise

Influenza Escalates

On 28 and 29 November 2017, regional authorities and health care providers of the Dutch province Zeeland participated in a simulation exercise dealing with an escalating seasonal influenza scenario.

During 24 tense hours, hospitals, general practitioners, nursing homes, home care providers, ambulance companies, public health services, mayors and city councils had to deal with a simulated flu epidemic that raged over the country.

More than a dozen organizations delegated specialists to populate the response-cell to feed the evolving narrative to the players. The Delft-based company Trimension masterminded this large operation, and Transmissible was contracted to contribute to the training scenario, and provide expertise on influenza epidemiology, prevention and control.

First impressions

Though the formal evaluation is still in progress, all parties involved shared first impressions in a 'hot debrief' at the end of the exercise. As far as testing public health preparedness goes, it is clear that there is no alternative to simulation exercises. It is not only an excellent way to remind oneself of the existing protocols; it makes you better understand the different ways in which your partners respond to emergencies; it shows how agreed emergency plans can still be interpreted differently; it demonstrates that most people struggle to anticipate the response capacity needs for the next month, when they are proudly managing double patient intakes today. These were observations that were shared across the table among all participants, immediately at the end of the exercise.

I look forward to the full evaluation report. Independent of that, I can already comment that such regional simulation exercises that involve operational experts, as well as strategic and tactical decision makers, are vital for a solid health emergency preparedness.

Very much worth the effort.


Joint Transmissible & Trimension workshop for Communicable Disease Control Training

A large group of people gets contaminated with a virulent pathogen, and regular treatment is ineffective. To make matters worse, the control measures are interrupted by increasing civil unrest. The Communicable Disease Control team of the Public Health Service 'Hollands-Midden', dared to engage in this scenario during a training workshop.

As per request of the Public Health Service, communicable disease Control consultant Arnold Bosman (Transmissible) and Trimension trainer Arthur van Lohuijzen got together to organise and animate this workshop. Arnold was responsible for detailing the case finding and epidemiological investigation. Arthur put this in the context of crisis management. The participants showed great engagement to identify the origin of the disease, in order to block further spread. In addition, the participant could use several interim evaluations to review their approach. It turned out a challenge to combine the structured approach according to the principles of crisis management with the required outbreak response.

Both trainers consider this collaboration between Transmissible and Trimension as a clear success and aim for continuing this training offer. Are you interested in to receive more details on this workshop, feel free to contact:

Arthur van Lohuijzen –
Arnold Bosman - Arnold.Bosman@Transmissible.EU


For more Transmissible training, read this page.

A day to remember: Daniel Elmer Salmon

It was 167 years ago today....

when Daniel Elmer Salmon (July 23, 1850 – August 30, 1914) was a veterinary surgeon. He earned the first D.V.M. degree awarded in the United States, and spent his career studying animal diseases for the U.S. Department of Agriculture. He gave his name to the Salmonella genus of bacteria, which was discovered by an assistant, and named in his honor.

Salmon was born in Mount Olive Township, New Jersey.[1] Dr. Salmon's father, Daniel L. Salmon, died in 1851 and his mother, Eleanor Flock Salmon, died in 1859, leaving him an orphan at the age of 8. He was then raised by his second cousin, Aaron Howell Salmon and spent time working both on Aaron's farm and as a clerk in a country store. His early education was at the Mount Olive District School, Chester Institute, and Eastman Business College. He then attended Cornell University and graduated with the degree of Bachelor of Veterinary Medicine in 1872. After an additional four years of study, in veterinary health and science, he was awarded the professional degree of Doctor of Veterinary Medicine from Cornell in 1876, the first D.V.M. degree granted in the United States. Toward the end of his career at Cornell, he studied at the Alfort Veterinary School in Paris, France.

Dr. Salmon opened a veterinary practice in Newark, New Jersey in 1872 and subsequently moved to Asheville, North Carolina in 1875 due to his health. In 1877 he gave a series of lectures at the University of Georgia on the topic of veterinary science. He worked for the State of New York, studying diseases in swine and for the United States Department of Agriculture studying animal diseases in the southern states. In 1883 he was asked to establish a veterinary division within the Department of Agriculture. It became the Bureau of Animal Industry and he served as its chief from 1884 to December 1, 1905. Under his leadership, the Bureau eradicated contagious pleural-pneumonia of cattle in the United States, studied and controlled Texas fever (Babesia), put in place the federal meat inspection program, began inspecting exported livestock and the ships carrying them, began inspecting and quarantining imported livestock, and studied the effect of animal diseases on public health. In 1906 he established the veterinary department at the University of Montevideo, Uruguay and was its head for five years. He returned to the United States in 1911 and concentrated on veterinary work in the western region of the country.

Salmonella is a genus of microorganisms named after him in Modern Latin in 1900 by J. Lignières, although the man who actually discovered and named the first strain, Salmonella cholerae suis, was Theobald Smith, Dr. Salmon's research assistant, who isolated the bacterium in 1885.

Since that time, more than 2,000 subtypes have been identified.

Daniel Salmon died of pneumonia August 30, 1914, in Butte, Montana and is buried in Washington, D.C.


  1. Daniel Elmer Salmon, in: Wikipedia, accessed 23 July 2017


A day to remember: Austin Bradford Hill - father of causation viewpoints

It was 120 years ago, today

When Austin Bradford Hill (8 July 1897 – 18 April 1991) was born in London. He was an English epidemiologist and statistician, pioneered the randomized clinical trial and, together with Richard Doll, demonstrated the connection between cigarette smoking and lung cancer. Hill is widely known for pioneering the "Bradford Hill criteria" for determining a causal association; however, that seems to be a falsification from his personal views. He never seems to have seen these as 'criteria', yet merely 'viewpoints'.

As a child, he lived at the family home, Osborne House, Loughton, Essex; he was educated at Chigwell School, Essex, and later served as a pilot in the First World War but was invalided out when he contracted tuberculosis. Two years in hospital and two years of convalescence put a medical qualification out of the question and he took a degree in economics by correspondence at London University.

In 1922 Hill went to work for the Industry Fatigue Research Board. He was associated with the medical statistician Major Greenwood and, to improve his statistical knowledge, Hill attended lectures by Karl Pearson. When Greenwood accepted a chair at the newly formed London School of Hygiene and Tropical Medicine, Hill moved with him, becoming Reader in Epidemiology and Vital Statistics in 1933 and Professor of Medical Statistics in 1947.

Hill had a distinguished career in research and teaching and as author of a very successful textbook, Principles of Medical Statistics, but he is famous for two landmark studies. He was the statistician on the Medical Research Council Streptomycin in Tuberculosis Trials Committee and their study evaluating the use of streptomycin in treating tuberculosis, is generally accepted as the first randomised clinical trial. The use of randomisation in agricultural experiments had been pioneered by Ronald Aylmer Fisher. The second study was rather a series of studies with Richard Doll on smoking and lung cancer. The first paper, published in 1950, was a case-control study comparing lung cancer patients with matched controls. Doll and Hill also started a long-term prospective study of smoking and health. This was an investigation of the smoking habits and health of 40,701 British doctors for several years (British doctors study). Fisher was in profound disagreement with the conclusions and procedures of the smoking/cancer work and from 1957 he criticised the work in the press and in academic publications.

Hill was made a fellow of the Royal Society in 1954. Fisher was actually one of the proposers. The certificate of election read:

Has, by the application of statistical methods, made valuable contributions to our knowledge of the incidence and aetiology of industrial diseases, of the effects of internal migration upon mortality rates, and of the natural and experimental epidemiology of various infections, for example of the risks of an attack of poliomyelitis following inoculation procedures and of the risk of congenital abnormalities being precipitated by maternal rubella in the pregnant woman. Since the war he has demonstrated in an exact and controlled field survey the association between cigarette smoking and the incidence of cancer of the lung, and has been the leader in the development in medicine of the precise experimental methods now used nationally and internationally in the evaluation of new therapeutic and prophylactic agents.

In 1950–52 Hill was president of the Royal Statistical Society and was awarded its Guy Medal in Gold in 1953. He was knighted in 1961. On Hill's death Peter Armitage wrote,

"to anyone involved in medical statistics, epidemiology or public health, Bradford Hill was quite simply the world’s leading medical statistician."

Work on Causation

Bradford Hill set out nine viewpoint on causality:  strength of association,  consistency, specificity, temporality,  biological gradient, plausibility,  coherence, experimental evidence, and analogy. While these viewpoints are helpful when considering cause and effect, he insisted that

“none of [his] nine viewpoints can bring indisputable evidence for or against the cause-and effect hypothesis”.

What they can do, with greater or lesser strength, is to help epidemiologists make up their minds on the fundamental question - Is there any other way of explaining the set of facts before them? Is there any other answer equally, or more, likely than cause and effect?

It is important to keep in mind that most judgments of cause in epidemiology are tentative and should remain open to change with new evidence. It is important to be remain critical, to aim always for stronger evidence, and to keep an open mind. Checklists of causal criteria should not replace critical thinking.

 "The world is richer in associations than meanings, and it is the part of wisdom to differentiate the two." 

John Barth, novelist.


  1. Austin Bradford Hill, in: Wikipedia, accessed 8 July 2017. 
  2. Causal Inference, in: FemWiki, accessed 8 July 2017

Day 2 - Digital Health Conference notes

Digital support to humanitarian aid

Day 2 started with a keynote presentation by professor Tina Gomes of Delft Technical University. Information systems need to address decision makers needs, which is easier said than done. Because: who are they? The taxonomy map of decision makers in humanitarian aid is extremely complex, and covers levels from grass roots (field) level, up to international organisations. Understanding this mapping is a key starting point in system design.

Dr. Gomes made the point that the cycle starts with preparedness, where issues of interoperability, sustainability and accessibility are key to emergency aid system design. At the development stage as well as in the stage of monitor and control, the issues of timeliness and relevance need to guide the functionality. Reliability and verifiability come into view at this stage.

When actions are taken, these need to follow the humanitarian principles of impartiality, humanity, inclusiveness, reciprocity, accountability and confidentiality. System designers will have to take these principles into the system design as well.

When you provide information to decision makers, then YOU become part of the decision making process.

This is a point that Dr. Gomes communicated clearly to the audience, with the view that technology does have an impact.

Developing new systems for humanitarian aid is a complex matter, and the worst thing one could do, is rolling out a new system during a crisis. Gomes illustrated this with an example from the 2014-2015 Ebola response.

Implementing new information technology in low and middle income countries for response to humanitarian crisis is complicated by many factors, not in the least the inverse relationship of ID-address density and vulnerability of populations.


Innovation awards

The second part of the morning included a series of elevator pitches of candidates for the innovation awards. More about that in an update of this post

Digital Health Conference 2017 - Day 1

From 3-5 July 2017, the 11th International Digital Health Conference is held in London, hosted by UCL. This year is the first 'independent' year, and therefore exciting to see how this event performs without being embedded in a larger IT conference.

The conference covers a wide spectrum of subjects, including communities of practice and social networks, analytics and engagement with tracking and monitoring wearable devices, big data, public health surveillance, persuasive technologies, epidemic intelligence, participatory surveillance, disaster and emergency medicine, serious games for public health interventions, and automated early identification of health threats and response.

The aim of the conference is to bring together public health agencies (WHO, ECDC, CDC, PHE) and computer science and IT and MedTech industry to cross-fertilize ideas and drive this growing interdisciplinary discipline.

The theme of this year is 'emergency and humanitarian medicine'.

The first day was opened by Oliver Morgan (WHO) with a presentation on the new Health Emergencies structure, and how this links to digital health. In less than one hour, Dr. Morgan gave an impressive overview of the global activities of the WHO in this area, and how IT tools and infrastructure play a vital role. The role of WHO in developing new global digital tools for core functions such as surveillance, early warning, epidemic intelligence and field investigations was very well illustrated.

Other parts of the programme on day 1 included a session on Digital Tools in Practice (which I had the privilege to moderate), poster presentations, a debate session on funding and impact on digital health, parallel sessions on online communities and modeling.

Looking back on Day 1, we see a rich diversity of digital health topics that illustrates how much this field is alive, even though the theme of this year may not have been that obvious in all sessions.

Follow tweets on this conference:



Transmissible Party: 1st Anniversary

Yes, Time Flies !

It is already a year ago that Transmissible was established in the Netherlands. And since June 1, 2016, the little boy has learned to walk.

Do you remember how good it felt, to be on your own two feet for the first time? Exhilarating!

Meanwhile, we have engaged in exciting public health projects, got connected to a growing group of great clients, developed partnerships with inspiring colleagues, and most of all: had fun doing it.


Reasons to be cheerful. And to party obviously 🙂


Global Hand Hygiene Day

5 May is global hand hygiene day. Each year the "SAVE LIVES: Clean Your Hands" campaign by the World Health Organisation, aims to progress the goal of maintaining a global profile on the importance of hand hygiene in health care and to ‘bring people together’ in support of hand hygiene improvement globally.

This year the theme is "Fight antibiotic resistance - it's in your hands", with calls to action for different target groups:

There is also a great link to a wealth of online training materials, in particular on hygiene in healthcare settings.

One of the challenges within a health care organisation is to have all health professionals on the same page regarding the hand hygiene. Sharing best practice workshops help to get professionals on the same page and agree on joint approaches. Transmissible helps you raise awareness with audiovisual messages and serious games. In addition, we help you organise and moderate workshops.

Do you want to see an overview of 250 years of Hand Hygiene? Click on the timeline below

[h5p id="7"]

Immunisation Week 2017

The World Immunisation Week 2017 has started on April 24. This global event aims to raise awareness about the critical importance of full immunisations throughout life.

Follow #VaccinesWork on Twitter, to experience all that happens around this global health event


Immunization saves millions of lives and is widely recognized as one of the world’s most successful and cost-effective health interventions. Today, there are still 19.4 million unvaccinated and under-vaccinated children in the world.

Despite improvements in individual countries and a strong global rate of new vaccine introduction, all of the targets for disease elimination—including measles, rubella, and maternal and neonatal tetanus—are behind schedule. In order for everyone, everywhere to survive and thrive, countries must make more concerted efforts to reach GVAP goals by 2020. Additionally, those countries that have achieved or made forward progress towards achieving the goals must work to sustain those efforts over time.

Why immunization matters now more than ever

Expanding access to immunization is crucial to achieving the Sustainable Development Goals. Routine immunization is a building block of strong primary health care and universal health coverage—it provides a point of contact for health care at the beginning of life and offers every child the chance at a healthy life from the start.

Immunization is also a fundamental strategy in achieving other health priorities, from controlling viral hepatitis, to curbing antimicrobial resistance, to providing a platform for adolescent health and improving antenatal and newborn care.

Debating Trust in Vaccines

The Biovision Life Sciences Forum offers an interactive platform bringing together actors in research, innovation, partnerships and finance to debate existing and future health issues and how to address them. One of those topics is Trust in Vaccines: a Workshop on Thursday morning 6 April 2017, discussing three questions:


  1. How to reach a better understanding of vaccines? What is needed?
  2. What do we expect from new vaccines?
  3. What would improve vaccine coverage?

Actors from industry, the public sector, educators, academia, and communicators, discussed these questions, making the link to the concept of trust. Trust was said to require a foundation of knowledge as well as belief. Factors influencing knowledge touch on education and communication. On the one hand, there has never in history been such access to knowledge, yet increasingly we face false facts, and the challenge to identify truth from lie. In addition, belief is not necessarily based on knowledge and facts, yet may be more a personal choice based on views and social context.

A 1-hour debate session for a larger audience followed the workshop. Transmissible provided the debate moderation among four expert speakers on the main stage, including Dr Alain Fischer (Institute Imagine), Dr Marie-Paule Kieny (WHO), Dr David Loew (Sanofi), and Dr Cyril Schiever (MSD). Speakers agreed on the need to invest more in education and communication around vaccines (towards the public and professionals), as well as improving access to vaccines and research. Issues of debate included (legal) compulsory vaccination (may in some countries actually feed into vaccine rejection), incentives for health professionals (risks perception that doctors have financial motives for advising vaccines) and public shaming of decisions to refuse vaccines (may create social polarization, bringing us further from a shared trust).

The speakers shared awareness that the individual citizen expects more and more autonomy to decide (wants to be in charge) and wants to be well informed. This changes the classic doctor-patient relationship fundamentally. We will need to find solutions to deal with that new reality. In addition, the generation of doctors who have seen first-hand the burden of vaccine-preventable diseases will retire, and millennial doctors, who 'live online', need to be made aware of what these diseases mean in reality. Will immersive simulation games be a helpful tool in such education? Investing in research for online platforms, sharing open access health data, infection modelling and simulation tools may prove relevant to explore.

Before the debate started, Arnold Bosman posed a provocative statement: the age of experts has ended, and the age of the self-empowered citizen has begun:

The debate session can be viewed here:

Summer Schools for Public Health in Europe, 2017 - a selection

Each summer there are plenty of opportunities for continuous professional education in public health. This post presents a selection, an overview of what we could find on the web quickly. If you know of a Summer School on Public Health Topics that is not on this list, please post the information below.

The Observatory Summer School

Sunday 23 July – Saturday 29 July 2017

The course takes place on the island of San Servolo, one of the most beautiful and awe-inspiring islands of the Venice lagoon.

The sixday course includes formal teaching but has at its core the experiences of participants in practice. A highly participative approach emphasises group work that cuts across themes, participant presentations, round tables and panel discussions. It mobilises the latest evidence and a multidisciplinary team of experts with a track record in the analysis, implementation and evaluation of personcentred health systems. Course participants will also be able to share perspectives with and gain insights from key international organisations including the World Health Organization, the European Commission and relevant professional, governmental and civil society organisations and to engage in political dialogue with senior policy makers. They will be part of the Summer School tradition, which fosters evidencebased policymaking and encourages European health policy debate by raising key issues, sharing learning and building lasting networks.

Annual ECDC Summer School

30 May to 2 June in Stockholm, Sweden.

The goal of the ECDC Summer School is to strengthen the mentoring and technical skills of both ECDC experts and experts within ECDC networks, such as fellowships’ supervisors, by providing an opportunity for networking and scientific exchange on methods for communicable disease prevention and control.

The ECDC invites experts form the EU networks (e.g. Fellowship Training Supervisors) to participate to the Summer School. The school is usually closed for external participants.

Diagnostic data for dummies: The untapped potential of data re-use, Rotterdam, the Netherlands

9 July 2017 - 12 July 2017
Health care professionals are building up data collections as part of their practice. Smart re-use of these data supports diagnosis and treatment of patients. These data could also be a basis for research and prevention. Furthermore, pooling data with collegues can take health care and prevention to a next level. This summer course provides you with practical knowledge and skills to get the best out of your data sets. You will learn to use state-of-the-art data analysis and visualization tools, while issues such as security, privacy and ethics will be addressed.

Future of Public Health in the Post-2015 World, Finland Kuopio

14-24 August 2017

This Summer School will cover the following topics:

Population and public health, London, UK

3-21 July 2017

This module will provide an introduction to definitions used in population and public health, basic theories, and conceptual frameworks linking major determinants of health with a range of individual and population health outcomes.

It will provide an introduction to the history of population health. The role of London in public health research will be explored and the basic measurements of outcomes and risk factors used in public health, and data sources used in population health, will be introduced.

Monitoring and Evaluation of Public Health Programs: Systems Approaches and Techniques, Italy

12 June 2017 - 17 June 2017

This course introduces methods and tools necessary for monitoring and evaluating public health programs during routine public health activities as well as during large scale emergencies and public health crisis. The course will use the case based teaching method developed by the Harvard Business School and examples from the ebola outbreak, recent water crisis and other types of events to describe how evaluation methods can be used to inform public health decision making. The range of topics includes: evaluation planning, survey development and validation techniques, assessment of modern and rapid testing methods; an overview of various methodologies and designs for estimating coverage and changes for a region; methods for evaluating sub-regional performance (i.e. the health districts of a region); and comprehensive monitoring and evaluation approaches that allow for both local and regional assessment. Emphasis will be on the practical aspects of design, analysis and presentation. Students will use a public health systems approach to the evaluation of the programs and discuss as a group the consequences of the decisions they make on the implementation and evaluation of specific public health programs.

Public Health, UK, London

17 July - 4 August 2017

The module will introduce you to public health; an exciting and growing field which is underpinned by a diverse group of disciplines reflecting both the arts and sciences, employing a range of strategies to promote and protect health and well-being. We will look at the evolution of public health specifically in the UK, but also consider how changing global landscape means that boundaries between populations are increasingly less well demarcated. We will explore the key concepts of epidemiology and the broader determinants of health. The complexity around evidence-based practice, policy and politics will also be considered. This module will provide a good foundation for anybody thinking about embarking upon a career in which public health can play a role.

Environmental epidemiology, Utrecht, the Netherlands

19-30 June 2017

The objective of the course is to provide the student with insight in the principles and important issues of environmental and occupational epidemiology. Topics that are covered include time series analyses, assessment of dose-response relationships, use of geographic information systems in exposure assessment, retrospective cohort studies, ecological studies, (correction for) measurement error in exposure and interpretation of studies on mortality (life expectancy versus body counts). Theory will be illustrated by current and emerging topics like climate change and electromagnetic fields.

Screening and epidemiology, Copenhagen, Denmark

14-22 August 2017

Students will be trained in critical assessment of the evidence on (cancer) screening. The course aims to provide a solid introduction to the major concepts, theories and debates relevant to screening, with particular emphasis on early detection of cancer. Emphasis will be placed on understanding the rationale for screening and evaluation of screening outcomes. Finally, the course will provide an overview of the main cancer screening programs that have been implemented in Denmark.

Research methods in health: Biostatistics, Italy

12 June 2017 - 17 June 2017

This course is designed to provide the student with an understanding of the foundations of biostatistics and of the various statistical techniques that have been developed to answer research questions in the health sciences. Students will be introduced to methods for the comparison of outcome between two groups (t-test and non parametric tests), as well as the extension to the comparison of outcome across several groups (ANOVA); methods for the study of association between two continuous variables (correlation and linear regression); the analysis of contingency tables; the study of survival (time-to-event) data. The afternoon sessions are devoted to discussion and learning to use Stata® to implement materials covered in the morning lectures.

Research methods in health: Epidemiology, Italy

12 June 2017 - 17 June 2017

This course will explore in greater depth the fundamental epidemiologic concepts introduced in Principles of Epidemiology (Week 1). The course will be taught with an emphasis on causal inference in epidemiologic research. Topics will mainly focus on chronic disease epidemiology, with a special emphasis on practical study design. Epidemiologic examples from major chronic diseases/conditions (e.g. heart disease and cancer) will be discussed. Students will revisit the issues of confounding, selection bias, effect modification, and generalizability in the context of these topics. Lectures will be augmented by workshops to illustrate practical examples in the epidemiologic literature. The material covered in Principles of Epidemiology will be assumed of the students entering this course.

Causal Inference in Epidemiology, Italy

5 June 2017 - 10 June 2017

Causal inference from observational data is a key task of biostatistics and of allied sciences such as sociology, econometrics, behavioral sciences, demography, economics, health services research, etc. These disciplines share a methodological framework for causal inference that has been developed over the last decades. This course presents this unifying causal theory and shows how biostatistical concepts and methods can be understood within this general framework. The course emphasizes conceptualization but also introduces statistical models and methods for causal effect estimation. Specifically, this course strives to a) formally define causal concepts such as causal effect and confounding using potential outcomes and counterfactuals, b) identify the conditions required to estimate causal effects using Directed Acyclic Graphs (DAGs), and c) introduce analytical methods that, under those conditions, provide estimates that can be endowed with a causal interpretation. Examples of such methods are regression adjustment, standardization and inverse probability weighting.

Effectiveness Research with Longitudinal Healthcare Databases, Italy

5 June 2017 - 10 June 2017

Large longitudinal healthcare databases have become important tools for studying the utilization patterns and clinical effectiveness of medical products and interventions in a wide variety of care settings. This course will prepare students to identify and use longitudinal databases for their own research. Strengths and limitations of large longitudinal healthcare databases that are commonly used for research will be considered. Special attention will be devoted to nationally representative databases that are critical for comparative effectiveness research. The course focuses on analytic principles and their application to database research. Participants will learn through lectures by experienced faculty and by evaluating published database studies. In computer labs they will learn to implement a database study comparing two medical products in a large healthcare claims database. The project will be conducted using the Aetion platform with an intuitive user interface that does not require any programming skills. The course requires a working understanding of epidemiologic study designs and typical analysis strategies. The target audience consists of researchers working in academia, medical product industry, health plans, government institutions, regulatory agencies, who have access to large longitudinal healthcare databases. They may use such data to evaluate the effectiveness of medical interventions and care patterns, to understand the comparative effectiveness and safety of medical products (drugs, devices), to test the impact of coverage policy changes, or to monitor the outcome of risk-sharing arrangements.

European Public Health in a Globalising World - introducing policy, research and practice from a European healthcare, disease prevention and health promotion perspective, Maastricht, the Netherlands.

(3-21 July)

The course provides an overview of modern health challenges in Europe and how they are embraced by a variety of stakeholders: policy makers, researchers, practitioners and the
civil society. The course focus on three perspectives: Firstly, health in Europe, hence, what is the health status across the European countries, how do the health systems look like, what is major challenges for individual countries. Secondly, the perspective of European health which focuses on integration and collaboration among Member States within the European Union (EU) and more widely according to the WHO European region. Lastly, European health in a globalised world is assessed. The course combines theory with practice through lectures, tutorials and field visits.
This course consists of 32 class hours divided over 3 weeks. Students earn 6 ECTS credits when they obtain a passing grade.

Creating health literate societies: bridging the gap of inequality, Maastricht, the Netherlands

(24 July – 11 August)

Health literacy is an important asset for managing health in the 21st century. Health literacy entails the knowledge, motivation, and competency to access, understand, appraise and apply information to make decisions concerning healthcare, disease prevention and health promotion in everyday life to improve quality of life during the life course. People-centred care and co-production of health are new avenues for the future, which demands active citizens and responsive systems. However, recent research has estimated that almost one have limited health literacy and that under-served population groups such as the elderly, less educated people and groups with low socio-economic status are even worse off. Strategic action is needed to bridge the gap.

The aim of the course is to equip students with health literacy leadership skills to play an active role as professionals in creating health literate societies. Students will explore the concept and its application in research, policy and practice. They will gain competency in developing health literacy strategies and programmes in high, middle and low-income countries to bridge the global gap of health inequality. Through the problem-based learning method they will gain knowledge on how to measure health literacy, how to design complex health literacy interventions and how to build health literacy friendly organisations, communities, cities and societies.

This course consists of 32 class hours divided over 2-3 weeks. Students earn 6 ECTS credits when they obtain a passing grade.

Public Health Assets: Mapping and Mobilizing Health Assets, Alicante, Spain

17-28 July 2017

Organised by the European Training Consortium in Public Health and Health Promotion (ETC-PHHP), this course is held in Alicante, Spain.  Central in this 26th ETC Summer School is the perspective of Public Health Assets complementary to the classic needs/deficit approach used in the majority of public health and health promotion programmes. The notion of assets has its origin in Asset Based Community Development (ABCD) and is nowadays often applied as a public health intervention tool. One special aim of this course will be discussing possible connections between Salutogenesis developed by Aaron Antonovsky and the Assets model of health. The aim of the residential Summer School in Alicante is to provide an international and multidisciplinary forum for the exchange of knowledge and skills and opportunities to explore:

The 2-week course opens with a 1-day International Concha Colomer Symposium which is open to a wider audience of local and international professionals and academics with an interest in health promotion or the theme ‘Public Health Assets’. Both theoretical and practical elements of health promotion are included throughout the programme, which is underpinned by an emphasis on participant interaction. This includes field visits to exemplary local programmes and opportunities for sharing knowledge and experiences with international colleagues involved in promoting health in its broadest sense. All participants are involved in preparing a "country presentation" to present to all participants during the beginning of the course and will later engage in developing a project (including a research component) as part of an international multidisciplinary working group.

Meta-Analysis in Systematic Reviews for Food And Feed Related Topics: York, United Kingdom

1-2 June 2017

The aim of this course, facilitated by the York Health Economics Consortium (YHEC), is to provide a comprehensive introduction to meta-analysis for systematic reviews of food and feed related topics. Participants will use software to conduct pairwise meta-analysis and meta-regression.

Systematic Reviews and Meta-Analysis: Bristol, United Kingdom

12-15 June 2017

This course is designed for clinicians, researchers, public health specialists and other health care professionals who want to perform and/or critically appraise systematic reviews and meta-analyses. The course predominantly covers systematic reviews of healthcare interventions, with some material being equally relevant to systematic reviews of other topics. Towards the end of the course, special sessions examine issues in systematic reviews and meta-analyses of observational studies and diagnostic test accuracy.

3rd European Summer School in Evidence-Based Public Health, Munich, Germany

4-8 July 2017

Evidence-based public health is the development, implementation and evaluation of effective programmes and policies in public health through application of principles of scientific reasoning, including systematic uses of data and information systems. This idea, inspired by the concepts of evidence-based medicine is gaining momentum – nationally, as well as internationally.

Following the success of the second European Summer School in Evidence Based Public the third event will return to the Pettenkofer School of Public Health, Ludwig-Maximilians-Universitat, Munich and will be held on July 4th to 8th 2016.

International Summer School - Health Policy & Management, University of Bayreuth, Germany

July 2017

The course Health Policy & Management looks at comparative politics and policy in high-income countries, focusing on European Union member states and North America. It will focus both on the relationship between political and policy-making structures and on health systems and policies. The course will start with basic structural variables and questions about their contemporary relevance: social insurance and national health service systems as well as forms of centralisation and decentralisation in politics. It will then cover the ways in which these basic structures shape conflicts over priorities, structures, services and equity in different policy areas, namely, health care financing reform, primary health care, hospital care, chronic and integrated care, and public health care (prevention and communicable disease control). The basic logic is then applied and extended to the globalisation and Europeanisation of health care by discussing the ways in which the EU does or does not shape European health systems and the impact and regulation of global markets in the context of services, professionals, and patients.

Summer School - "Social Cohesion: Concept, Implementation and Impact Evaluation", Kyrgyzstan

11–18 June 2017

SIPRI and the University of Central Asia (UCA) are pleased to invite applicants to a summer school on social cohesion in Kyrgyzstan.

Social cohesion has emerged over the last two decades as an important concept in both academic and political discourse. Quality of connections and cooperation between people and groups is essential to stability and development. Social cohesion—convergence across groups in society—provides a structure that helps ensure greater degrees of predictability and certainty in inter- and intra-group relations. While there is no guarantee that all groups within a society will agree on all issues, convergence across groups offers an incentive for groups to coexist as a peaceful society.

The summer school ‘Social Cohesion: Concept, Implementation and Impact Evaluation’ is a capacity-building activity for researchers, practitioners and policymakers in Kyrgyzstan and Central Asia. It is organized as part of the ‘Social Cohesion through Community-based Development’ project implemented in Kyrgyzstan from 2014 to 2017 and funded by the World Bank and the Aga Khan Foundation. The project aims to identify, pilot and build capacity for social cohesion mechanisms in community-driven development approaches.

6th international BfR-Summer Academy on Risk Assessment and Risk Communication, Berlin, Germany

3 - 14 July 2017

The international BfR-Summer Academy on Risk Assessment and Risk Communication in the area of Food safety will be conducted by highly qualified and experienced BfR-scientists as well as external experts with profound and long standing experience in risk assessment of chemical or microbial risks. The BfR-Summer Academy is intended for the members of staff of your organisations engaged in food and feed safety, who have already experience in risk assessment analysis. The participants will acquire practical risk assessment analysis and gain deeper understanding in risk communication measures. Consequently this BfR-Summer Academy is from professionals to professionals.

European Drugs Summer School, Lisbon, Portugal (No, it is probably not what you think...)

26 June-7 July 2017

This two-week summer school prepares professionals and students to meet the complex policy challenges that face Europe in the field of drugs. Involving scientific experts from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), but also university professors and policy-makers, it provides a multi-disciplinary and inclusive approach to the study of the drug problem in Europe and beyond. As this summer school will give 6 ECTS credits for its courses, students can easily transfer credits to other European universities using the ECTS system. Credits will be attributed formally to post graduate students (Master and PHD), but it is possible to allow undergraduate to use these credits in their home universities.

Summer Courses Global Health, Copenhagen, Denmark

Various courses, all summer long. Deadline 1 April. Read fast and be quick!

The University of Copenhagen's International Summer Programme offers a number of popular global health-related summer courses, which are open to both students and external applicants with an interest in global health issues.

The 250-year-old history of hand hygiene in healthcare

Early days: between recognition and ridicule

Alexander Gordon documented the first systematic observation regarding hand hygiene more than 200 years ago in Aberdeen, Scotland. He recognized the contagiousness of the puerperal fever and the role of caretakers’ hands in cross-transmission leading to outbreaks and high fatality. Over the centuries, several pioneers suggested the hand hygiene as a preventive measure, with various degrees of professional recognition. Work of Ignaz Phillip Semmelweis, Hungarian obstetrician who demonstrated experimentally that appropriate hand hygiene significantly reduced risk of puerperal infections and maternal deaths, was rejected by peers. Similarly, Gordon’s theory was ridiculed and dismissed by the doctors, midwives and the public of Aberdeen. And even when Watson and Holmes received recognition for their medical achievements, they had to endure attacks on their theories of hygiene, often finding their recommendations disregarded.

Evidence base helps, yet attitude is key

After 1870, the germ-theory offered a strong support for earlier hygiene theories, established through discoveries of Pasteur, Koch, and Lister. Yet, even in 21st century compliance to hand hygiene remains low. Current work by Didier Pittet highlights the importance of a multimodal approach. Knowledge of the evidence base behind hygiene alone is not sufficient. Attitude is another important factor, among health care workers. And finally, the system must be designed to allow opportunity for applying hygienic practices. According to Pittet, strategies to improve hand hygiene compliance must include system change, staff education and motivation, the use of performance indicators, and hospital management support.

This poster presents the chronology of these milestones in hand hygiene. It was presented at the Semmelweis Conference in Budapest, 7-8 March 2017.

Authors: Rita Szabo, Andrea Kurcz, Arnold Bosman

Transmissible Briefs: Podcast channel for learning

Do you find it challenging to keep up with reading all public health news that is published daily?

With this new channel we aim to alleviate the task just a tiny bit. By regularly selecting European public health news in communicable disease control, Briefs is a channel to summarise reports on public health alerts and to combine it with a brief recap of key messages about our knowledge of the pathogen.

You can subscribe to Briefs as a Podcast, via iTunes or simply tap into the feed.

In addition, you can watch it on Vimeo:

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Hope you like it 🙂

Public Health Competencies - A perspective

50 years of ASPHER

The Association for Schools of Public Health in the European Region (ASPHER) celebrated the 50th birthday this year. Reason to celebrate. Also a good opportunity to look ahead, in an attempt to predict what new domains lay ahead in the future.

Invited by ASPHER, I wrote a perspective on public health competencies, the role of ASPHER until now and an expectation of future challenges. The result is published today in EuroHealth, the Quarterly Journal of the European Observatory of Health Systems and Policy.

For those who are interested, you may read the issue below:

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Ready to plan 2017?

Transmissible's 2017 Year Planner

Such lovely birthday present I got

The Transmissible Year Planner 2017 has arrived! In total, 102 historic Infectious Disease Icons and Saints appear on the planner. A quiz is incorporated in the margins of the planner; 17 descriptions to be linked to dates.

Curious for the details? Download the PDF here, for you to print out. Be aware that the planner requires to be printed on at least A2 size, preferably A1, in order to be useful as planning tool. However, printing it on A3 will probably allow you to read the fine print, and therefore have a go at solving the quiz. Link the descriptions to the correct dates and send the answers to, including your name and address, and have a chance to win a prize:

The first 5 people who submit the correct answers will receive a full color A0 size year planner.


Full color printed version also available in our shop.

Click to access the login or register cheese