Arboviral disease surveillance/clinical staff perceptions

Arboviral disease surveillance/clinical staff perception of factors contributing to the a) success and b) barriers/challenges with respect to case management (ref Q25)

Country	Successes	Barriers
Albania
Armenia	Success with respect to case management the laboratory investigation capacities in the country.	Absence of case-management protocols, lack of trainings, and low awareness on arboviral infections.
Bosnia and Herzegovina
Bulgaria
Croatia	Interdisciplinary and multisectoral "One Health" approach
France	Important territorial network in first and second level care.	For Réunion, seroprevalence of dengue following several epidemic seasons with a high risk of secondary dengue fever and serious cases; differential diagnosis of leptospirosis
Georgia	Laboratory capacity as a success.	Lack of specialists and laboratory capabilities locally at the medical facilities
Germany	Seminars, training, higher compensations	Seminars, training
Greece	Laboratory capacity - laboratory expertise, free-of-charge (for the patient) diagnosis. ICU availability for severe cases. Direct communication for guidance and consultation of the treating cllinicians is available (provided by infectious diseases specialists of the National Public Health Organization, upon request).	Timeliness of diagnosis - Awareness of clinicians regarding imported cases of non-endemic diseases - Regular training. Low experience in managing imported cases of some non-endemic diseases - Regular training and development of guidelines for case management.
Hungary
Italy
Malta	Physicians are capable of managing such cases
Monaco
Portugal
Romania	Experience in case management of West Nile fever	For other non-WNV arboviral disease this can be a challenge
San Marino
Slovenia	Well trained clinical personal contributes to the success in management of the patients with arboviral diseases. There are no serious barriers or challenges with respect to case management.
Spain
Switzerland	Enough capacity	Discovery of first local case could be difficult/delayed. All mosquito-borne arboviral disease cases have been travel-related up to now. Due to a lack of awareness, it might be difficult for the clinical staff to detect a first autochthonous case in a person without travel-history
Turkey