The integrated “One Health” approach
What is the One Health approach?
The One Health approach is based on a simple idea: human health, animal health, and the environment are closely connected. Many health risks emerge at the point where these three areas meet and cannot be properly understood or managed if they are treated separately.
Adopted internationally by organizations such as the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organisation for Animal Health (WOAH), the One Health approach promotes closer cooperation between disciplines and institutions in order to anticipate health threats and better protect population health.
Why link human, animal, and environmental health?
Many infectious diseases pass between animals and people or are shaped by environmental factors such as water quality, climate, and the presence of vectors like ticks and mosquitoes.
Bringing together data from human, animal, and environmental health makes it possible to spot warning signs that would stay invisible within a single sector. By looking at these data side by side, we can better understand how diseases spread, anticipate emerging risks, and coordinate prevention and response across sectors rather than reacting only after human cases have already appeared.
One Health surveillance in Luxembourg
In Luxembourg, One Health surveillance is based on a set of complementary systems. These are developed and run by several specialised authorities and institutions in line with European and national regulatory frameworks.
Food safety surveillance
Food safety surveillance is mainly carried out by the Luxembourg Veterinary and Food Administration (ALVA), created in 2022, as part of the official controls required by European regulations. It covers microbiological agents, chemical and biological contaminants, and materials that come into contact with food.
These activities rely on controls carried out along the entire food chain, from primary production to distribution, and on analyses performed by the National Health Laboratory (LNS), which provides scientific expertise and acts as the national reference laboratory for several zoonotic agents.
Food surveillance also feeds into European alert and information-sharing systems, in particular RASFF (Rapid Alert System for Food and Feed) and reporting to EFSA (European Food Safety Authority), allowing rapid management of alerts and coordination at EU level.
Veterinary surveillance of zoonoses
Surveillance of animal zoonoses is the responsibility of the Luxembourg Veterinary and Food Administration (ALVA), and more specifically of the State Veterinary Medicine Laboratory (LMVE). Its purpose is to detect and monitor diseases transmissible from animals to humans, in line with European and international obligations.
This surveillance is based on official veterinary controls, specific eradication or monitoring programmes, and mandatory reporting of animal diseases defined by European legislation. Confirmatory and characterization analyses are carried out in cooperation with the National Health Laboratory (LNS) and European reference laboratories.
The data collected feed into reporting systems for EFSA, contributing to an integrated view of zoonotic risks at European level.
Environmental surveillance
Environmental surveillance aims to better understand how environmental factors affect human health and to detect emerging environment-related health threats. It covers, in particular, air and water quality, the presence of pathogens in wastewater, pollen, cyanobacteria, and the monitoring of vectors such as mosquitoes.
These activities are coordinated between several actors, including the Luxembourg Directorate of Health, the Luxembourg Water Management Administration (AGE), the Environment Administration, the Luxembourg Institute of Science and Technology (LIST), and the National Health Laboratory (LNS). They rely on monitoring systems, specialized databases, and public information platforms.
Developing a national exchange platform
As part of PHRESH, Luxembourg is developing a national exchange platform to strengthen coordination between the actors involved in surveillance and health risk management. Today, information about events that may affect public health often circulates through multiple and heterogeneous channels, which can slow down sharing and make cross-sector analysis more difficult. The platform will provide a secure digital space where health authorities, veterinary services, laboratories, and other relevant partners can share information, alerts, and analyses in a structured and targeted way, according to their roles and responsibilities. Inspired by existing European platforms, this infrastructure will make intersectoral communication easier, support coordinated monitoring of health events, and align responses, while fitting into the national and European surveillance ecosystem.
Raising awareness among doctors
Doctors play a key role at the interface between patients, the healthcare system, and public health surveillance. Their ability to identify, report, and put certain clinical cases into context is essential for early detection of health threats, especially when environmental, food-related, or animal factors may be involved. PHRESH therefore places strong emphasis on raising awareness and training among doctors, to reinforce their understanding of integrated surveillance and encourage their active contribution to the system.
Tick sentinel network
A sentinel network of doctors has been set up to strengthen surveillance of tick-borne diseases and improve early detection of related risks. Participating doctors play a central role by identifying tick bites and symptoms suggestive of conditions such as Lyme disease or tick-borne encephalitis. They report suspected cases and complete, via a digital questionnaire accessible through a link or QR code, detailed information on each case (symptoms, diagnosis, management). Doctors are also encouraged to inform patients about prevention measures and to give them a flyer and a QR code allowing them to complete an additional questionnaire.
Data collected from doctors and patients are centralized by the Health Inspection Division of the Luxembourg Health Directorate, which analyses them to identify epidemiological trends and risk areas. This information feeds into awareness-raising activities for the public and professionals, as well as regular exchanges with the relevant institutions and partners, particularly in human, animal, and environmental health. The results are discussed within the network at the end of the season.
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