A prioritization exercise was conducted in Belgium focusing on emerging or re-emerging infectious diseases which might constitute a threat for public health in Belgium. The objective of the exercise was to identify priority diseases for which regular risk assessments might be needed in the future to support competent authorities in developing or updating emergency preparedness plans.

The ECDC-recommended Multi-Criteria Decision Analysis (MCDA) methodology was used.

Thirty-one diseases, considered as potential (re-)emerging health threats, were assessed against 15 pre-defined criteria covering three domains: A) likelihood of (re-)introduction in Belgium, B) epidemic potential and C) disease impact. The assessment was done through consultation of Belgian experts from different backgrounds and settings.

Diseases were ranked for each criteria. Ranks per criteria were averaged withing each domain (likelihood of (re-)introduction, epidemic potential and disease impact) and then across domains.

Overall, the top 10 ranked diseases were avian influenza infections, coronaviruses (MERS/SARS/SARS-CoV2), other zoonotic influenza infections, haemorrhagic fevers (Marburg, Crimean-Congo, Ebola and Lassa), West-Nile fever, invasive Klebsiella infection and tuberculosis.

By domain,

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• Avian and zoonotic influenza infections, coronavirus infections and tuberculosis ranked in the top 10 for both likelihood of (re-)introduction and disease impact;
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• West-Nile fever and Chikungunya infection ranked in the top 10 for both likelihood of (re-)introduction and epidemic potential;
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• Haemorrhagic fevers ranked in the top 10 for both epidemic potential and disease impact.
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