Table 1.
Milestones of Greek CD control legislation in context
| Epidemiologic and historical context | Developments in Greek CD control law | International and EU developments | |
|---|---|---|---|
| Nineteenth century | 1833: Modern Greek State established | 1833: Sanitary Police, prefectural PH doctors | |
| 1828, 1837: Plague epidemics | 1834: National Sanitary Board | ||
| 1854: Cholera epidemic (Athens) | 1835: Mandatory vaccination (smallpox) | ||
| 1897: Greek–Turkish war | 1836: Mandatory CD notification | ||
| Twentieth century | 1912–1914: Balkan wars | 1911: Isolation, quarantine: cholera, smallpox | 1908: Establishment of International Health Office (Paris) |
| 1917–1918: 1st world war (Greek involvement) | 1914, 1921, 1928: CD control infrastructure (not implemented) | 1922: Establishment of League of Nations’ Health Committee & Health Section | |
| 1916–1918: Malaria epidemic in army | 1915: Mandatory clinical evaluation, travel restrictions (plague) | 1948: Establishment of WHO | |
| 1918: H1N1 pandemic (Spanish flu) | 1917: Ministry of Health, PH dpt established | 1951: International Sanitary Regulations | |
| 1919–1921: Typhus epidemic | 1929: National School of PH, supported by League of Nations Health Organization | • CD notification, isolation & quarantine, mainly regarding aircraft & ship clearance | |
| 1923: Lausanne Treaty: 1.5 million incoming refugees | 1938: Peripheral CD control boards | ||
| 1924: Typhus and malaria in refugee camps in North. Greece, 20% dead | 1950: Notifiable CD list, mass vaccination, countermeasure distribution, public education | 1969: IHR | |
| 1927–1928: Dengue epidemic, 1.3 million cases | 1955: Communicability criteria | • Prevention of transnational CD spread through preset measures (cholera, plague, yellow fever) | |
| 1932: Sovereign default, debt crisis | 1960: Mandatory mass clinical evaluation (TB) | ||
| 1933: TB>150,000 cases | 1981: Science-based criteria for mandatory STD treatment, confidentiality requirements | 1998: EU surveillance & CD control network | |
| 1940–1944: 2nd world war (Greek involvement) | 1986: HIV notification, strict confidentiality | ||
| 1946–1949: Civil war | 1992: HCDC established | ||
| 1951: last smallpox case in Greece | |||
| 1981: HIV/AIDS emergence | |||
| 1996: last poliomyelitis case in Greece | |||
| Twenty-first century | 2003: SARS pandemic (no cases in Greece) | 2003, 2005: CD control law reform (partly implemented), r-IHR requirements integrated | 2004: ECDC established. |
| 2004: Athens Olympic Games | Mandate for surveillance, risk assessment and response, communication, scientific guidance | ||
| 2005: Avian influenza H5N1 (no human cases in Greece) | 2007: r-IHR enacted. | ||
| 2009: Pandemic influenza H1N1 | Duty of WHO states for surveillance and response capacity & prevention of transnational CD spread with respect for human rights | ||
| Aug 2010: West Nile virus encephalitis epidemic in North. Greece |
ECDC, European Centre for Disease Control & Prevention; EU, European Union; HCDC, Hellenic Centre for Disease Control & Prevention; r-IHR, revised International Health regulations; PH, Public Health; SARS, Severe Acute Respiratory Syndrome; STD, sexually transmitted diseases; TB, tuberculosis; WHO, World Health Organization.