Figure.

Schematic overview of The Zoonoses Structure containing SO-Z; RT-Z; OMT-Z; AGCM-Z; EPC-Z)

AGCM-Z (Administrative Governmental Coordination Meeting Zoonoses): administrative organisations involved in the control of the outbreak judge advised measurements of the OMT-Z on governmental feasibility and desirability. Conclusively, decision-making on control measures takes place at the governmental level.

EPC-Z (Expert Panel Consultation Zoonoses): an expert consultation can be organised in less urgent cases, which extensively analyses existing evidence and knowledge gaps. Recommendations are made about control strategy as well as on research strategy in order to obtain the relevant knowledge for risk assessment and/ or control measures.

OMT-Z (Outbreak Management Team Zoonoses): formed in case of an outbreak for which guidelines on outbreak control do not exist, or do not cover the specific outbreak situation. Experts assess the signal in depth and advice the AGCM-Z about the risk and appropriate control measures.

RT-Z (Response Team Zoonoses): response including upscaling. Full assessment of signal and advice on strategy to control spreading, possible interventions, diagnostics and treatment, communication.

SO-Z: Signalling Forum Zoonoses. Signalling and first assessment of (potentially) zoonotic infections.

This structure for the control of zoonoses is based on the existing Dutch structure for the control of infectious diseases.

Source: Ministry of Health, Welfare and Sport, Ministry of Agriculture, Nature and Food Quality (update 2018, by RIVM).

The chair of the SO-Z informs the chair of the RT-Z/EPC-Z (head of the National coordination Centre for Infectious Disease Control at RIVM) in case a signal needs further action. Signals are reported to the chair of RT-Z when the following criteria are met: (i) when outbreaks of known zoonoses occur with higher frequency or severity; (ii) when outbreaks of zoonoses occur that cannot be treated (easily); (iii) in case of a new or emerging zoonosis and (iv) in the case of social unrest. As defined in the zoonoses structure, the director of the Centre for Infectious Disease Control (RIVM-Cib) is the chair of the OMT-Z.