In the last decades, Belgium witnessed a constant decrease of the morbidity and mortality associated with communicable diseases, thanks to the improvement of living conditions and the implementation of control programs such as vaccination and hygiene control measures. However, several factors might break the control level reached by the country:
- Increasing movements of goods and people
- Increasing poverty
- Environmental challenges and climate change
- Emergence and spread of antimicrobial resistance
- New societal challenges (ageing, vaccine hesitancy, sexual practice, …)
Therefore, Belgium needs to maintain all activities related to communicable diseases, essentially the continuous improvement of the surveillance systems (clinical and laboratory routine data collection, complemented by community surveys), in order to detect outbreaks and the emergence of unusual diseases or antimicrobial resistance and to implement appropriate control measures or adapt the existing ones.
In this chapter, the focus will be on those communicable diseases that have the largest impact on public health, i.e., influenza and influenza-like illness, tuberculosis, and HIV and other sexually transmitted diseases. For other communicable diseases, which currently have a less important impact, the focus will be on recent trends, to document either their control or emergence.