5.X.1. PechaKucha: Redesigning infectious disease surveillance for complexity: past lessons, future tools

Abstract Surveillance systems are a foundational component of public health infrastructure, enabling early outbreak detection, epidemic control, and health policy planning. Yet, their design and function have never been static. They evolve in response to scientific advances, sociopolitical transformations, and the emergence of novel threats. Today, as we confront vector-borne epidemics, antimicrobial resistance, climate-driven zoonoses, and digital health transitions, infectious disease surveillance must transform once again, integrating diverse data streams and disciplines under a unified perspective. This workshop offers a multidimensional exploration of surveillance, framed by its historical depth and projected into its future. The selected contributions follow a coherent narrative arc. We begin by revisiting 19th-century registers from Northern Italy, which documented not only smallpox and measles but also unexplained animal die-offs, early signals of the cross-species logic that underpins today's One Health frameworks. Subsequent presentations examine hospital-based risk prediction using AI, vaccine effectiveness monitoring, wastewater epidemiology, and the use of behavioural data from digital platforms. Rather than treating these as isolated approaches, the workshop encourages a holistic understanding of surveillance as a system of systems. Hospital records, environmental signals, human behaviour, and digital traces each provide unique vantage points, but their integration is essential for timeliness, precision, and equity in disease control. Collectively, the presentations highlight how surveillance is being reshaped by the availability of new data, computational capacity, and methodological innovation. A final roundtable, moderated by Professors Harvala and Ganczak, renowned experts in public health surveillance and policy, will invite discussion with the audience to reflect on priorities, ethical challenges, and pathways to interoperability. By connecting historical insight with contemporary evidence, this session aims to reframe infectious disease surveillance as a strategic, anticipatory, and adaptive public health function. Key messages • Surveillance must integrate clinical, environmental, behavioural and digital data to face 21st-century infectious disease threats. • Coordinated, adaptive and ethically grounded surveillance is key to strengthening public health preparedness and response.