Table-Top Exercises (TTX)

This space is designed to share publicly the materials created to run the ECDC Simulation Exercises. You will find Scenarios, Injects, Master list of Events and some background material to understand the context for which the exercises were created. The objective is that these materials can be reused as a basis for customized exercises at national or sub-national level in the EU Member States. You are free to reuse and modify the contents under he CC B.Y. 4.0.

You may also be interested to check the e-learning on how to design a TTX.

This exercise is a Table Top Exercise (TTX) created in 2018.

The overreaching aim of this Exercise was to explore the response to the emergence of a novel strain of a difficult-to-treat, pandrug-resistant bacterium in a healthcare setting, with the potential threat for a cross-border spread.

The objectives of the exercise are:

  1. To develop a greater awareness of the subject of epidemic antimicrobial resistance threats;
  2. To identify gaps in current arrangements to detect, verify, ascertain the public health impact and assess risk associated with an unusual cluster of serious healthcare-associated infections caused by a difficult-to-treat, pandrug-resistant bacterial strain;
  3. To consider the cross-border implications of such an event and suggest strategies for mitigation;
  4. To consider how the healthcare and public health community can work more closely together at national and international level taking into account EU legislation, such as Decision 1082/2013/EU on serious cross-border threats to health, Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare and any other EU legislation, as well as the European One-Health Action Plan on Antimicrobial Resistance;
  5. To consider the interaction and coordination between the EU healthcare and public health community with international partners and third countries in case of a crisis of international significance beyond the EU;
  6. To consider the role of International agencies, such as the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) in relation to its mandate regarding risk identification, risk assessment and surveillance.

Duration: 1 day and half day (12 hours).

Related keywords: pandrug-resistant bacterial,  Anti-Microbial Resistence, EWRS, EPIS, IHR, cross-border spread, healthcare setting.

This exercise is a TableTop Exercise (TTX) created in 2009.

The aim of Exercise Orange Circle was to explore procedures and functions regarding early detection, assessment and communication associated with events related to a Vaccine Preventable Disease (VPD) or immunisation programmes.

The objectives of exercise were:
  1. To test the coordination and internal communication among ECDC units and horizontal programme, and external communications with Member States and relevant stakeholders.
  2. To explore early detection mechanisms.
  3. To assess internal and external coordination of the threat assessment.
  4. To manage the closure of a VPD event.

Duration: 1 day (7 hours).

Related keywords: Vaccine Preventable Disease, VPD, meningococcal disease, meningococcal vaccination, vaccine.

This exercise is a Tabletop Exercise created in 2008.

The overarching aim of Exercise Blue Triangle was to test the standard operating procedures for the response to a food and waterborne disease threat at an EU level, developed by the ECDC Preparedness and Response Unit together with the Food and Waterborne Disease Horizontal Programme.


The agreed objectives of the exercise can be summarised as following:

  1. To test the capacity/co-ordination for early detection and response of a food and waterborne disease (FWD) threat at an EU level
  2. To test the functionality of ECDC guidelines for response to a FWD threat (Guiding Principles, in particular, Part II: Food and Waterborne Disease Threats at EU level).
  3. Examine how a FWD is detected in the early stages and how subsequent co-ordination and response is managed.
  4. To test how the threat assessment is developed from different sources of information.
  5. Test the co-ordination and response with other stakeholders.
  6. Test how ECDC coordinates with Member States and the European Commission in the response to an incident of this nature
  7. Test the capabilities of the European ad hoc response team to produce a timely initial threat assessment
  8. To analyse the existing internal ECDC command, control and communication structure during an EU level FWD outbreak


Duration: 1 day (8 hours)

Related keywords: non-O157 Shiga-toxin producing E. coli, food and waterborne diseases, Early detection, Outbreak Response, Cross-border, Co-ordinated response, .

This exercise is a Tabletop Exercise (TTX) created in 2007.

Exercise Red Wing was created to explore draft procedures for contact tracing of passengers proposed by the working group of the Health Security Committee. (Standard operating procedure for passenger tracing in a case of a potential exposure to a communicable disease occurring in a Member State of the European Union after an international flight”).

The objectives of the exercise were:

  1. To explore contact tracing procedures within the EU, based on the draft paper developed by the working group of the Health Security Committee.
  2. To explore the reaction of stakeholders to an event which might require international contact tracing within the European Union based on the draft paper developed by the working group of the Health Security Committee.

  3. To clarify the collaboration mechanisms, roles and responsibilities between member states and between member states and European co-ordinating bodies.

  4.  To explore the procedures required by the International Health Regulations (IHR) and the role of WHO in outbreaks of notifiable infectious disease within the European Union boundary.

  5. Explore the role of ECDC in an event which might require international contact tracing within the European Union based on the draft paper developed by the working group of the Health Security Committee.

Duration: 1 day (7 hours)

Related keywords: Ebola, Flight, International contact tracing, Health Security Committee, Outbreak Response, Cross-border, International Health Regulation (IHR),

This exercise is a Table Top Exercise (TTX) created in 2016.

This exercise differs from the other exercises in this library in its approach. With a strong focus on capacity building, it takes participants through the various steps in a facilitated fashion.

The aim of this exercise was: To exercise the public health emergency preparedness of the participating countries to a major outbreak of mosquito-borne viral disease, of both national and international dimensions.

The objectives of the exercise were:

  1. In-country emergency recognition and management: detect and risk assess the situation, activate emergency organisation and plans, manage and monitor the emergency;
  2. Inter-sectoral collaboration: work effectively between the health and key related sectors, to assess the risks and manage the emergency;
  3. International collaboration: interact effectively with contiguous and other countries in the wider region, and international authorities, to assess, manage, communicate and work collaboratively to address, mitigate and resolve the international emergency;
  4. Risk communication: to communicate effectively regarding the health risks, between stakeholders, professionals and the public.
  5. Review and evaluation: for each country to reflect on potential lessons from the exercise relating to their present state of preparedness for public health emergencies, involving mosquito borne viral diseases in particular, and for communicable disease events more generally.

Duration: 1 days (7.5 hours)

Related keywords: