Introducing a novel epidemiologic category to move beyond the outbreak centered paradigm

This Perspective introduces the concept of Epidemiologically Relevant Event (ERE), a novel operational category designed to enhance the early detection, documentation, and response to public health signals that fall outside conventional classifications such as clusters or outbreaks. While current frameworks are largely shaped by binary outbreak-centered logic, many events that trigger significant public health action remain unclassified, inconsistently documented, and difficult to evaluate retrospectively. EREs are defined as early-warning signals that warrant a public health response based on their potential for harm or escalation, even if they do not meet formal outbreak criteria. By integrating EREs into surveillance systems, health authorities can improve risk assessment, resource prioritization, and accountability. The ERE framework is applicable to infectious and non-infectious hazards—whether community-based, nosocomial, or environmental—and is particularly valuable in contexts of uncertainty or limited surveillance capacity. The concept aims not to replace existing categories, but to fill a definitional and operational gap—stimulating expert dialogue and supporting a more flexible, responsive, and transparent public health system.