The e-Bug Project

Teaching resources covering the ages of 5 to 18 years focused on the topics of microbiology, hand and respiratory hygiene, vaccinations and antibiotic use.

The e-Bug project was established in 2006 with 60% co-funding by DG SANCO (European Commission Directorate General for Health and Consumers) and was coordinated by the Public Health England’s Primary Care Unit in England.

e-Bug was developed due to a lack of teaching resources around prudent antibiotic use and antibiotic resistance in Europe. In many European countries, antibiotic prescription rates are highest in children. Teaching children about microbiology, antibiotics and the increasing problems of antibiotic resistance with unnecessary use, should raise awareness of prudent antibiotic use in children who are our future generation of users.


  • To reduce the incidence of antibiotic resistance across Europe by educating the future prescribers and users of antibiotics on prudent antibiotic use.
  • To reduce the incidence of infection in children and communities by educating around good hygiene practices to reduce the need for antibiotics.
  • To compliment national antibiotic and hygiene educational campaigns.
  • Exchange information and experience of good practice within the educational curriculum with European partner countries.
  • Translate and implement the e-Bug resource across Europe in close collaboration with local Ministries of Health and Education.


E-Bug includes resources for teachers, students, and the community. There is also food, oral and farm hygiene for younger students, and sexual health and chlamydia for older. There are interactive websites for students hosting complementary games, interactive quizzes, disease fact sheets and much more.

Community resources include a 6 session hygiene and self-care course called Beat the Bugs. Beat the Bugs is a fun, interactive and adaptable course, which covers all of the same topics as the school resources with the addition of action planning to encourage behaviour change. Beat the Bugs can be delivered with all ages and any type of community group.

Additional resources include assembly activities and peer education. E-Bug also has training for educators, including online and face to face workshops.


10 associate partners and 8 collaborating partner countries were involved in the initial development of e-Bug from 2006 – 2009. Following that, there was full translation of the resources in the associate partner countries. Evaluations of the resources were completed in England, France and the Czech Republic, within 2 regions of each country (rural and urban).

Currently we have the resources translated into 23 different languages with 26 different partner countries involved in promotion and implementation of e-Bug, including Saudi Arabia, Palestine and Turkey. The resource is evaluated and improved through a range of research methods.

Suggestions for Further Implementation

Between 1st Sep 2016 – 31st Aug 2017 the e-Bug website had over 126,000 visits from 220 different countries.  We have implemented e-Bug in schools and community groups.

We would like to implement e-Bug in paediatric wards and hospital schools and investigate the appropriateness of this new setting.

Challenges and Learning

One of the main challenges for promotion of the resource is that many of the e-Bug topics such as hygiene and antibiotics are not covered heavily in school curriculums (UK and abroad). It’s also impossible to know how many schools currently use e-Bug. While we can track visits to the website, we cannot know how many schools are using the printed resources.

Secrets to success include gaining endorsement from bodies such as NICE and the Ministry of Education, regional promotion, such as through local authorities and healthy schools programmes.

The e-Bug resources have been endorsed by the Ministry of Education and NICE. NICE guidance on antimicrobial stewardship in the general population recommends all schools use e-Bug to educate hygiene and antibiotics.

Focus groups of primary and secondary teachers in the UK and France were held to establish requirements of the resource. From this, draft layouts of the resources were produced and shared with 36 health and education representatives from e-Bug partner countries. Following this, school children took part in a series of artwork development questionnaires to assess the most appropriate style for the design of the pack and website.

Visit the project website.


Project Lead: Prof Cliodna McNulty, Clinical Microbiologist

Organisation: Public Health England

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