Status, quality and specific needs of Ebola virus diagnostic capacity and capability in laboratories of the two European preparedness laboratory networks EMERGE and EVD-LabNet
From December 2013 onward, the world experienced the largest Ebola virus (EBOV) outbreak to date, with more than 28,000 cases including more than 11,000 deaths mostly in Guinea, Liberia and Sierra Leone [1]. The outbreak with EBOV strain Zaire in West Africa was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO) between 8 August 2014 and 29 March 2016 [2,3]. Upon declaration of the PHEIC, the European Centre for Disease Prevention and Control (ECDC) forecast that despite low probability of imported cases, a substantial number of people would need to be investigated to rule out EBOV infection in the European Union (EU) and the European Economic Area (EEA) during the outbreak [4]. A modelling study listed four European countries (Belgium, France, Germany and the United Kingdom (UK)) in the 16 countries most at risk for importation of EBOV, while three additional European countries (Italy, the Netherlands and Spain) were modelled to be at risk for transiting EBOV-infected travellers [5]. A risk for local transmission should also be considered in case of repatriation of patients or accidentally exposed persons (e.g. healthcare workers and/or laboratory personnel) to European countries [6,7].
Two laboratory networks were actively involved in provision of EBOV diagnostic support: (i) the EU-funded joint-action initiative QUANDHIP (continued as EMERGE JA) that focused on high-consequence cross-border threats (highly pathogenic bacteria and risk group 4 (RG4) viruses) and was activated by the EU Health Security Committee (HSC) in August 2014, and (ii) the ECDC-funded European Network for Imported Viral Diseases (ENIVD, now named EVD-LabNet [8-10]). In September 2014, an assessment through the ENIVD network showed that 31 laboratories, including eight biosafety level four (BSL4) facilities, were able to handle EBOV diagnostic requests, and it was concluded that Europe had sufficient laboratory capacity to detect imported EBOV cases [11]. After the end of the PHEIC, EMERGE JA conducted an inventory of the demands on EBOV diagnostic capacity and capability during the outbreak in European laboratories associated with its network and EVD-LabNet. This was done to gain insight into problems encountered, protocols used and lessons learned and to identify needs for training and other improvements to strengthen the European laboratory response to future outbreaks.
full article
- Chantal B Reusken1, Ramona M?gling1, Pieter W Smit1, Roland Grunow2, Giuseppe Ippolito3, Antonino Di Caro3, Marion Koopmans1
From December 2013 onward, the world experienced the largest Ebola virus (EBOV) outbreak to date, with more than 28,000 cases including more than 11,000 deaths mostly in Guinea, Liberia and Sierra Leone [1]. The outbreak with EBOV strain Zaire in West Africa was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO) between 8 August 2014 and 29 March 2016 [2,3]. Upon declaration of the PHEIC, the European Centre for Disease Prevention and Control (ECDC) forecast that despite low probability of imported cases, a substantial number of people would need to be investigated to rule out EBOV infection in the European Union (EU) and the European Economic Area (EEA) during the outbreak [4]. A modelling study listed four European countries (Belgium, France, Germany and the United Kingdom (UK)) in the 16 countries most at risk for importation of EBOV, while three additional European countries (Italy, the Netherlands and Spain) were modelled to be at risk for transiting EBOV-infected travellers [5]. A risk for local transmission should also be considered in case of repatriation of patients or accidentally exposed persons (e.g. healthcare workers and/or laboratory personnel) to European countries [6,7].
Two laboratory networks were actively involved in provision of EBOV diagnostic support: (i) the EU-funded joint-action initiative QUANDHIP (continued as EMERGE JA) that focused on high-consequence cross-border threats (highly pathogenic bacteria and risk group 4 (RG4) viruses) and was activated by the EU Health Security Committee (HSC) in August 2014, and (ii) the ECDC-funded European Network for Imported Viral Diseases (ENIVD, now named EVD-LabNet [8-10]). In September 2014, an assessment through the ENIVD network showed that 31 laboratories, including eight biosafety level four (BSL4) facilities, were able to handle EBOV diagnostic requests, and it was concluded that Europe had sufficient laboratory capacity to detect imported EBOV cases [11]. After the end of the PHEIC, EMERGE JA conducted an inventory of the demands on EBOV diagnostic capacity and capability during the outbreak in European laboratories associated with its network and EVD-LabNet. This was done to gain insight into problems encountered, protocols used and lessons learned and to identify needs for training and other improvements to strengthen the European laboratory response to future outbreaks.
full article