Elsevier

Journal of Clinical Virology

Volume 62, January 2015, Pages 124-134
Journal of Clinical Virology

Identification of essential outstanding questions for an adequate European laboratory response to Ebolavirus Zaire West Africa 2014

https://doi.org/10.1016/j.jcv.2014.11.007Get rights and content

Highlights

  • A WHO coordinated international laboratory response is necessary.

  • Essential information should be collected coordinated and systematically.

  • This should be in the public domain to ensure adequate laboratory response.

Abstract

On August 8 2014, the World Health Organization (WHO) declared the outbreak of Ebola Virus Disease (EVD) evolving in West Africa since December 2013, a Public Health Emergency of International Concern (PHEIC). It is expected that the outbreak of Ebolavirus Disease (EVD) in West Africa will lead to increased testing of individuals in Europe for EVD. The severity of the situation in West Africa warranted a critical appraisal of the laboratory preparedness and response for EVD, with a focus on information needs for laboratories involved in diagnostics of rare viral diseases associated with the European Network for the Diagnostics of “Imported” Viral Diseases”, ENIVD. Essential knowledge and knowledge gaps for an adequate laboratory response focusing on virus properties, infection kinetics, tests specifics and field performances were identified. An inventory of the laboratory capacity for EVD diagnostics among ENIVD laboratories was made.

Section snippets

Background

An outbreak of Ebola virus disease (EVD) has been ongoing in West Africa since December 2013 affecting Guinea, Liberia and Sierra Leone. As of 25th October 2014, the cumulative number of probable and confirmed cases stands at 10,141, including 4922 deaths, making this EVD outbreak the worst in history in terms of geographical spread and number of cases and deaths reported. A total of 450 health care workers (HCW) have been reported with EVD of which 244 have died [1], [2]. In Lagos, Nigeria,

Geographic spread

In the current outbreak (as of October 25, 2014) countries in three risk categories should be taken into account with respect to travel to Europe and EVD inclusion in differential diagnostics in travelers:

  • -

    countries with widespread and intense transmission: Guinea, Liberia, and Sierra Leone.

  • -

    countries with an initial imported case or cases, or with localized transmission: Mali, Spain and the United States but also DRC (unrelated outbreak). Nigeria and Senegal are officially EBOV free.

  • -

    countries

EBOV testing capacity Europe

To analyze the capacity for diagnostics of suspected EVD cases in Europe, the ENIVD performed a survey of diagnostic laboratories within the network. Of 40 laboratories from 30 countries responding, 31 were involved in the diagnostics of suspected EVD cases including 8 P4 labs (Budapest, Hamburg, Lyon, Marburg, Porton Down, Rome, Spitz, Stockholm) (Fig. 2). The total number of samples received so far (as of September 10, 2014) has been very limited, with higher numbers in the P4 labs (Lyon:

Summary knowledge gaps and conclusions

  • Knowledge gaps for an adequate laboratory response in the current EBOV outbreak have been identified and need to be addressed urgently. This should be achieved by a WHO coordinated international laboratory response including a study protocol addressing the most pressing information needs. Obtained knowledge should be put in the public domain as soon as possible.

  • The genomic diversity of EBOV in the current outbreak should be verified against operational RT-PCR methods and should be monitored

Funding

The laboratory preparedness and response assessment checklist was developed in part within the project “Establishment of an expert laboratory network for early detection, surveillance and epidemic preparedness and support to emerging or re-emerging and vector-borne threats in Europe” coordinated by the European Network of Imported Viral Disease (ENIVD) and funded by the European Center for Disease Prevention and Control (ECDC) under the Framework Service Contract Ref OJ/20/12/2013-PROC/2012/060

Competing interests

None.

Ethical approval

Not applicable.

Acknowledgements

Participants in the Ebola Capacity Survey (September 2014): Albania Tirana, Institute of Public Health, Majlinda Kota; Austria Vienna, Med. University Vienna Department of Virology, Stephan Aberle, Austria Vienna, Austrian Agency for Health and Food Safety-Institute for medical Microbiology and Hygiene Vienna, Alexander Indra; Bosnia and Herzegovina Sarajevo, Clinical microbiology, Clinical Center University of Sarajevo, Amela Dedeic-Ljubovic; Belgium Antwerp, Institute of Tropical Medicine,

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