Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T00:43:41.948Z Has data issue: false hasContentIssue false

Ensuring On-site Ebola Patient Monitoring and Follow-up: Development of a Laboratory Structure Embedded in an Ebola Treatment Center

Published online by Cambridge University Press:  24 June 2019

Anita Williams*
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit LuxOR, Luxembourg, Luxembourg
Mathieu Amand
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Guinea Mission, Conakry, Guinea Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
Rafael Van den Bergh
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit LuxOR, Luxembourg, Luxembourg
Hilde De Clerck
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Medical Department, Brussels, Belgium
Annick Antierens
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Medical Department, Brussels, Belgium
Pascale Chaillet
Affiliation:
Médecins Sans Frontières, Operational Centre Brussels, Medical Department, Brussels, Belgium
*
Correspondence and reprint requests to Anita Williams, Médecins Sans Frontières Luxembourg, 68 rue de Gasperich, L-1617 Luxembourg (e-mail: [email protected]).

Abstract

The capacity to rapidly distinguish Ebola virus disease from other infectious diseases and to monitor biochemistry and viremia levels is crucial to the clinical management of suspected Ebola virus disease cases. This article describes the design and practical considerations of a laboratory straddling the high- and low-risk zones of an Ebola treatment center to produce timely diagnostic and clinical results for informed case management of Ebola virus disease in real-life conditions. This innovation may be of relevance for actors requiring flexible laboratory implementation in contexts of high-communicability, high-lethality disease outbreaks.

Type
Concepts in Disaster Medicine
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Ebola Outbreak 2014–2015. World Health Organization website. http://www.who.int/csr/disease/ebola/en/. Accessed February 13, 2018.Google Scholar
Personal Protective Equipment in the Context of Filovirus Disease Outbreak Response. World Health Organization website. https://www.who.int/csr/resources/publications/ebola/ppe-guideline/en/. Published 2014. Accessed February 13, 2018.Google Scholar
Médecins Sans Frontières. Filovirus Field Manual. Geneva, Switzerland: Médecins Sans Frontières; 2014.Google Scholar
Van den Bergh, R, Chaillet, P, Sow, MS, et al. Feasibility of Xpert Ebola Assay in Médecins Sans Frontières Ebola Program, Guinea. Emerg Infect Dis. 2016;22(2):210216. doi: 10.3201/eid2202.151238CrossRefGoogle Scholar
Wilson, D, Chosewood, LC, eds. Biosafety in Microbiological and Biomedical Laboratories. 5th ed. Atlanta, Georgia: Centers for Disease Control and Prevention; 2009.Google Scholar
Wambani, R, Ogola, P, Arika, W, et al. Ebola virus disease: a biological and epidemiological perspective of a virulent virus. J Infect Dis Diagn. 2016;1(1):16.Google Scholar
Abbott Point of Care Inc. i-STAT User Guide [package insert]. The Hague, Netherlands: Emergo Europe; October 2017.Google Scholar
Chertow, DS, Kleine, C, Edwards, JK, et al. Ebola virus disease in West Africa—clinical manifestations and management. N Engl J Med. 2014;371(22):20542057. doi: 10.1056/NEJMp1413084CrossRefGoogle ScholarPubMed
Hunt, L, Gupta-Wright, A, Simms, V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015;15(11):12921299. doi: 10.1016/S1473-3099(15)00144-9CrossRefGoogle ScholarPubMed
Uyeki, TM, Mehta, AK, Davey, RTJ, et al. Clinical management of Ebola virus disease in the United States and Europe. N Engl J Med. 2016;374(7):636646. doi: 10.1056/NEJMoa1504874CrossRefGoogle ScholarPubMed
Fowler, RA, Fletcher, T, Fischer, WA, et al. Caring for critically ill patients with Ebola virus disease: perspectives from West Africa. Am J Respir Crit Care Med. 2014;190(7):733737. doi: 10.1164/rccm.201408-1514CPCrossRefGoogle ScholarPubMed
Bah, EI, Lamah, M-C, Fletcher, T, et al. Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. N Engl J Med. 2015;372(1):4047. doi: 10.1056/NEJMoa1411249CrossRefGoogle ScholarPubMed
Lamontagne, F, Fowler, RA, Adhikari, NK, et al. Evidence-based guidelines for supportive care of patients with Ebola virus disease. The Lancet. 2018;391(10121):700708. doi: 10.1016/S0140-6736(17)31795-6CrossRefGoogle ScholarPubMed
Flint, M, Goodman, CH, Bearden, S, et al. Ebola virus diagnostics: the US Centers for Disease Control and Prevention Laboratory in Sierra Leone, August 2014 to March 2015. J Infect Dis. 2015;212(suppl 2):S350S358. doi: 10.1093/infdis/jiv361CrossRefGoogle ScholarPubMed