Infectious diseases remain a threat to public health in today's interconnected world. There is an ongoing debate on how responses to threats of infectious diseases can best be coordinated, and the field remains nascent in understanding which specific structural governance arrangement will perform best. The present paper contributes to this discussion by demonstrating that it is possible to develop working hypotheses specifying the relationship between the type of infectious disease crisis and type of response to the crisis. For type of crises and type of response mechanisms there is still a lack of research, but the hypothesis combining these two provide a perspective for a future research and action agenda. It certainly prevents us from choosing between schism or hypes when it comes to crisis response. It provides instruments to realize that no single type of response is the most effective and that not all responses are equally effective in a concrete case.

BackgroundThe Ebola outbreak in West-Africa triggered risk communication activities to promote adequate preventive behaviour in the Netherlands. Our study investigated the level of knowledge, perceptions, and media use regarding Ebola.MethodsIn December 2014, an online questionnaire was administered to the Dutch population (n = 526) and Health Care Workers (HCW) (n = 760).ResultsThe mean knowledge score (range 0–15) of HCW (m = 13.3;SD = 1.4) was significantly higher than the general public (m = 10.8;SD = 2.0). No significant difference was found in perceived severity and susceptibility. Perceived fear of the general public (m = 2.5; SD = 0.8) was significantly higher than among HCW (m = 2.4; SD = 0.7). Respondents primarily used television to obtain information.ConclusionsWhile Ebola was perceived severe, it did not lead to excessive fear or perceived susceptibility for developing the disease. Nonetheless, our research showed that knowledge with respect to human-to-human transmission is low, while this is crucial to complying with preventive measures. Our study reveals priorities for improving risk communication.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2906-7) contains supplementary material, which is available to authorized users.

Context:During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).Objective:In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness.Design:In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital.Results:Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed.Conclusions:Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious diseases needs a multidisciplinary approach overarching both the public health sector and the curative sector. In the Netherlands a national platform for preparedness is established, in which both the curative sector and public health sector participate, in order to implement the outcomes of this study.