Framework for the design and operation of high-level isolation units: consensus of the European Network of Infectious Diseases

Abstract

Patients with highly infectious diseases require safe, secure, high-quality medical care with high-level infection control, which may be most effectively delivered by specially trained staff in the setting of a high-level isolation unit (HLIU). The European Network of Infectious Diseases is a European Commission co-funded network of experts in the management of highly infectious diseases from national (or regional) centres designated for the care of this patient population. Participants took a consensus-based approach to develop a framework for the design and operation of HLIUs in Europe, covering clinical care provision, diagnostic services, transport, health and safety, and essential design and construction features, to support planning by health authorities for the safe and effective management of highly infectious diseases and preparedness for infectious disease emergencies in Europe.

Strukturelle Erfordernisse für das Management von Patienten mit hochkontagiösen, lebensbedrohlichen Erkrankungen – Update 2015

“…Der Zusammenschluss aller Kompetenz-und Behandlungszentren in einem Ständigen Arbeitskreis (STAKOB) hat Synergien im Sinne einer systematischen Verbesserung der Infrastrukturen und einer Bündelung von Ressourcen ermöglicht. Diese Fortschritte haben zu vergleichbaren Anstrengungen auf europäi-scher Ebene (EuNID-Netzwerk) geführt [12]. …”

“…Hierbei ist es insbesondere notwendig, die Erfordernisse der Versorgung solcher Patienten auf dem Boden der in Deutschland gemachten Erfahrungen ("lessons learned") mit importierten bzw. repatriierten Fällen von Lassa-Fieber und Ebolafieber [5][6][7][8][9][10] darzustellen sowie die Aspekte der Diskussion auf internationaler Ebene [11][12][13][14][15][16][17] zu vergegenwärtigen und zu strukturieren.…”

Biosecurity Measures in 48 Isolation Facilities Managing Highly Infectious Diseases

“…But in specific, highly specialized clinical settings, such as the isolation facilities used for the management of patients with highly infectious diseases (see sidebar), the application of biosecurity measures could find a useful application, as has been suggested by European and U.S. consensus panels that discussed the construction and management of these units. [4][5][6][7] The European Network for Highly Infectious Diseases (EuroNHID) project is a 42-month-long project ( July 2007 to December 2010), co-funded by the European Commission network, which includes 16 member states: Austria, Bulgaria, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Malta, Norway, Poland, Slovenia, Spain, and the United Kingdom. Part of the project was a series of surveys, using standardized checklists, that were conducted in 48 isolation facilities identified by national health authorities as referral centers for the management of imported or autochthonous cases of highly infectious diseases.…”

“…Topics that were explored were: infrastructure issues of the isolation facility, technical issues of the isolation facility, staff availability and management, administrative aspects of the isolation facility, management of personal protective equipment, hand hygiene, prevention of needle-stick injuries, transportation of patients, routine hygiene and disinfection, waste management, postmortem procedures, surge capacity, organizational and administrative aspects for healthcare workers' safety, medical aspects for healthcare workers' safety, healthcare workers' education and training, and infection control in emergency departments or medical admission departments. 4,5 Highly infectious diseases are those that:…”

“…[4][5][6][7] Biosecurity measures should find an application in these highly specialized clinical settings, especially in the isolation facilities identified by National Health Authorities for referring patients with highly infectious diseases: the event of a real patient with a highly infectious disease had occurred in about half of these facilities. Specimens from these patients may contain a high concentration of agents that could potentially be used as a biological weapon.…”