Infection control management of patients with suspected highly infectious diseases in emergency departments: data from a survey in 41 facilities in 14 European countries

Abstract

BackgroundIn Emergency and Medical Admission Departments (EDs and MADs), prompt recognition and appropriate infection control management of patients with Highly Infectious Diseases (HIDs, e.g. Viral Hemorrhagic Fevers and SARS) are fundamental for avoiding nosocomial outbreaks.MethodsThe EuroNHID (European Network for Highly Infectious Diseases) project collected data from 41 EDs and MADs in 14 European countries, located in the same facility as a national/regional referral centre for HIDs, using specifically developed checklists, during on-site visits from February to November 2009.ResultsIsolation rooms were available in 34 facilities (82,9%): these rooms had anteroom in 19, dedicated entrance in 15, negative pressure in 17, and HEPA filtration of exhausting air in 12. Only 6 centres (14,6%) had isolation rooms with all characteristics. Personnel trained for the recognition of HIDs was available in 24 facilities; management protocols for HIDs were available in 35.ConclusionsPreparedness level for the safe and appropriate management of HIDs is partially adequate in the surveyed EDs and MADs.

Diagnostic performances of clinical laboratory tests using Triton X-100 to reduce the biohazard associated with routine testing of Ebola virus-infected patients

“…However, it may occur that a patient is transported to an emergency care unit in very serious condition related to the infection or worsening of his/her clinical conditions due to a pre-existing illness. Moreover, the non-specific signs and symptoms early in the course of EVD render it difficult to differentiate them from other infectious diseases on clinical grounds alone and clinicians at the ER may require urgent laboratory tests before the results of molecular tests confirming or excluding the infection are ready and the patient is transferred to a referral centre [5,6]. In such cases, even laboratories that are not equipped to handle safety biological samples may be required to carry out emergency diagnostic tests.…”

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“…[33][34][35] Those studies didn't consider the functionality of measured preparedness during the response phase, but the current study evaluated both preparedness and its functionality, as command and control performance, during a simulated disaster. This result is consistent with previous studies that report no adequate disaster preparedness in Italy hospitals.…”

Ebola and other viral haemorrhagic fevers

“…16 Unfortunately, a travel history is rarely elicited in most day to day consultations, leading to delays in diagnosis and in the isolation of patients at risk. [17][18][19] The updated guidance is aimed at a range of clinicians, both specialist and non-specialist. It includes flow diagrams, tables, and technical appendices that offer clear advice on the assessment of exposure risk, management of patients, and all aspects of infection control.…”