Management of patients in Germany with suspected viral haemorrhagic fever and other potentially lethal contagious infections

Abstract

Patients suffering from viral haemorrhagic fevers must be handled specifically. The clinical diagnosis of these diseases in the initial stage is difficult because early symptoms are non specific. In Germany, specific diagnosis is available at two diagnostic centres with biosafety level 4 facilities. Five high security infectious disease isolation units for patient care are available in Munich, Leipzig, Hamburg, Berlin, and Frankfurt. In addition, a corresponding number of centres of competence are established to offer support and advice to the hospitals initially treating the patients and to the local public health officers. The decentralisation of these centres of competence is recommended to allow for more timely and reactive responses to VHF epidemic threats.The risk categorisation for contacts has proved to be very useful in practice.

Response to Imported Case of Marburg Hemorrhagic Fever, the Netherlands

“…In the Netherlands, statutory power to prevent a healthy person from traveling abroad is limited, but the Public Health Law is being revised, and emergency legal provisions are being considered. Despite various recommendations (14,18,(25)(26)(27), no evidence-based, widely accepted international protocol is available to guide contact classification and monitoring in the case of MHF. Legislation on containment of dangerous pathogens (1) and measures applied to contacts differ among countries, sometimes with extreme consequences.…”

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

“…Transport arrangements (panel 4) for patients with highly infectious diseases in Europe vary, as do the legal regulations applicable in each country. 8,9,12,30,31 Most countries require ambulance crews to be specially trained; some require the use of specialised patient transport equipment (stretcher transport isolators),…”

European concepts for the domestic transport of highly infectious patients

“…In Germany the Permanent Working Group of Competence and Treatment Centres for HIDs was established to provide a geographical coverage of HLIUs set up in eight cities, covering a maximum perimeter of 250-300 km each following national law that prohibits air transport of HIDs [11]. Hence, domestic transportation of HIDs is exclusively conducted on modified or specifically designed ground ambulances.…”