Beyond Ebola treatment units: severe infection temporary treatment units as an essential element of Ebola case management during an outbreak.
In the course of the Ebola outbreak in West Africa that was witnessed since early 2014, the response mechanisms showed deficits in terms of timeliness, volume and adequacy. The authors were deployed in the Ebola campaign in the West African country Liberia, where by September 2014 the changing epidemiological pattern made reconsiderations of guidelines and adopted procedures necessary. A temporary facility set up as a conventional Ebola Treatment Unit in the Liberian capital Monrovia was re-dedicated into a Severe Infections Temporary Treatment Unit. This facility allowed for stratification based on the nosocomial risk of exposure to Ebola virus for a growing subgroup of admitted patients that in the end would turn out as Ebola negative cases. At the same time, adequate diagnostic measures and treatment for the non-Ebola conditions of these patients could be provided without compromising work safety of the employed staff. The key elements of the new unit comprised a Suspect Cases Area similar to that of conventional Ebola treatment units for newly arriving patients, an Unlikely Cases Area for patients with a first negative Ebola PCR result, and a Confirmed Negative Cases Area for patients in whom Ebola could be ruled out. The authors, comprising representatives of the Liberian Ministry of Health and Social Welfare, as well as infectious disease specialists from the German Ebola Task Force are presenting key features of the adapted concept, and are highlighting its relevance in raising acceptance for outbreak counter-measures within the population at stake.
NATO Centre of Excellence for Military Medicine, Deployment Health Surveillance Capability, Dachauer Str. 128, 80637, Munich, Germany.
Christian
C
Janke
German Red Cross, Berlin, Germany.|Medical Department, Division of Infectiology and Pneumonology, Charité - Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany.
Katrin Moira
KM
Heim
German Red Cross, Berlin, Germany.|Medical Department, Division of Infectiology and Pneumonology, Charité - Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany.
Florian
F
Steiner
Ministry of Health and Social Welfare of Liberia/Incidence Management System of Liberia, Ebola Case Management Team, Monrovia, Liberia.
Moses
M
Massaquoi
Ministry of Health and Social Welfare of Liberia/Incidence Management System of Liberia, Ebola Case Management Team, Monrovia, Liberia.
Miatta Zenabu
MZ
Gbanya
Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital Hamburg, Bernhard-Nocht-Straße 74, 20259, Hamburg, Germany.
Claudia
C
Frey
German Red Cross, Berlin, Germany. froeschl@lrz.uni-muenchen.de.|Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Leopoldstr. 5, 80802, Munich, Germany. froeschl@lrz.uni-muenchen.de.|German Centre for Infection Research (DZIF), Partner Site, Munich, Germany. froeschl@lrz.uni-muenchen.de.
Guenter
0000-0003-2743-7555
G
Froeschl
D000354:Africa, Western / Q000453:epidemiology; D019090:Case Management / Q000458:organization & administration*; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000235:genetics / Q000302:isolation & purification; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007988:Liberia; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000302:isolation & purification / Q000378:metabolism
D012367:RNA, Viral
Case management; Ebola; Ebola treatment unit; Epidemiology; Infectious disease unit; Isolation; Liberia; Nosocomial infection; SITTU; Severe infections teamporary treatment unit