Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries

Stefan Schilling, Francesco Maria Fusco, Giuseppina De Iaco, Barbara Bannister, Helena C. Maltezou, Gail Carson, Rene Gottschalk, Hans Reinhard Brodt, Philippe Brouqui, Vincenzo Puro, Giuseppe Ippolito

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Highly Infectious Diseases (HIDs) are (i) easily transmissible form person to person; (ii) cause a life-threatening illness with no or few treatment options; and (iii) pose a threat for both personnel and the public. Hence, even suspected HID cases should be managed in specialised facilities minimizing infection risks but allowing state-of-the-art critical care. Consensus statements on the operational management of isolation facilities have been published recently. The study presented was set up to compare the operational management, resources, and technical equipment among European isolation facilities. Due to differences in geography, population density, and national response plans it was hypothesized that adherence to recommendations will vary.

Methods and Findings: Until mid of 2010 the European Network for Highly Infectious Diseases conducted a cross-sectional analysis of isolation facilities in Europe, recruiting 48 isolation facilities in 16 countries. Three checklists were disseminated, assessing 44 items and 148 specific questions. The median feedback rate for specific questions was 97.9% (n = 47/48) (range: n = 7/48 (14.6%) to n = 48/48 (100%). Although all facilities enrolled were nominated specialised facilities' serving countries or regions, their design, equipment and personnel management varied. Eighteen facilities fulfilled the definition of a High Level Isolation Unit'. In contrast, 24 facilities could not operate independently from their co-located hospital, and five could not ensure access to equipment essential for infection control. Data presented are not representative for the EU in general, as only 16/27 (59.3%) of all Member States agreed to participate. Another limitation of this study is the time elapsed between data collection and publication; e.g. in Germany one additional facility opened in the meantime.

Conclusion: There are disparities both within and between European countries regarding the design and equipment of isolation facilities. With regard to the International Health Regulations, terminology, capacities and equipment should be standardised.

Original languageEnglish
Article numbere100401
JournalPLoS One
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 28 2014

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cross-sectional studies
infectious diseases
Communicable Diseases
Equipment Design
Cross-Sectional Studies
Equipment and Supplies
Personnel Management
Geography
human resources management
Critical Care
Infection Control
Population Density
equipment design
Checklist
Terminology
Germany
Publications
resource management
terminology
geography

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries. / Schilling, Stefan; Fusco, Francesco Maria; De Iaco, Giuseppina; Bannister, Barbara; Maltezou, Helena C.; Carson, Gail; Gottschalk, Rene; Brodt, Hans Reinhard; Brouqui, Philippe; Puro, Vincenzo; Ippolito, Giuseppe.

In: PLoS One, Vol. 9, No. 10, e100401, 28.10.2014.

Research output: Contribution to journalArticle

Schilling, S, Fusco, FM, De Iaco, G, Bannister, B, Maltezou, HC, Carson, G, Gottschalk, R, Brodt, HR, Brouqui, P, Puro, V & Ippolito, G 2014, 'Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries', PLoS One, vol. 9, no. 10, e100401. https://doi.org/10.1371/journal.pone.0100401
Schilling S, Fusco FM, De Iaco G, Bannister B, Maltezou HC, Carson G et al. Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries. PLoS One. 2014 Oct 28;9(10). e100401. https://doi.org/10.1371/journal.pone.0100401
Schilling, Stefan ; Fusco, Francesco Maria ; De Iaco, Giuseppina ; Bannister, Barbara ; Maltezou, Helena C. ; Carson, Gail ; Gottschalk, Rene ; Brodt, Hans Reinhard ; Brouqui, Philippe ; Puro, Vincenzo ; Ippolito, Giuseppe. / Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries. In: PLoS One. 2014 ; Vol. 9, No. 10.
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abstract = "Background: Highly Infectious Diseases (HIDs) are (i) easily transmissible form person to person; (ii) cause a life-threatening illness with no or few treatment options; and (iii) pose a threat for both personnel and the public. Hence, even suspected HID cases should be managed in specialised facilities minimizing infection risks but allowing state-of-the-art critical care. Consensus statements on the operational management of isolation facilities have been published recently. The study presented was set up to compare the operational management, resources, and technical equipment among European isolation facilities. Due to differences in geography, population density, and national response plans it was hypothesized that adherence to recommendations will vary.Methods and Findings: Until mid of 2010 the European Network for Highly Infectious Diseases conducted a cross-sectional analysis of isolation facilities in Europe, recruiting 48 isolation facilities in 16 countries. Three checklists were disseminated, assessing 44 items and 148 specific questions. The median feedback rate for specific questions was 97.9{\%} (n = 47/48) (range: n = 7/48 (14.6{\%}) to n = 48/48 (100{\%}). Although all facilities enrolled were nominated specialised facilities' serving countries or regions, their design, equipment and personnel management varied. Eighteen facilities fulfilled the definition of a High Level Isolation Unit'. In contrast, 24 facilities could not operate independently from their co-located hospital, and five could not ensure access to equipment essential for infection control. Data presented are not representative for the EU in general, as only 16/27 (59.3{\%}) of all Member States agreed to participate. Another limitation of this study is the time elapsed between data collection and publication; e.g. in Germany one additional facility opened in the meantime.Conclusion: There are disparities both within and between European countries regarding the design and equipment of isolation facilities. With regard to the International Health Regulations, terminology, capacities and equipment should be standardised.",
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