„Establishment of Mobile Laboratories up to

Risk Group 4 in combination with CBRN

Capacity Building in sub-Saharan Africa“

Funded by European Commission

Cooperation Office (DevCo)

Preparedness phase

European Mobile Laboratory

(EMLab) Project

• Main Partners: Bernhard-Nocht-Institute for Tropical Medicine

„Institut für Mikrobiologie der Bundeswehr“ (Germany)

„Institution Nazionale per le Malatti Infettive L. Spallanzani“

(Rome, Italy)

– Public Health England (Salisbury, UK)

– Institute of Virology Marburg (Germany)

– Laboratoire P4 Inserm (Lyon, France)

– Spiez Laboratory (Switzerland)

• Additional Partners:

BSL4 Hungary, RKI, University Ljubljana (Slovenia), and Institut

Pasteur, France

The Consortium

• Developed by Bundeswehr (Medical

Service of German Armed Forces)

• Stationed in EU (Munich)

• Portable equipment deployable by

public airplane or two pick-ups:

10-20 Boxes 30 kg each.

• Molecular diagnostics for viruses and

bacteria

• Serology

• Portable class III cabinets

The mobile laboratory

Detection phase

Emergence of Zaire Ebola Virus

Disease in Guinea

First activities in Guinea

• 14 March: Ministry of Health and World

Health Organization (WHO) team arrived in

Gueckedou, Guinea.

• 18 March: Team of Medecins Sans Frontieres

(MSF) arrived on site

• Both teams started epidemiological

investigation and collection of samples

• MSF sent 20 samples to Europe.

Results of the Laboratories in

Europe (Lyon and Hamburg)

• 15 of 20 patients tested positive for Ebola

virus Zaire

• Sequencing to determine origin of virus

(natural or laboratory origin)

Guinea virus is different

from known strains

Where does the outbreak

comes from?

• Look back of transmission chains indicate

that first case may be a child in village

Meliandou who died in December 2013

• Outbreak was most likely caused by a

single natural source

Response phase

Deployment of European

Mobile Lab to Guinea

Under WHO Global Outbreak and

Alert Network

25 March until now

Key facts

• Commercial filovirus RT-PCR kit used by

EMLab - excellent performance in the field

• 8 teams = 35 staff members from EU have

been deployed

• 1000 samples tested (blood, swab, urine)

>300 Ebola virus positive

Problems / Key issues

• Detection phase

– Transport of samples to international reference centers may be delayed due to IATA regulations (CatA transport not possible or refused)

– Sharing of strains from Guinea among international reference centers difficult due to dual-use regulations (long export control process, >3 months)

Problems / Key issues

• Response phase

– In-country transport logistics

– On-site infrastructures required (tent, rooms, power)

– Biosafety and biosecurity on site (samples often not properly packaged)

– Shipment of samples (tested positive) for safe storage outside the country

Problems / Key issues

• Response phase

– Security of staff • Health security: accidents, infections, other illness

• Repatriation difficult

Thanks to the colleagues who went

to the field and provided support from

the home base • Public Health England, Microbiology Services Salisbury, UK

• Instituto Nazionale per le Malattie Infettive „L. Spallanzani“, Rome, Italy

• Institut für Mikrobiologie der Bundeswehr, Munich, Germany

• Philipps-Universität Marburg, Institut für Virologie, Marburg, Germany

• Laboratoire P4 Inserm Jean Merieux / Institut Pasteur, Lyon, France

• Spiez Laboratory, Spiez, Switzerland

• National Center for Epidemiology, Hungarian National Biosafety Laboratory, Budapest

• University Lljubljana, Slovenia

• Robert-Koch-Institute, Berlin, Germany