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From December 2013 to March 2016, West Africa experienced the largest Ebola virus (EBOV) outbreak to date, leading to a European-wide activation of laboratory preparedness and response. At the end of the outbreak, laboratories associated with the two European preparedness networks of expert laboratories EMERGE JA and EVD-LabNet were invited to participate in an assessment of the response of European laboratories to the EBOV outbreak, to identify learning points and training needs to strengthen future outbreak responses. Response aspects assessed included diagnostics, biorisk management and quality assurance. The overall coverage of EBOV diagnostics in the European Union/European Economic Area (EU/EEA) was found to be adequate although some points for quality improvement were identified. These included the need for relevant International Organization for Standardization (ISO) accreditation, the provision of EBOV external quality assessments (EQA) in periods where there is no emergency, facilitating access to controls and knowledge, biorisk management without compromising biosafety and a rapid public health response, and the need for both sustained and contingency funding for preparedness and response activities.


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  1. World Health Organization (WHO). Situation report. Ebola virus disease. Geneva; WHO; 2016. Available from: http://apps.who.int/iris/bitstream/10665/208883/1/ebolasitrep_10Jun2016_eng.pdf?ua=1
  2. World Health Organization (WHO). Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. Geneva: WHO; 2014 Available from: http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/
  3. World Health Organization (WHO). Statement on the 9th meeting of the IHR Emergency Committee regarding the Ebola outbreak in West Africa. Geneva: WHO; 2016 Available from: http://www.who.int/mediacentre/news/statements/2016/end-of-ebola-pheic/en/
  4. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. fourth update. Rapid Risk Assessment. Stockholm: ECDC; 2014. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Ebola-virus-disease-west-africa-risk-assessment-27-08-2014.pdf
  5. Gomes MFC, Pastore Y Piontti A, Rossi L, Chao D, Longini I, Halloran ME, et al. Assessing the international spreading risk associated with the 2014 West African ebola outbreak. PLoS Curr. 2014;6:ecurrents.outbreaks.cd818f63d40e24aef769dda7df9e0da5. PMID: 25642360 
  6. European Centre for Disease Prevention and Control (ECDC). Assessing and planning medical evacuation flights to Europe for patients with Ebola virus disease and people exposed to Ebola virus. ECDC technical report. Stockholm: ECDC; 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/ebola-guidance-air-transport-update-decontamination.pdf
  7. European Centre for Disease Prevention and Control (ECDC). Public health management of persons having had contact with Ebola virus disease cases in the EU. ECDC technical report. Stockholm: ECDC; 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/ebola-public-health-contact-management.pdf
  8. EVD-LabNet. European expert laboratory network for emerging viral diseases. Rotterdam: EVD-LabNet. [Accessed: 12 May 2016 Available from: https://www.evd-labnet.eu/
  9. Nisii C, Vincenti D, Fusco FM, Schmidt-Chanasit J, Carbonnelle C, Raoul H, et al. The contribution of the European high containment laboratories during the 2014-2015 Ebola Virus Disease emergency. Clin Microbiol Infect. 2017;23(2):58-60.  https://doi.org/10.1016/j.cmi.2016.07.003  PMID: 27404371 
  10. EMERGE: Efficient response to highly dangerous and emerging pathogens at EU level. Berlin: EMERGE. [Accessed: 12 May 2016. Available from: http://www.emerge.rki.eu
  11. Reusken C, Niedrig M, Pas S, Anda P, Baize S, Charrel R, et al. Identification of essential outstanding questions for an adequate European laboratory response to Ebolavirus Zaire West Africa 2014. J Clin Virol. 2015;62:124-34.  https://doi.org/10.1016/j.jcv.2014.11.007  PMID: 25692204 
  12. Haddock E, Feldmann F, Feldmann H. Effective Chemical Inactivation of Ebola Virus. Emerg Infect Dis. 2016;22(7):1292-4.  https://doi.org/10.3201/eid2207.160233  PMID: 27070504 
  13. International Organization for Standardization (ISO). Medical laboratories - requirements for quality and competence. ISO 15189:2012. Geneva: ISO; 2012. Available from: https://www.iso.org/obp/ui/#iso:std:iso:15189:ed-3:en
  14. International Organization for Standardization (ISO). General requirements for the competence of testing and calibration laboratories. ISO/IEC 17025:2005. Geneva: ISO; 2005. Available from: https://www.iso.org/obp/ui/#iso:std:iso-iec:17025:ed-2:v1:en
  15. International Organization for Standardization (ISO). Quality management systems - requirements. ISO 9001:2015. Geneva: ISO; 2015. Available from: https://www.iso.org/obp/ui/#iso:std:62085:en
  16. Ellerbrok H, Jacobsen S, Patel P, Rieger T, Eickmann M, Becker S, et al. External quality assessment study for ebolavirus PCR-diagnostic promotes international preparedness during the 2014 - 2016 Ebola outbreak in West Africa. PLoS Negl Trop Dis. 2017;11(5):e0005570.  https://doi.org/10.1371/journal.pntd.0005570  PMID: 28459810 
  17. Council of the Europan Union. Council conclusions on ‘Lessons learned for public health from the Ebola outbreak in West Africa – health security in the European Union’. Luxembourg: Council of the European Union; 2015. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52015XG1217(02)&from=EN
  18. World Health Organization (WHO). Follow up to the World Health Assembly decision on the Ebola virus disease outbreak and the Special Session of the Executive Board on Ebola: Roadmap for Action. Geneva: WHO; 2015. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/WHO-outbreasks-emergencies-Roadmap.pdf
  19. Broadhurst MJ, Brooks TJ, Pollock NR. Diagnosis of Ebola virus disease: past, present, and future. Clin Microbiol Rev. 2016;29(4):773-93.  https://doi.org/10.1128/CMR.00003-16  PMID: 27413095 
  20. Lau KA, Theis T, Gray J, Rawlinson WD. Ebola preparedness: diagnosis improvement using rapid approaches for proficiency testing. J Clin Microbiol. 2017;55(3):783-90.  https://doi.org/10.1128/JCM.02173-16  PMID: 27974537 
  21. Cherpillod P, Schibler M, Vieille G, Cordey S, Mamin A, Vetter P, et al. Ebola virus disease diagnosis by real-time RT-PCR: a comparative study of 11 different procedures. J Clin Virol. 2016;77:9-14.  https://doi.org/10.1016/j.jcv.2016.01.017  PMID: 26874083 
  22. Rieger T, Kerber R, El Halas H, Pallasch E, Duraffour S, Günther S, et al. Evaluation of RealStar reverse transcription-polymerase chain reaction kits for filovirus detection in the laboratory and field. J Infect Dis. 2016;214(suppl 3):S243-9.  https://doi.org/10.1093/infdis/jiw246  PMID: 27549586 
  23. Boisen ML, Cross RW, Hartnett JN, Goba A, Momoh M, Fullah M, et al. Field validation of the ReEBOV antigen rapid test for point-of-care diagnosis of Ebola virus infection. J Infect Dis. 2016;214(suppl 3):S203-9.  https://doi.org/10.1093/infdis/jiw261  PMID: 27521365 
  24. Gay-Andrieu F, Magassouba N, Picot V, Phillips CL, Peyrefitte CN, Dacosta B, et al. Clinical evaluation of the BioFire FilmArray BioThreat-E test for the diagnosis of Ebola virus disease in Guinea. J Clin Virol. 2017;92:20-4.  https://doi.org/10.1016/j.jcv.2017.04.015  PMID: 28505570 
  25. Loftis AJ, Quellie S, Chason K, Sumo E, Toukolon M, Otieno Y, et al. Validation of the Cepheid GeneXpert for detecting Ebola virus in semen. J Infect Dis. 2017;215(3):344-50. PMID: 27932614 
  26. Nisii C, Castilletti C, Di Caro A, Capobianchi MR, Brown D, Lloyd G, et al. The European network of Biosafety-Level-4 laboratories: enhancing European preparedness for new health threats. Clin Microbiol Infect. 2009;15(8):720-6.  https://doi.org/10.1111/j.1469-0691.2009.02946.x  PMID: 19754729 
  27. Nisii C, Castilletti C, Raoul H, Hewson R, Brown D, Gopal R, et al. Biosafety level-4 laboratories in Europe: opportunities for public health, diagnostics, and research. PLoS Pathog. 2013;9(1):e1003105.  https://doi.org/10.1371/journal.ppat.1003105  PMID: 23349630 
  28. World Health Organization (WHO). Laboratory diagnosis of Ebola virus disease. Geneva: WHO; 2014. Available from: http://apps.who.int/iris/bitstream/10665/134009/1/WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf
  29. Weidmann M, Avsic-Zupanc T, Bino S, Bouloy M, Burt F, Chinikar S, et al. Biosafety standards for working with Crimean-Congo hemorrhagic fever virus. J Gen Virol. 2016;97(11):2799-808.  https://doi.org/10.1099/jgv.0.000610  PMID: 27667586 
  30. European Committee for Standardization (CEN). Laboratory biorisk management. CEN Workshop Agreement CWA 15793. Brussels: CEN; 2011. Available from: http://www.uab.cat/doc/CWA15793_2011
  31. World Health Organization (WHO). Biorisk management. Laboratory biosecurity guidance. Geneva: WHO; 2006 Available from: http://www.who.int/csr/resources/publications/biosafety/WHO_CDS_EPR_2006_6.pdf
  32. Colavita F, Quartu S, Lalle E, Bordi L, Lapa D, Meschi S, et al. Evaluation of the inactivation effect of Triton X-100 on Ebola virus infectivity. J Clin Virol. 2017;86:27-30.  https://doi.org/10.1016/j.jcv.2016.11.009  PMID: 27912126 
  33. Tempestilli M, Pucci L, Notari S, Di Caro A, Castilletti C, Rivelli MR, et al. Diagnostic performances of clinical laboratory tests using Triton X-100 to reduce the biohazard associated with routine testing of Ebola virus-infected patients. Clin Chem Lab Med. 2015;53(12):1967-73.  https://doi.org/10.1515/cclm-2015-0119  PMID: 26053010 
  34. EVAg. European Virus Archive goes Global. Marseille: EVAg; [Accessed:12 May 2016 Available from: https://www.european-virus-archive.com/
  35. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. 13th update. Rapid Risk Assessment. Stockholm: ECDC; 2015. Available from: http://ecdc.europa.eu/en/publications/Publications/Ebola-west-africa-13th-update.pdf
  36. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. Seventh update. Rapid Risk Assessment. Stockholm: ECDC; 2014. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/ebola-Sierra-Leone-Liberia-Guinea-Spain-United-States-risk-assessment.pdf
  37. Panning M, Laue T, Olschlager S, Eickmann M, Becker S, Raith S, et al. Diagnostic reverse-transcription polymerase chain reaction kit for filoviruses based on the strain collections of all European biosafety level 4 laboratories. J Infect Dis. 2007;196(s2) Suppl 2;S199-204.  https://doi.org/10.1086/520600  PMID: 17940950 
  38. Gibb TR, Norwood DA Jr, Woollen N, Henchal EA. Development and evaluation of a fluorogenic 5′ nuclease assay to detect and differentiate between Ebola virus subtypes Zaire and Sudan. J Clin Microbiol. 2001;39(11):4125-30.  https://doi.org/10.1128/JCM.39.11.4125-4130.2001  PMID: 11682540 
  39. Ogawa H, Miyamoto H, Ebihara H, Ito K, Morikawa S, Feldmann H, et al. Detection of all known filovirus species by reverse transcription-polymerase chain reaction using a primer set specific for the viral nucleoprotein gene. J Virol Methods. 2011;171(1):310-3.  https://doi.org/10.1016/j.jviromet.2010.11.010  PMID: 21093485 
  40. Sanchez A, Ksiazek TG, Rollin PE, Miranda ME, Trappier SG, Khan AS, et al. Detection and molecular characterization of Ebola viruses causing disease in human and nonhuman primates. J Infect Dis. 1999;179(s1) Suppl 1;S164-9.  https://doi.org/10.1086/514282  PMID: 9988180 
  41. Trombley AR, Wachter L, Garrison J, Buckley-Beason VA, Jahrling J, Hensley LE, et al. Comprehensive panel of real-time TaqMan polymerase chain reaction assays for detection and absolute quantification of filoviruses, arenaviruses, and New World hantaviruses. Am J Trop Med Hyg. 2010;82(5):954-60.  https://doi.org/10.4269/ajtmh.2010.09-0636  PMID: 20439981 
  42. Huang Y, Wei H, Wang Y, Shi Z, Raoul H, Yuan Z. Rapid detection of filoviruses by real-time TaqMan polymerase chain reaction assays. Virol Sin. 2012;27(5):273-7.  https://doi.org/10.1007/s12250-012-3252-y  PMID: 23001480 
  43. Dedkov VG, Magassouba NF, Safonova MV, Deviatkin AA, Dolgova AS, Pyankov OV, et al. Development and evaluation of a real-time RT-PCR assay for the detection of Ebola virus (Zaire) during an Ebola outbreak in Guinea in 2014-2015. J Virol Methods. 2016;228:26-30.  https://doi.org/10.1016/j.jviromet.2015.11.007  PMID: 26597659 
  44. Jääskeläinen AJ, Moilanen K, Aaltonen K, Putkuri N, Sironen T, Kallio-Kokko H, et al. Development and evaluation of a real-time EBOV-L-RT-qPCR for detection of Zaire ebolavirus. J Clin Virol. 2015;67:56-8.  https://doi.org/10.1016/j.jcv.2015.04.003  PMID: 25959160 
  45. Weidmann M, Mühlberger E, Hufert FT. Rapid detection protocol for filoviruses. J Clin Virol. 2004;30(1):94-9.  https://doi.org/10.1016/j.jcv.2003.09.004  PMID: 15072761 
  46. de La Vega MA, Caleo G, Audet J, Qiu X, Kozak RA, Brooks JI, et al. Ebola viral load at diagnosis associates with patient outcome and outbreak evolution. J Clin Invest. 2015;125(12):4421-8.  https://doi.org/10.1172/JCI83162  PMID: 26551677 
  47. Centers for Disease Control and Prevention (CDC). Fact sheet for health care providers: interpreting CDC Ebola virus NP real-time RT-PCR (EBOV NP rRT-PCR) assay results. Atlanta: CDC; 2015. Available from: https://www.fda.gov/downloads/MedicalDevices/Safety/EmergencySituations/UCM436303.pdf

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