Partners in the infection-epidemiological network introduce themselves:

European network to the diagnostics ›importierter‹ virus illnesses (ENIVD)

In the passed years it showed up again and again that special virale exciters, which can cause heavy illnesses with humans from tropical countries can be brought in to Europe and also to Germany. Examples are the exciters hemorrhagic fever like the Lassa leaving and the Ebola virus. The risk of a possible bringing in exists in connection with the entry after stay in the appropriate Endemiegebieten. Considering the fact that a multiplicity of exciters is applicable it executed and with most this exciter hardly possibilities of a specific prophylaxis or a specific therapy exists, the WHO in the years 1993 and 1994 expert conferences about ›Neue and again occurring Infektionserreger ‹1,2. Main topics were illnesses, those by Arthropoden to be transferred (Arboviren) and hemorrhagic fever (VHF), which are caused by different viruses. A result of these conferences was world-wide the recommendation, networks for the change of information to establish methods and reagents.

In contrast to the laboratory diagnostics in the respective European countries endemic exciter the experience and the expert's assessment are missing for the diagnostics of such rare and ›importierten ‹ exciters in many countries. The exciters which are applicable here can, if at all, only in few specialized laboratories are diagnosed. At present large differences between the laboratories in Europe, which diagnose rare and ›importierte ‹ exciters, exist. In France, Sweden and Great Britain e.g. central mechanisms were created; in Germany different laboratories in a the position are to diagnose infections by special exciters. In some European countries are specialized laboratories with a high standard, while other countries have neither over experts nor the suitable laboratory equipment. Depending upon the respective prerequisites and also special interests laboratories in all rule concentrate on different areas of the virus diagnostics.

At present the diagnostics for rare exciters is executed mainly with self-developed tests. Serologische test such as immunfluoreszenz, Haemagglutinationshemmteste, ELISA or neutralization test executed, however also the virus isolation in cell cultures or the Genomnachweis with the help of the PCR. illnesses by these exciters there are rare, is missing a standardisation regarding the production of investigation material and on specificity and sensitivity the test as a function of the point in time of the illness of the patient. Only for few exciters commercial are offered to test, since only a small market is available. Besides there is no external quality control, approximately in the context of a procedure of admission. Due to the large number of exciters, particularly within the area the hemorrhagic fever, no country is alone able to reproach a complete diagnostic pallet. Above all smaller countries are in addition unable.

The methodical-technical problems and with ›Import ‹ such exciter connected endangerment of the population make it necessary to cooperate in the area of the diagnostics internationally more closely. By the structure of a European network for the DIAGNOSTICS OF ›Imported‹ Viral Diseases - ENIVD was considered to that. In five meetings scientist/inside from relevant special laboratories from a larger number of European countries - Belgium, Denmark, Germany, Finland, France, Greece, Great Britain, Ireland, Italy, the Netherlands, Austria, Portugal, Sweden, Spain - in a together signed communist manifesto on emphasis of a co-operation agreed:

1. Structure of a European network to the diagnostics more rarely and ›importierter ‹ viraler exciter; mutual support with the exchange of materials, e.g. serums, Virusisolaten, methods and information for the improvement of the diagnostics,
2. Selection of viraler exciters with high Kontagiositaet, for which a diagnostics must be executed fast (<24 h);Create a list of laboratories, which are able to carry out this diagnostics,
3. to prepare of the research methods applied by recommendations for the standardisation and quality assurance,
4. Create quality requirements determined by work instructions for the execution of standard tests according to,
5. Optimize limited resources by exchange of reagents, descriptions of method and expert's assessment,
6. Improve the contacts by regular meetings, exchange and training of laboratory personnel,
7. Keep open the network for scientists from further European laboratories,
8. Coordinate from activities with other internationally operating groups, e.g. the Surveillance network group and the task force on of vaccines and viral diseases, other national organizations like the CDC or international organizations such as WHO and PAHO.

Co-operation offers the chance to offer to all partners in this European network a broad spectrum at diagnostics. Emphasis of regional or international interest can be defined, processed by an expert laboratory and be put to other partners at the disposal. The allocation of the functions on the individual laboratories will benefit all European partners. After a description of the deficits of different countries it must be decided whether additional diagnostic capacities must be structured or whether by a transfer of functions by some few laboratories the supply can be sufficiently guaranteed.

The question of the quality assurance of the diagnostics was concerned in first interlaboratory tests. Test for the regulation of anti-bodies approximately Dengue dengue-und Hantaviren were examined. The laboratories involved obtained a satisfying agreement concerning the quality this diagnostic test. For the future further interlaboratory tests are planned.

The network is located in close connection with the WHO, which this European initiative very much welcomed and in the meetings took part. On the part of the Special Pathogens Branch that of center for Disease control and Prevention in Atlanta exists likewise interest in a co-operation. It would be desirable that the future development of the network could be guaranteed by a direct promotion on the part of the European Union commission, which was not possible so far due to limited means.

On the homepage of the RKI information is offered for the ENIVD and for the range of topics of imported infections under http://www2.rki.de/INFEKT/ENIVD/ENIVD_P.HTM (dependent on the type of the information these are publicly accessible or them to be available exclusive to the coworkers of the network):

• List of the European laboratories, which cooperate in the network,
• Outline of the performances of the laboratories (exciter, research methods, e.g. ELISA, examined IF, PCR, etc.),
• Recommendations for the execution of the investigations of rare exciters,
• References to further information in the Internet about these exciters as well as about biological security, conferences, congresses to this group of topics etc.,
• a list of the WHO to current outbreaks,
• Logs of the last meetings of the ENIVD,
• Recommendations of the WHO regarding the procedure with suspicion on VHF.

1. Emerging infectious diseases: Memorandum from a WHO meeting. Bulletin WHO 1994; 72: 845-850
2. Report OF WHO meeting on Emerging Infectious Diseases. Geneva Switzerland, 25.-26 April 1994. World Health Organization CDS/BVI, 94: 2

To the joint founders and active partners of the ENIVD from Germany PD Dr. H. Feldmann, Institut for Virologie of the Philipps University of Marburg, Dr. M. Niedrig, Robert institute for cook Berlin, and Professor Dr. H. Schmitz, Bernhard Nocht Bernhard-Nocht-Institut for tropical medicine, Hamburg, Professor Dr. W. Slencka, Institut for Virologie of the Philipps University of Marburg belongs. **time-out** - information to the ENIVD give Dr. Matthias low, Robert institute, bank 20, 13353 Berlin, Tel: + 49 / 30 / 4547-2370, -2321 (Sekr.), fax: + 49 / 30 / 4547-2625, -2604 (Sekr.), E-Mail: niedrigm@rki.de.