Overview


Considerable attention has recently been directed to emerging and re-emerging infections in national and international discussions. Infectious diseases are a continuing menace to all people, regardless of age, gender, lifestyle, ethnic background, and socio-economic status. They cause suffering and death, and impose an enormous financial burden on society.

Numerous viral outbreaks in the last few years like Ebola in Kikwit/Zaire, Côte d'Ivoire, and Liberia in 1996/97 and Nipha Virus in Malaysia in 1998 led to the building of the European Network for Diagnostics of "Imported" Viral Diseases (ENIVD). After several meetings scientists from university medical centres, country health departments, and hospitals all over Europe have raised this network and agreed to collaborate on a few major tasks for the future, fixed in a Memorandum of Understanding signed by all members and their institutions.

The ENIVD members meet regularly together with representatives from EC and WHO to exchange and gather information working on the improvement of the collaboration and diagnostics for "imported" viral diseases in Europe. Sharing the duties and strengthen the collaboration in the EC will help to enhance the emergency preparedness in all participating countries to the benefit for there citizens.

As we can see in the map below as well as in the table, each country in Europe may be hit by an import of suspected or real viral haemorrhagic fever (VHF). Most experts think that this is only the tip of an iceberg, because the majority of the VHF cases will not be diagnosed. This opinion is supported by the fact that lots of imported malaria cases are diagnosed too late by physicians not familiar with the clinical picture and not aware of this disease.


Import of VHF and SARS to Europe

VHF Import to European countries

Pathogen Imported from Imported to when Reference
suspected CCHF3 Zimbabwe UK 11/1998 1
suspected VHF1 Gambia Belgium 11/1998 2
Yellow Fever Ivory Coast Germany 08/1999 3a 3b
Lassa Ivory Coast Germany 01/2000 4a 4b
Lassa Sierra Leone U K 03/2000 5a 5b
Lassa Nigeria Germany 03/20006
Lassa Sierra Leone Netherlands 07/2000 7a 7b
suspected VHF2 Kenya Germany 12/2000 8
suspected VHF1 Sierra Leone Germany 03/2001 9
Hanta (Andes) Chile/Argentine France 03/2001 10
Rift Valley Chad France 09/2001 11
CCHF3 Bulgaria Germany 10/2001 -
Yellow Fever Gambia Belgium 11/2001 12
West Nile USA France 08/2002 13
suspected VHF4 Nepal Spain 09/2002 -
suspected VHF1 Cameroon Ireland 10/2002 -
Lassa Sierra Leone UK 02/2003 14
SARS Asia Europe Spring 2003 15
West Nile USA Germany 08/2003 16
West Nile Portugal Ireland 07/2004 17a 17b
West Nile USA Germany 09/2004 16a
CCHF3 Senegal France 11/2004 18
Chikungunya Réunion Europe 2005 19a 19b
Chikungunya India Italy 06/2007 20a 20b
Marburg Uganda Netherlands 07/2008 21
Lassa Nigeria UK 01/2009 22
Lassa Mali UK 02/2009 23
CCHF3 Afghanistan UK 10/2012 24
Mayaro French Guiana Germany 08/2013 25
CCHF Bulgaria UK 06/2014 26
1 final diagnosis: Malaria, 2 final diagnosis: generalised Herpes (HSV 1), 3 Crimean-Congo HF, 4 No final diagnosis