Department of Viroscience, WHO Collaborating Center for Arboviruses and Viral Haemorrhagic Fever Reference and Research, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Department of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
Clin Microbiol Infect. 2018 Mar;24(3):221-228. doi: 10.1016/j.cmi.2017.12.010. Epub 2017 Dec 20.
The global health burden of arboviruses is continuously rising, which results in increasing pressure on local and (inter)national laboratory infrastructures. Timely and accurate diagnosis of cases is one of the main pillars for public health and clinical responses to an arbovirus emergence.
This narrative review aims to summarize recent advances and to identify needs in laboratory preparedness and response activities, with a focus on viruses transmitted by arthropods in Europe. The review is based on evidence extracted from PubMed searches, Public Health and clinical laboratory experiences from the authors and the authors' opinions substantiated by peer-reviewed scientific literature.
We illustrate the importance of inter-epidemic laboratory preparedness activities to ensure adequate Public Health and clinical responses. We describe the status of arbovirus endemicity and emergence in Europe thereby highlighting the need for preparedness for these viruses. We discuss the components and pitfalls of an adequate laboratory preparedness and response and the broader context of the current landscape of international research, clinical and laboratory preparedness networks. The complexity of arbovirus laboratory preparedness and response is described.
Outbreak preparedness plans need to look beyond national reference laboratories, to include first-line responding onsite hospital laboratories and plans for strengthening of such local capacity and capability as required depending on the nature of the outbreak. In particular, the diagnosis of arbovirus infections is complicated by the existence of geographic overlap of circulation of numerous arboviruses, the overlap in clinical manifestation between many arboviruses and other aetiologies and the existence of cross-reactivity between related arboviruses in serology testing. Inter-epidemic preparedness activities need strong national and international networks addressing these issues. However, the current mushrooming of European preparedness networks requires governance to bring the European preparedness and response to a next level.
虫媒病毒的全球健康负担不断增加，这给当地和（国际）实验室基础设施带来了越来越大的压力。及时、准确地诊断病例是公共卫生和临床应对虫媒病毒出现的主要支柱之一。
本叙述性综述旨在总结最近的进展，并确定实验室准备和应对活动的需求，重点是欧洲通过节肢动物传播的病毒。该综述基于从 PubMed 搜索中提取的证据、作者的公共卫生和临床实验室经验以及作者的意见，这些意见得到了同行评议科学文献的支持。
我们说明了在流行间歇期进行实验室准备活动以确保充分的公共卫生和临床应对的重要性。我们描述了欧洲虫媒病毒流行和出现的现状，从而强调了为此类病毒做好准备的必要性。我们讨论了充分的实验室准备和应对的组成部分和陷阱，以及当前国际研究、临床和实验室准备网络的更广泛背景。描述了虫媒病毒实验室准备和应对的复杂性。
暴发准备计划需要超越国家参考实验室，包括第一线现场医院实验室，并根据暴发的性质制定加强这种当地能力和能力的计划。特别是，由于许多虫媒病毒的地理分布重叠，许多虫媒病毒和其他病因之间的临床表现重叠，以及血清学检测中相关虫媒病毒之间存在交叉反应性，虫媒病毒感染的诊断变得复杂。流行间歇期的准备活动需要强有力的国家和国际网络来解决这些问题。然而，目前欧洲准备网络的激增需要治理，以使欧洲的准备和应对工作达到一个新的水平。
