The Lancet Infectious Diseases, Volume 9, Issue 5, Pages 301 - 311, May 2009

Philippe Brouqui MD a , Vincenzo Puro MD b, Francesco M Fusco MD b, Barbara Bannister MSc c, Stephan Schilling MD d, Per Follin MD e, René Gottschalk MD f, Robert Hemmer MD g, Helena C Maltezou MD h, Kristi Ott MD i, Renaat Peleman MD j, Christian Perronne MD k, Gerard Sheehan MD l, Heli Siikamäki MD m, Peter Skinhoj MD n, Giuseppe Ippolito MD b, for the EUNID Working Group‡

The European Network for Infectious Diseases (EUNID) is a network of clinicians, public health epidemiologists, microbiologists, infection control, and critical-care doctors from the European member states, who are experienced in the management of patients with highly infectious diseases. We aim to develop a consensus recommendation for infection control during clinical management and invasive procedures in such patients.

After an extensive literature review, draft recommendations were amended jointly by 27 partners from 15 European countries. Recommendations include repetitive training of staff to ascertain infection control, systematic use of cough and respiratory etiquette at admission to the emergency department, fluid sampling in the isolation room, and analyses in biosafety level 3/4 laboratories, and preference for point-of-care bedside laboratory tests. Children should be cared for by paediatricians and intensive-care patients should be cared for by critical-care doctors in high-level isolation units (HLIU). Invasive procedures should be avoided if unnecessary or done in the HLIU, as should chest radiography, ultrasonography, and renal dialysis. Procedures that require transport of patients out of the HLIU should be done during designated sessions or hours in secure transport. Picture archiving and communication systems should be used. Post-mortem examination should be avoided; biopsy or blood collection is preferred.