The Institute of Tropical Medicine in Antwerp (ITM) will carry out Ebola diagnosis in its own laboratories in Antwerp. Until now, samples of suspected Ebola cases were sent abroad. This extended the waiting time for results with 12 to 24 hours. ITM had the technical capacity to do the diagnoses already in place and now got approval by the competent Flemish and federal authorities after a thorough biosafety inspection.
The diagnoses are carried out jointly by ITM’s virology research group and its clinical laboratory. Virologists first neutralise the blood sample and then extract and isolate its genetic material. The procedure is performed in a highly secure BSL3+ laboratory (“Biosafety Level 3+”). The perfectly innocuous sample is subsequently analysed by the clinical lab using advanced molecular diagnostics. The virus is identified via multiplication and detection of part of its genetic material.
The result is available within four hours after arrival of the samples. For further study, the virus-positive samples are still sent to a specialised BSL4 laboratory in Hamburg, where the virus can be cultivated. There are no laboratories with the highest biosafety level in Belgium.
ITM already has a few BSL3 laboratories for research on HIV multiresistant tuberculosis. Its researchers have years of experience with safe working practices in these laboratories. The institute reserves a specific area to the diagnosis of Ebola with stricter safety measures, such as the use of protective gear. The Ebola virus is not cultivated or studied here.
“By carrying out the diagnosis in Belgium we can quickly confirm or exclude Ebola virus infections and therefore reassure patients, their relatives and the community almost immediately in case of false alarms. The Ebola virus was discovered here in 1976. As a national reference centre for tropical diseases, the Institute has the expertise and infrastructure needed to safely fulfill this crucial task,” said Prof. Kevin Ariën, head of ITM’s Unit of Virology.
In this function ITM also has extensive knowledge and experience in diagnosing infectious diseases in general. It acts as international reference laboratory for the World Health Organization for a range of pathogens. ITM houses in total 13 reference laboratories for diseases in humans and animals.
ITM advises and informs governments, institutions and the general public, among others via a new ebola website. The recently appointed national Ebola coordinator, Dr. Erica Vlieghe, comes from its ranks.
ITM supports the fight against Ebola in West Africa in different ways. Some of its doctors, laboratory technicians and other experts work with Médecins Sans Frontières (Doctors without Borders), the European mobile lab or the World Health Organization in the affected countries. The Institute also leads a prestigious international research consortiumwhich will assess whether treatment with antibodies in the blood of Ebola survivors could help infected patients to fight off the disease.
Q&A – Ebola diagnostics at ITM
Where do the potential Ebola samples come from?
In principle each Belgian hospital can send a sample, but most of the times it will be a specialised hospital such as the Saint-Pierre University Hospital (Brussels), the Antwerp University Hospital or the Leuven University Hospital.
How are the samples delivered to ITM?
The samples are delivered with a special transport for dangerous goods, also known as an “ADR transport”. The samples themselves are placed in special containers for safe transport.
How is a diagnosis made?
The samples are neutralised in all safety in in the BSL3 laboratory. In the process viral genetic material is extracted from the samples. From this moment onwards the extract is completely harmless and is analysed in the medical laboratory (a Biosafety Level 2 laboratory) using molecular techniques.
If a sample is found positive, it is sent to Hamburg (Germany) for further analysis in a BSL4 laboratory (the highest safety level). Belgium does not have a BSL4 laboratory.
Is it safe to perform the diagnosis in Antwerp?
ITM has extensive knowledge and experience in diagnosing infectious diseases. Our specialized laboratory technicians do so in a secured environment, sealed off from the outside world. Furthermore, the Ebola virus is not cultivated or studied in Antwerp. This is only allowed in a BSL4 laboratory (the highest biosafety level). There are no such laboratories in Belgium.
Why is it so important to perform the diagnosis in Belgium?
ITM can make a diagnosis within 4 hours of arrival of the sample. Until now 12 to 24 hours more were needed. If we can confirm or exclude Ebola virus infections quicker, it also means that we can reassure patients, their relatives and the community sooner in case of false alarms.
Ebola diagnostics at ITM was established after exhaustive consultations with the following public authorities:
- Belgian Federal Public Service Employment, Labour and Social Dialogue
- Division of Biosafety and Biotechnology (SBB) of the Scientific Institute of Public Health (IPH)
- Department of Environment, Nature and Energy of the Flemish government