Sanitätsakademie der BundeswehrSanitätsakademie der Bundeswehr

Mobile Elements for Outbreak Response

Challenges, Solutions and Lessons-learned

Abteilung FMedizinischer ABC-Schutz

Colonel Roman Wölfel, MD PhD DTMH

Bundeswehr Medical Academy

Bundeswehr Institute of Microbiology

Bacteriology & Toxinology

Virology &Intracellular Pathogens

Division for Med. Bio Recon &

Verification

Director

Quality Management

Central Diagnostic Unit

Central Scientific Services

Bact. Disease Research Groups I-III

Biological Toxins Group

Bact. Immunology Research Group

Viral Disease Research Groups I-III

Rickettsia Research Group

Electron Microscopy Group

Biosafety Lab Team

Technical R&D and Dx Systems Group

Forensic Molecular Genomics Group

Admin Support Team

Modular Mission Concept

Personal protective equipment

MedBio sampling

Vector I (rodents)

Vector II (ticks & insects)

Ultra-low-temperature transport

Rapidly deployable BioLab

Inflatable Biolab Tents

Autonomous power supply

• pathogen known/unknown

• available resources on-site

• need for sustainability

• transport resources

• available lead-time

Mission requirements

Mission Tailoring

B

• bio reconnaissance, expert advice• human & veterinary sampling / necropsy• forensic verification & documentation• IATA shipment (1-5 sets)• POC tests (HHTK)

24h

2/1/0//3

CLI EPI PH PAC VET PAT

OF-4 OF-3 OR-7

Med Bio ReconTeam

BioMed Recon TeamEquipment

Bio Med Recon Team - Med Bio Sampling Kit

Bio Med Recon Team - Expert Bio Sampling

Bio Med Recon Team - Mission Tactics

Bio Med Recon Team - Expert Bio Sampling

Bio Med Recon Team - SIBA Missions

12

Bio Med Recon Team - SIBA Missions

13

Average mission duration

90minutes

Bio Med Recon Team - Field Necropsy

14

Container Labs – Not rapidly deployable

Rapidly Deployable Lab Equipment

Rapidly Deployable BioLab

Air Transport

17

CCHF Diagnostik im Kosovo 2007 & 2008

CCHF Diagnostik im Kosovo 2007 & 2008

The European Mobile Lab - EMLab Transfer of military know-how

European Mobile Lab - Bases

Tansania

Nigeria

Europe

WHOGlobal Outbreak Alert &

Response Network

The European Mobile Lab - EMLabThe human factor

The European Mobile Lab - EMLabThe Training

The European Mobile Lab - EMLabThe Training

Ebola OutbreakGuinea – March 2014

26.03.14 27.03.14

28.03.14 28.03.14

20.03.14

18.03.14

23.03.14

The European Mobile Lab - EMLab Ebola Outbreak in Guinea

30th March 2014

Deployment & Relocating of Mobile Lab Units

4 Lab Units deployed5 Relocations

Deployment & Relocating of Mobile Lab Units

4 Lab Units deployed5 Relocations

Challenge: Food Supply

Challenge: Waiting for Samples

Challenge: Death of Patients

Challenge: Mission Debriefing

Challenge: Transportation & Traffic

Challenge: EMLab Teams

… ten 5-day trainings conducted since April 2014

40h EMLab Team Training Curriculum

Introduction in the mobile field-lab concept 1hTechnical instruction on handling of mobile lab equipment 2hGlovebox maintenance 1hSmartCycler maintenance and repair 1hPersonnel protective equipment 2hPower converter operation 1hLab waste management in the field 1hScenario-based lab team training 18hSample reception & documentation 1hDocumentation, statistics and reporting of data 2hqPCR results interpretation & troubleshooting 2hStorage of samples 1hPreparation of samples for IATA shipment 2hSatellite phone communication 1hTeam safety and biosecurity in the field 1hDisinfection regime 3h

EMLab Statistics since March 2014

• 38 lab teams deployed

• served 6 locations in LIB, GIN and SLE

• operational 12h / 7d

• turn-around time less than 6 hours

• down-time 0 days

• tested > 11.000 samples (3.300 positive for Ebola virus)

German Biosecurity Initiative Mali

German Biosecurity Initiative Mali

Training von EMLab Teams, eigener Kräfte & anderer Nationen

BEL MilitärlaborGuinea, Nzere Kore

Mobile Lab Trainings for Partner Institutions

17 Trainings 136 Participants20 Nations5 Days 28 Scenarios