Page 170 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan
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168 Chapter 8
Methods
Infectious diseases preparedness and response in the Netherlands
In the Netherlands, notification of 43 infectious diseases is legally anchored in the Public Health Act (Wet Publieke Gezondheid) [22, 23]. In this act, 43 diseas- es are assigned into A, B, and C categories, depending on the necessary con- trol measures. In case of an A-notifiable disease such as EVD, national outbreak management is centralized to effectively implement uniform control measures, in line with International Health Regulations [24]. The Dutch Minister of Health, Welfare and Sports appointed the National Institute for Public Health and the Environment (RIVM) as a national coordinator, responsible for guidelines and advice, communication to professionals and the public, and the activation of control measures in the event of a possible EVD case.
Within the healthcare sector in the Netherlands, general practitioners (GPs) are first responders [25]. Except for emergencies, patients must consult their GP for referral to a hospital. During the EVD epidemic, GPs were respon- sible for referral of suspected cases to one of the eight academic hospitals in the Netherlands. In addition, eighty peripheral hospitals facing suspected cases at the emergency department had to refer such cases to an academic hospital. Twenty-five regional ambulance services were accountable for transportation of suspected and confirmed EVD cases to an academic hospital. All eight aca- demic hospitals were responsible for management of EVD patients admitted for diagnostics, whereas four of them were appointed for long-term care of pa- tients diagnosed with EVD [26, 27]. One virological laboratory, the Department of Virology of the Erasmus Medical Center, was designated for EVD diagnostics for the whole country. This laboratory is a reference centre for WHO on viral infections. Twenty-five Municipal Health Services (MHSs) were accountable for regional public health activities including control, monitoring, and contact-trac- ing of suspected cases. Figure 1 depicts all healthcare and public health orga- nizations involved in EVD response and preparedness, showing on the left side the routing of a suspected EVD case through GPs and emergency departments to academic hospitals and, on the right side, the public health organizations: MHSs and RIVM.






























































































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