Letter to the editor: Management of patients with Ebola virus disease in Europe: high-level isolation units should have a key role

In the past, the rare imported cases of Ebola and Marburg in western European countries and the United States were managed in high-level isolation units (HLIUs) [2]. Subsequently, reported experiences indicate that strict contact-droplet isolation is enough for preventing transmission. From this hypothesis, the idea may derive that HLIUs are not strictly necessary for the management of EVD patients, who may be safely managed in non-specialised hospitals, as suggested by some international recommendations elaborated during the current Ebola outbreak in West Africa [3,4]. Even if we concur that strict contact-droplet isolation is enough to prevent transmission during routine care, we believe that HLIUs should have a key role in EVD containment in countries where such facilities are available. An HLIU is a healthcare facility specifically designed to provide safe, secure, high-quality, and appropriate care, with optimal infection containment and infection prevention and control procedures, for a single patient or a small number of patients who have, or who may have, a highly infectious disease [5].