MEDICAL SERVICES
The polyclinic is probably ITM’s best-known branch among the Belgian public, as it provides high-quality care to tens of thousands of travellers, migrants and people with HIV or other sexually transmitted infections (STIs) every year. The pre- and post-travel clinic, HIV centre, and STI clinic are supported by ITM’s dedicated expert laboratories that also serve as reference laboratories in Belgium and beyond. The polyclinic is part of our Department of Clinical Sciences, hosting academic units, medical units and reference laboratories.
Zika cases among Belgian travellers:
2.956
of diagnostic tests
130
confirmed cases
35.563
consultations in 2016
This distinct ITM model bridges patient care and medical research, placing the patient at the heart of the departments’ and institution’s missions. Our clinics and laboratories collaborate closely with other centres in Europe and across the globe, for example in the development and validation of diagnostic tests, the surveillance of import diseases and the implementation of multi-centre clinical studies and trials.
In total, fourteen of ITM’s medical and research laboratories are recognised national or international reference centres. Our HIV/STI and immunology laboratories have yet again been accredited as WHO-collaborating centres up to 2020, and continue to provide advice and develop guidelines in support of international programmes. So far, they have also assessed more than 250 different rapid tests for the WHO and/or WHO member states. The green light of our laboratories is required before new tests can be marketed or utilised in endemic settings. A new audit and certification programme was introduced as part of restructuring within the WHO and ITM’s HIV/STI laboratory was one of the first to be confirmed for a new mandate as WHO testing laboratory.
Our reference laboratories
1. National Reference Centre for arboviruses
2. National Reference Centre for sexually transmitted diseases (Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium)
3. National Reference Centre for Rickettsia and Anaplasma (consortium with Koningin Astrid Militair Hospitaal)
4. National Reference Centre for Coxiella burnetti and Bartonella (consortium with UCL Saint-Luc et CODA)
5. National AIDS Reference Laboratory
6. WHO Collaborating Centre for HIV/AIDS Diagnostics and Laboratory Support
7. National reference laboratory for infectious and tropical diseases
8. WHO Collaborating Centre for the Diagnosis and Surveillance of Mycobacterium Ulcerans Infection
9. Supranational Reference Laboratory (SRL) for Drug-Resistant Tuberculosis
10. World Organization for Animal Health Reference Laboratory for Surra
11. WHO Collaborating Centre for Research and Training of Sleeping Sickness Diagnosis
12. National Reference Laboratory for Trichinellosis, Echinococcosis, Sarcosporidiosis and Anisakiasis
13. FAO Reference Centre for Livestock Trypanosomiasis
14. OIE-Reference Centre for theileriosis
Top 5
vaccinations
1. Yellow fever
2. Hepatitis A
3. Polio
4. Typhoid
5. Tetanus + Diphteria
Medical services include:
Pre- and post-travel medicine
HIV/STI clinic
Helpcenter
Reference laboratories
QUICKER AND EASIER
VACCINATION SCHEMES FOR RABIES
Belgium has been rabies free since 2001. However, in Africa and Asia, this disease remains extremely common, claiming more than 60.000 lives a year, mostly among young children. Strikingly, it is a disease that is preventable through the vaccination of children and dogs. The World Health Organization wants to eradicate rabies globally by 2030 and ITM actively supports this objective by researching how to improve vaccination schedules.
If bitten, bite wounds should be washed thoroughly with soap and water for 15 minutes, as the virus is extremely sensitive to detergents, followed by treatment with disinfectants. Medical attention for further care and possible post-exposure prophylaxis (vaccination after the risk contact) should be sought out as soon as possible.
ITM recommends preventive vaccination – which offers partial protection, but revaccination is required after a bite – for those planning adventurous travels or regular visits to risk countries (like in Africa or Asia). However, rabies preventive vaccination is currently not simple requiring three shots at three different times to build up protection against the disease (day 1, day 7 and day 28). Due to poor health infrastructure, it is not easy to implement such a difficult scheme in the countries where the disease claims most lives. Since 2011, ITM and the Ministry of Defence have been jointly carrying out research into easier and shorter rabies vaccination schedules to help eradicate this disease worldwide.
QUICKER AND EASIER
VACCINATION SCHEMES FOR RABIES
Belgium has been rabies free since 2001. However, in Africa and Asia, this disease remains extremely common, claiming more than 60.000 lives a year, mostly among young children. Strikingly, it is a disease that is preventable through the vaccination of children and dogs. The World Health Organization wants to eradicate rabies globally by 2030 and ITM actively supports this objective by researching how to improve vaccination schedules. If bitten, bite wounds should be washed thoroughly with soap and water for 15 minutes, as the virus is extremely sensitive to detergents, followed by treatment with disinfectants. Medical attention for further care and possible post-exposure prophylaxis (vaccination after the risk contact) should be sought out as soon as possible. ITM recommends preventive vaccination - which offers partial protection, but revaccination is required after a bite - for those planning adventurous travels or regular visits to risk countries (like in Africa or Asia). However, rabies preventive vaccination is currently not simple requiring three shots at three different times to build up protection against the disease (day 1, day 7 and day 28). Due to poor health infrastructure, it is not easy to implement such a difficult scheme in the countries where the disease claims most lives. Since 2011, ITM and the Ministry of Defence have been jointly carrying out research into easier and shorter rabies vaccination schedules to help eradicate this disease worldwide.
Portrait
Zika: headline story of 2016
The Zika virus epidemic in Latin America put physician Ralph Huits, molecular biologist Lieselotte Cnops and their colleagues from ITM’s medical services to the test in 2016. With Ebola barely under control,our expertise in tropical fever was once again solicited by the public
and the authorities.
Lieselotte Cnops and Ralph Huits
Belgian travellers have always had a weak spot for Latin America’s popular holiday destinations. In 2016, they were joined by thousands of athletes and supporters attending the Rio Olympics in Brazil, the country most severely hit by the Zika virus outbreak.
According to Ralph Huits, who in 2010 began research in Aruba on dengue, a virus very similar to Zika, “Even though Zika virus infection had been considered a mild flu-like illness, the link between Zika virus and microcephaly put a relatively mild and unknown virus high up on the health agenda”. As early as January 2016, ITM began advising pregnant women or couples who wished to conceive, to avoid travelling to areas where the Zika virus was endemic.
Lieselotte Cnops had already developed molecular diagnostic tests for many viruses, including chikungunya, which had also caused a large outbreak in Latin America in 2014. When, in 2015, the first Zika virus reports arrived from Brazil, Cnops anticipated the need to develop another test. “We knew that, in case of a large outbreak, it was only a matter of time before we were going to deal with this rapidly spreading virus in our travel clinic,” said Cnops. ITM confirmed the first Belgian Zika case in January 2016 using an in-house developed molecular test.
From 2015, ever more scientific evidence was published about congenital malformations and the possibility of sexual transmission. However, no reliable diagnostic test was yet at hand to confirm an infection after the acute infection phase had passed. In a matter of weeks, our virology unit and clinical laboratory developed and implemented new tests, which detect antibodies specific to the virus, even when the body has recovered from the infection.
“Each day, we received returning travellers with questions about exposure to the virus. Especially for pregnant women or couples with a wish to become pregnant, knowing whether or not they had been infected was crucial,” said Huits. In the course of 2016, ITM’s clinical laboratory tested over 2000 returning travellers, confirming over 100 Zika cases. Our experts also responded to countless media requests about the Zika virus epidemic.
The situation remains far more pressing in some of the over 60 endemic countries, some of which have been confronted with millions of cases. ITM does joint research with a fertility clinic in Trinidad and Tobago and is a member of the large European Union funded research network ZikaPLAN, which aims at fighting Zika today and at building long-term outbreak response capacity in Latin America. In ZikaPLAN, our researchers are charged with investigating sexual transmission and developing more rapid diagnostics for Zika virus infections. ■
Want to know more
about us?
Institute of Tropical Medicine in Antwerp
Nationalestraat 155, 2000 Antwerp, Belgium
www.itg.be - communicatie@itg.be