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European 'Mobilise' Project to Develop Mobile Labs for Managing Infectious Disease Outbreaks


NEW YORK – A new EU-funded project commenced this month that aims to develop a new kind of mobile laboratory that can be used to test emerging pathogens in the field using advanced molecular technologies, such as PCR and next-generation sequencing.

Mobilise, a "novel and green mobile One Health laboratory for (re-)emerging infectious disease outbreaks," starts on Oct. 1 and will run through September 2025. Investigators from the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany, are overseeing Mobilise, which involves partners from five countries and has a total budget of €4.4 million ($4.3 million).

Florian Gehre, a molecular biologist at BNITM stationed in Arusha, Tanzania, said that the catalyst for Mobilise is climate change, leading to warmer temperatures and the rapid spread of new disease vectors in Europe. "With changing temperatures and rainfall, we are becoming a habitat for vectors and have new vector-borne diseases," such as dengue fever, Crimean-Congo hemorrhagic fever, and West Nile virus.

"We already have big outbreaks of Crimean-Congo and West Nile in Southern Europe," Gehre noted, adding that some diseases, such as Crimean-Congo, produce a fever that can have severe consequences for patients if not immediately treated. By deploying a fleet of mobile labs capable of handling Biosafety Level 4 pathogens, like Crimean-Congo virus and West Nile virus, the Mobilise project hopes to make it easier to diagnose pathogens and identify new ones, bypassing conventional approaches that require samples to be sent to central laboratories for analysis.

There are currently only a handful of labs that can handle BSL4 pathogens, which require the highest level of safety precautions, such as the use of protective suits and special facilities.

"The idea is to bring BSL4 capacity to the sample," Gehre said.

Muna Affara, a molecular biologist at BNITM, described the envisioned field lab as "looking like a 20-foot shipping container," but consisting of other materials. "It is insulated, lighter, and portable in that it can be transported by a standard vehicle," such as a container truck, she said.

This mobile lab is also supposed to have a minimal environmental impact and be compliant with the European Green Deal, a set of policy initiatives approved by the European Commission in 2020 that aim to make the EU climate neutral by 2050.

"We want to be as green as possible and ideally we want to go fully electric, but right now we are thinking about a hybrid platform," Gehre said. "We also want to have smart workflows, so that we don't run all the machines at the same time."

MDSC Systems, a Tallinn, Estonia-based company that specializes in building container-based solutions for various purposes, such as mobile doctors' offices or field hospitals, is a partner on Mobilise, which will have its kickoff meeting next month in Tallinn.

Kristjan Kamdron, a board member of MDSC Systems, said that the company has not previously participated in such a well-funded EU project, and that for MDSC, Mobilise is a "great opportunity to work with so many research institutions."

Kamdron noted that MDSC has long-term experience in designing and producing mobile solutions, and that its goal is to develop "innovative renewable energy solutions and integrate them" into the company's Rolling Unit side-extendable vehicle.

"Hopefully, this development project will help create value and solutions that we can use to update our product line in the future," Kamdron said.

In terms of equipment and instruments that the mobile labs will have, whole-genome sequencing will be an essential component of the labs produced by Mobilise. Affara said that a separate initiative, the East African Community Mobile Labs project, is currently implementing Illumina Seq 100s in the field, with the option of transferring samples to larger Illumina NextSeq systems in central laboratories. This setup could serve as an example for Mobilise.

The EAC Mobile Labs project involves BNITM as well as partners in several East African countries, including Burundi, Kenya, Rwanda, South Sudan, Tanzania, and Uganda. It commenced in 2017, with €10 million in funding from the German Development Bank. A paper detailing the effort was published last year in the journal BMC Medicine. Another article describing the use of EAC Mobile Labs to contain the COVID-19 pandemic, appeared in the journal Globalization and Health in April 2021.

Still, Affara stressed it has not been decided what platform Mobilise will use.

A core concept for Mobilise is One Health, a strategy for an interdisciplinary approach to healthcare. Rather than focusing on human, animal, or insect-borne vectors, One Health instead encourages investigators to look across species, and to establish unbiased ways for managing disease outbreaks.

Such an approach could address the shortcomings of current mobile labs. According to a survey that BNITM conducted of existing mobile labs in Europe, about two-thirds of the 193 labs assessed were run by civilians, and nearly 90 percent were exclusively for human diagnostics. Only a tenth had an accredited quality management system, and just 3 percent were equipped to handle BSL4 pathogens. Gehre noted that the survey findings, which were mentioned in a project summary, have not yet been published, and that the researchers continue to look into the mobile lab landscape both in Europe and in Africa.

The project's One Health approach also influences its sequencing strategy, according to Gehre, as the investigators aim to rely on metagenomic sequencing, where one can identify viruses in a sample, rather than test for specific known viruses.

"We want to establish an unbiased One Health sequencing approach," Gehre said. "A lot of times you look for one virus, such as Ebola, and miss others," he said. "We don't want to look for pathogens, just screen samples using a metagenomic approach." The mobile labs would therefore be able to identify unknown outbreaks from unknown sources, while liaising with central labs, he said.

Other diagnostics are planned. Affara said that PCR would be the "gold standard method" for labs in the field, but the Mobilise investigators also want to develop and use rapid, electronic testing platforms, to reduce the amount of interaction between BSL4 pathogens and technicians.

According to Gehre, the priority pathogens at the moment are Crimean-Congo and West Nile. Mobilise plans to design and deploy an artificial intelligence-based emergency operation center and decision support system to assist end users in coordinating fleets of mobile labs across Europe and to manage outbreaks in real time. Gehre said that this would consist of a dashboard that would monitor outbreaks and determine where to deploy labs.

"If an outbreak developed, and the system said you would need 10 mobile labs to contain it, you could request labs from, say, Italy to send to Austria," Gehre said. "That way you could deploy mobile labs in the most efficient way."

Exus, an Athens, Greece-based software company, has been tasked with developing the system.

Once a Technology Readiness Level 7 prototype of Mobilise's mobile laboratories is ready by September 2025, the investigators aim to field test it with the aid of national agencies and first responders in Austria, Romania, Greece, and East Africa.

Gehre noted that the Friedrich Loeffler Institute, the Federal Institute for Animal Health of Germany, the country's leading animal disease center, is a partner in Mobilise, as is AGES, the Austrian Agency for Health and Nutritional Safety and the National Public Health Organization of Greece.

Once vetted in field trials, the lab could be developed into a fully commercial project, he added.