{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:31:32Z","timestamp":1777681892861,"version":"3.51.4"},"reference-count":92,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:p>High-level isolation units (HLIUs) have been established by countries to provide safe and optimal medical care for patients with high-consequence infectious diseases. We aimed to identify global high-level isolation capabilities and determine gaps and priorities of global HLIUs, using a multiple method approach that included a systematic review of published and gray literature and a review of Joint External Evaluations and Global Health Security Index reports from 112 countries. A follow-up electronic survey was distributed to identified HLIUs. The landscape analysis found 44 previously designated\/self-described HLIUs in 19 countries. An additional 33 countries had potential HLIUs; however, there were not enough details on capabilities to determine if they fit the HLIU definition. An electronic survey was distributed to 36 HLIUs to validate landscape analysis findings and to understand challenges, best practices, and priorities for increased networking with a global HLIU cohort; 31 (86%) HLIUs responded. Responses revealed an additional 30 confirmed HLIUs that were not identified in the landscape analysis. To our knowledge, this was the first mapping and the largest ever survey of global HLIUs. Survey findings identified major gaps in visibility of HLIUs: while our landscape analysis initially identified 44 units, the survey unveiled an additional 30 HLIUs that had not been previously identified or confirmed. The lack of formalized regional or global coordinating organizations exacerbates these visibility gaps. The unique characteristics and capabilities of these facilities, coupled with the likelihood these units serve as core components of national health security plans, provides an opportunity for increased connection and networking to advance the field of high-level isolation and address identified gaps in coordination, build an evidence base for HLIU approaches, and inform HLIU definitions and key components.<\/jats:p>","DOI":"10.1089\/hs.2023.0181","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T10:01:50Z","timestamp":1722852110000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Level Isolation: A Landscape Analysis of Global Capabilities and Opportunities to Advance the Field"],"prefix":"10.1177","volume":"22","author":[{"given":"Jocelyn J.","family":"Herstein","sequence":"first","affiliation":[{"name":"Jocelyn J. Herstein, PhD, MPH, is an Assistant Professor, Department of Environmental, Agricultural and Occupational Health, College of Public Health, and Director, National Emerging Special Pathogens Training and Education Center (NETEC) International Partnerships and Programs;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Lukowski","sequence":"additional","affiliation":[{"name":"Joseph Lukowski, MPH, is a Data Coordinator II, Lymphoma Study Group\u2014Tissue Bank\/Consent, Oncology\/Hematology, Department of Internal Medicine;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael","family":"ElRayes","sequence":"additional","affiliation":[{"name":"Wael ElRayes, MBBCh, PhD, MS, FACHE, is Faculty, Department of Health Services Research and Administration, and Co-Director, Center for Global Health and Development, College of Public Health;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Lowe","sequence":"additional","affiliation":[{"name":"John J. Lowe, PhD, is Director, Global Center for Health Security, Professor and Chair, Department of Environmental, Agricultural and Occupational Health, College of Public Health, and Assistant Vice Chancellor for Health Security Training and Education, Office of the Vice Chancellor for Academic Affairs;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneesh K.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Aneesh K. Mehta, MD, FIDSA, FAST, is Professor of Medicine and of Surgery, Assistant Director of Transplant Infectious Diseases, and Chief of Infectious Diseases Services, Emory University Hospital, Emory University School of Medicine, Atlanta, GA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikramjit","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Vikramjit Mukherjee, MD, FRCP, is Director, Critical Care, and Director, Special Pathogens Program, NYC Health + Hospitals\/Bellevue, and Associate Professor, NYU School of Medicine, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie L.","family":"Stern","sequence":"additional","affiliation":[{"name":"Katie L. 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