About the project

FiLi-Vi-X stands for "Preparing First Line health care workers in the Flemish health care system for 'virus X', by setting  up and validating a training package, using viral hemorrhagic fever as a model". 

Abstract of the project

Pandemic preparedness includes many challenges and activities. Healthcare workers in primary care (such as family physicians, emergency room and ambulance workers) play a special role in this. They are the first ones to be confronted with a new threat; missed diagnoses can quickly trigger local outbreaks and further spread, including within the healthcare facility. Effective surveillance therefore requires well-trained staff in the field, who can recognize unusual or high-risk situations, sound the alarm and initiate a proper response. The European Centre for Disease Prevention and Control (ECDC) already recommended our country in 2015 to strengthen the preparedness of first-line healthcare providers.

The sudden emergence of COVID-19 in 2020 and of Mpox in Europe in 2022 has demonstrated the variability of how a new threat can emerge. Preparing as generically as possible for a "worst case scenario" is essential; WHO therefore launched the concept of "preparedness for virus X" (2018). The challenge here is to keeping knowledge readily available about rare, impactful pathology, within professionals whose day-to-day expertise lies elsewhere. Viral hemorrhagic fever (VHF) could be used as a proxy for this given its high mortality, high risk for nosocomial infection and permanent risk. VHF often presents itself with small-scale outbreaks, but such high-impact pathogens can spread rapidly if they enter settings that are insufficiently prepared for them.

Since 2016, we have procedures and training for VHF in Flanders/Belgium, but these mainly focus on the last part of the response chain. In this project, we want to develop a method and training package that can be used to systematically train first-line healthcare workers at the beginning of the alert and response chain, where alertness, recognition of infectious risk situations and a correct response can be tested and practiced. The package and method will be compiled in consultation with the relevant professional groups and authorities, and will also be tested internationally. To our knowledge, such a didactic program does not yet exist in Belgium, and by extension in Europe, and is therefore a first in its kind. It is therefore the intention within the project to further develop this "ugly" prototype (TRL4) to a TRL6 level (prototype system tested in intended environment close to expected performance).


The primary partnership of this project consists of the UAntwerpen (UA), the University Hospital of Antwerpen (UZA) and the Institute of Tropical Medicine (ITG), with Radboudumc as international partner. The three Antwerp institutions already have decades of sustained collaboration in the care of patients with infectious diseases, and in research and training on infectious diseases; they already collaborated intensively in VHF-preparedness and COVID-19 response. Recently, this collaboration was extended to Radboudumc. 

Work packages / specific objectives 

The project includes four work packages: (1) General coordination and project management; (2) Compilation of didactic package and writing of different exercise scenarios; (3) Organization of a summer course focused on pandemic preparedness within the health system and (4) Performance and analysis of pilot exercises with international validation. 

During the work, field partners from different disciplines (professional organizations, health authorities, educational experts) will be invited to monitor the content, methodology and improvement cycle within the process.

The ultimate goal is that this training package would not only be rolled out within Flanders/Belgium, but could also be further tested and used at the European level to keep front-line workers trained.This partnership will therefore already establish contacts with other European HLIUs during this project in order to further Europeanize this roadmap in a second stage.