TY - JOUR
T1 - Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone
AU - Schieffelin, John S.
AU - Shaffer, Jeffrey G.
AU - Goba, Augustine
AU - Gbakie, Michael
AU - Gire, Stephen K.
AU - Colubri, Andres
AU - Sealfon, Rachel S.G.
AU - Kanneh, Lansana
AU - Moigboi, Alex
AU - Momoh, Mambu
AU - Fullah, Mohammed
AU - Moses, Lina M.
AU - Brown, Bethany L.
AU - Andersen, Kristian G.
AU - Winnicki, Sarah
AU - Schaffner, Stephen F.
AU - Park, Daniel J.
AU - Yozwiak, Nathan L.
AU - Jiang, Pan Pan
AU - Kargbo, David
AU - Jalloh, Simbirie
AU - Fonnie, Mbalu
AU - Sinnah, Vandi
AU - French, Issa
AU - Kovoma, Alice
AU - Kamara, Fatima K.
AU - Tucker, Veronica
AU - Konuwa, Edwin
AU - Sellu, Josephine
AU - Mustapha, Ibrahim
AU - Foday, Momoh
AU - Yillah, Mohamed
AU - Kanneh, Franklyn
AU - Saffa, Sidiki
AU - Massally, James L.B.
AU - Boisen, Matt L.
AU - Branco, Luis M.
AU - Vandi, Mohamed A.
AU - Grant, Donald S.
AU - Happi, Christian
AU - Gevao, Sahr M.
AU - Fletcher, Tom
AU - Fowler, Robert A.
AU - Bausch, Daniel G.
AU - Sabeti, Pardis C.
AU - Khan, S. Humarr
AU - Garry, Robert F.
AU - KGH Lassa Fever Program, Lassa Fever Program
PY - 2014/11/27
Y1 - 2014/11/27
N2 - BackgroundLimited clinical and laboratory data are available on patients with Ebola virus disease (EVD). The Kenema Government Hospital in Sierra Leone, which had an existing infrastructure for research regarding viral hemorrhagic fever, has received and cared for patients with EVD since the beginning of the outbreak in Sierra Leone in May 2014.MethodsWe reviewed available epidemiologic, clinical, and laboratory records of patients in whom EVD was diagnosed between May 25 and June 18, 2014. We used quantitative reverse-transcriptase–polymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients.ResultsOf 106 patients in whom EVD was diagnosed, 87 had a known outcome, and 44 had detailed clinical information available. The incubation period was estimated to be 6 to 12 days, and the case fatality rate was 74%. Common findings at presentation included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), and vomiting (in 34%). Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Exploratory analyses indicated that patients under the age of 21 years had a lower case fatality rate than those over the age of 45 years (57% vs. 94%, P=0.03), and patients presenting with fewer than 100,000 EBOV copies per milliliter had a lower case fatality rate than those with 10 million EBOV copies per milliliter or more (33% vs. 94%, P=0.003). Bleeding occurred in only 1 patient.ConclusionsThe incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.)
AB - BackgroundLimited clinical and laboratory data are available on patients with Ebola virus disease (EVD). The Kenema Government Hospital in Sierra Leone, which had an existing infrastructure for research regarding viral hemorrhagic fever, has received and cared for patients with EVD since the beginning of the outbreak in Sierra Leone in May 2014.MethodsWe reviewed available epidemiologic, clinical, and laboratory records of patients in whom EVD was diagnosed between May 25 and June 18, 2014. We used quantitative reverse-transcriptase–polymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients.ResultsOf 106 patients in whom EVD was diagnosed, 87 had a known outcome, and 44 had detailed clinical information available. The incubation period was estimated to be 6 to 12 days, and the case fatality rate was 74%. Common findings at presentation included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), and vomiting (in 34%). Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Exploratory analyses indicated that patients under the age of 21 years had a lower case fatality rate than those over the age of 45 years (57% vs. 94%, P=0.03), and patients presenting with fewer than 100,000 EBOV copies per milliliter had a lower case fatality rate than those with 10 million EBOV copies per milliliter or more (33% vs. 94%, P=0.003). Bleeding occurred in only 1 patient.ConclusionsThe incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.)
U2 - 10.1056/nejmoa1411680
DO - 10.1056/nejmoa1411680
M3 - Article
SN - 0028-4793
VL - 371
SP - 2092
EP - 2100
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 22
ER -
