Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea

Hdl Handle:
http://hdl.handle.net/10144/336795
Title:
Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea
Authors:
Bah, Elhadj Ibrahima; Lamah, Marie-Claire; Fletcher, Tom; Jacob, Shevin T; Brett-Major, David M; Sall, Amadou Alpha; Shindo, Nahoko; Fischer, William A; Lamontagne, Francois; Saliou, Sow Mamadou; Bausch, Daniel G; Moumié, Barry; Jagatic, Tim; Sprecher, Armand; Lawler, James V; Mayet, Thierry; Jacquerioz, Frederique A; Baggi, María F Méndez; Vallenas, Constanza; Clement, Christophe; Mardel, Simon; Faye, Ousmane; Faye, Oumar; Soropogui, Baré; Magassouba, Nfaly; Koivogui, Lamine; Pinto, Ruxandra; Fowler, Robert A
Journal:
The New England Journal of Medicine
Abstract:
Background In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date. Methods From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors. Results Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed cases, the median age was 38 years (interquartile range, 28 to 46), 24 patients (65%) were men, and 14 (38%) were health care workers; among the health care workers, nosocomial transmission was implicated in 12 patients (32%). Patients with confirmed EVD presented to the hospital a median of 5 days (interquartile range, 3 to 7) after the onset of symptoms, most commonly with fever (in 84% of the patients; mean temperature, 38.6°C), fatigue (in 65%), diarrhea (in 62%), and tachycardia (mean heart rate, >93 beats per minute). Of these patients, 28 (76%) were treated with intravenous fluids and 37 (100%) with antibiotics. Sixteen patients (43%) died, with a median time from symptom onset to death of 8 days (interquartile range, 7 to 11). Patients who were 40 years of age or older, as compared with those under the age of 40 years, had a relative risk of death of 3.49 (95% confidence interval, 1.42 to 8.59; P=0.007). Conclusions Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea. Despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.
Publisher:
Massachusetts Medical Society
Issue Date:
5-Nov-2014
URI:
http://hdl.handle.net/10144/336795
DOI:
10.1056/NEJMoa1411249
PubMed ID:
25372658
Additional Links:
http://www.nejm.org/doi/full/10.1056/NEJMoa1411249
Language:
en
Description:
To access this article, click on "Additional Links".
ISSN:
1533-4406
Appears in Collections:
Other Diseases

Full metadata record

DC FieldValue Language
dc.contributor.authorBah, Elhadj Ibrahimaen_GB
dc.contributor.authorLamah, Marie-Claireen_GB
dc.contributor.authorFletcher, Tomen_GB
dc.contributor.authorJacob, Shevin Ten_GB
dc.contributor.authorBrett-Major, David Men_GB
dc.contributor.authorSall, Amadou Alphaen_GB
dc.contributor.authorShindo, Nahokoen_GB
dc.contributor.authorFischer, William Aen_GB
dc.contributor.authorLamontagne, Francoisen_GB
dc.contributor.authorSaliou, Sow Mamadouen_GB
dc.contributor.authorBausch, Daniel Gen_GB
dc.contributor.authorMoumié, Barryen_GB
dc.contributor.authorJagatic, Timen_GB
dc.contributor.authorSprecher, Armanden_GB
dc.contributor.authorLawler, James Ven_GB
dc.contributor.authorMayet, Thierryen_GB
dc.contributor.authorJacquerioz, Frederique Aen_GB
dc.contributor.authorBaggi, María F Méndezen_GB
dc.contributor.authorVallenas, Constanzaen_GB
dc.contributor.authorClement, Christopheen_GB
dc.contributor.authorMardel, Simonen_GB
dc.contributor.authorFaye, Ousmaneen_GB
dc.contributor.authorFaye, Oumaren_GB
dc.contributor.authorSoropogui, Baréen_GB
dc.contributor.authorMagassouba, Nfalyen_GB
dc.contributor.authorKoivogui, Lamineen_GB
dc.contributor.authorPinto, Ruxandraen_GB
dc.contributor.authorFowler, Robert Aen_GB
dc.date.accessioned2014-12-07T23:55:57Z-
dc.date.available2014-12-07T23:55:57Z-
dc.date.issued2014-11-05-
dc.identifier.citationClinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea. 2014: N. Engl. J. Med.en_GB
dc.identifier.issn1533-4406-
dc.identifier.pmid25372658-
dc.identifier.doi10.1056/NEJMoa1411249-
dc.identifier.urihttp://hdl.handle.net/10144/336795-
dc.descriptionTo access this article, click on "Additional Links".en_GB
dc.description.abstractBackground In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date. Methods From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors. Results Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed cases, the median age was 38 years (interquartile range, 28 to 46), 24 patients (65%) were men, and 14 (38%) were health care workers; among the health care workers, nosocomial transmission was implicated in 12 patients (32%). Patients with confirmed EVD presented to the hospital a median of 5 days (interquartile range, 3 to 7) after the onset of symptoms, most commonly with fever (in 84% of the patients; mean temperature, 38.6°C), fatigue (in 65%), diarrhea (in 62%), and tachycardia (mean heart rate, >93 beats per minute). Of these patients, 28 (76%) were treated with intravenous fluids and 37 (100%) with antibiotics. Sixteen patients (43%) died, with a median time from symptom onset to death of 8 days (interquartile range, 7 to 11). Patients who were 40 years of age or older, as compared with those under the age of 40 years, had a relative risk of death of 3.49 (95% confidence interval, 1.42 to 8.59; P=0.007). Conclusions Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea. Despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherMassachusetts Medical Societyen_GB
dc.relation.urlhttp://www.nejm.org/doi/full/10.1056/NEJMoa1411249en_GB
dc.rightsArchived with thanks to The New England Journal of Medicineen_GB
dc.titleClinical Presentation of Patients with Ebola Virus Disease in Conakry, Guineaen
dc.identifier.journalThe New England Journal of Medicineen_GB

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.