Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea
Authors
Bah, Elhadj IbrahimaLamah, 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
Issue Date
2014-11-05
Metadata
Show full item recordAbstract
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 SocietyPubMed ID
25372658Additional Links
http://www.nejm.org/doi/full/10.1056/NEJMoa1411249Language
enDescription
To access this article, click on "Additional Links".ISSN
1533-4406ae974a485f413a2113503eed53cd6c53
10.1056/NEJMoa1411249