LogoLogoMSF Science Portal
  • My saved items
logo

© Médecins Sans Frontières

MSF Science Portal
About MSF Science Portal
About MSF
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use

v2.1.4829.produseast1

Journal Article > Research

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

Brah E, Lamah MC, Fletcher TE, Jacob S, Brett-Major D, Sall AA, Shindo N, Fischer WA, Lamontagne F, Saliou S, Bausch DG, Moumie B, Jagatic T, Sprecher A, Lawler J, Mayet T, Jacquerioz F, Baggi M, Vallenas C, Clement C, Mardel S, Faye O, Soropogui B, Magassouba N, Koivogui L, Pinto R, Fowler RA
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%.
Countries
Guinea
Subject Area
Ebolaoutbreaksinfections, viral
DOI
10.1056/NEJMoa1411249
Published Date
05-Nov-2014
PubMed ID
25372658
Languages
English
Journal
New England Journal of Medicine
Volume / Issue / Pages
Volume 372, Issue 1
Issue Date
01-Jan-2015
Dimensions Badge