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Clinical presentation of patients with Ebola virus disease in Conakry, Guinea.
N Engl J Med 2015; 372(1):40-7NEJM

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%.

Authors+Show Affiliations

The authors' affiliations are listed in the Appendix.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25372658

Citation

Bah, Elhadj Ibrahima, et al. "Clinical Presentation of Patients With Ebola Virus Disease in Conakry, Guinea." The New England Journal of Medicine, vol. 372, no. 1, 2015, pp. 40-7.
Bah EI, Lamah MC, Fletcher T, et al. Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. N Engl J Med. 2015;372(1):40-7.
Bah, E. I., Lamah, M. C., Fletcher, T., Jacob, S. T., Brett-Major, D. M., Sall, A. A., ... Fowler, R. A. (2015). Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. The New England Journal of Medicine, 372(1), pp. 40-7. doi:10.1056/NEJMoa1411249.
Bah EI, et al. Clinical Presentation of Patients With Ebola Virus Disease in Conakry, Guinea. N Engl J Med. 2015 Jan 1;372(1):40-7. PubMed PMID: 25372658.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. AU - Bah,Elhadj Ibrahima, AU - Lamah,Marie-Claire, AU - Fletcher,Tom, AU - Jacob,Shevin T, AU - Brett-Major,David M, AU - Sall,Amadou Alpha, AU - Shindo,Nahoko, AU - Fischer,William A,2nd AU - Lamontagne,Francois, AU - Saliou,Sow Mamadou, AU - Bausch,Daniel G, AU - Moumié,Barry, AU - Jagatic,Tim, AU - Sprecher,Armand, AU - Lawler,James V, AU - Mayet,Thierry, AU - Jacquerioz,Frederique A, AU - Méndez Baggi,María F, AU - Vallenas,Constanza, AU - Clement,Christophe, AU - Mardel,Simon, AU - Faye,Ousmane, AU - Faye,Oumar, AU - Soropogui,Baré, AU - Magassouba,Nfaly, AU - Koivogui,Lamine, AU - Pinto,Ruxandra, AU - Fowler,Robert A, Y1 - 2014/11/05/ PY - 2014/11/6/entrez PY - 2014/11/6/pubmed PY - 2015/1/8/medline SP - 40 EP - 7 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 372 IS - 1 N2 - 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%. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/25372658/full_citation L2 - http://www.nejm.org/doi/full/10.1056/NEJMoa1411249?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -