Clinical characteristics of 154 patients suspected of having Ebola virus disease in the Ebola holding center of Jui Government Hospital in Sierra Leone during the 2014 Ebola outbreak

Abstract

This article sought to analyze the clinical features of 154 patients suspected of having Ebola virus disease (EVD) in an Ebola holding center in Sierra Leone from October 1 through November 9, 2014. We found that 108 of the 154 patients were confirmed with EVD. Eighty-five had known outcomes. Forty-nine of the 85 patients had been exposed to EVD. The average mortality rate was 60%. The mean interval between the onset of symptoms and hospitalization was 5.8 ± 3.3 days. The mean incubation period was 9.2 ± 6.7 days. Common symptoms of the EVD patients on admission were fatigue (85.2%), anorexia (84.3%), fever (75.9%), and headache (72.2%). Our data showed that the total symptoms of confirmed EVD patients were significantly higher than those of non-EVD patients (9 vs. 5.5; p < 0.001). The likelihood of EVD was 87.6% when a patient presented more than 6 out of 21 symptoms on admission. The survivors were significantly younger than non-survivors (24.0 ± 10.0 years vs. 31.3 ± 15.3 years; p = 0.016). The real-time polymerase chain reaction (PCR) analysis showed that, in the survivors, the virus load was significantly lower (Ct value: 25.2 ± 4.1 vs. 28.7 ± 5.7; p = 0.002). Multivariate analysis showed that age, fever, and viral load were independent predictors of mortality. Taken together, our data suggested that a cutoff of six symptoms could be used to predict patients with high or low risk of EVD. It seemed that age, fever, and viral load were the main risk factors associated with EVD mortality.

Rapid Bedside Inactivation of Ebola Virus for Safe Nucleic Acid Tests

“…We used two million infectious virus particles of cultured virus, which corresponded to a C q value of about 15 in our RT-PCR settings. This corresponded to a higher concentration level of the EBOV compared to the most reported cases from the 2014 outbreak (24,25).…”

Viral load is strongly associated with length of stay in adults hospitalised with viral acute respiratory illness

“…Real-time PCR Ct values are now considered by many to be a robust surrogate for quantified viral load and are increasingly reported in published studies of acute viral illness including those examining respiratory viruses [6,32] and also in the recent Ebola virus pandemic [33,34]. Furthermore, the use of protocolised sampling techniques, processing by dedicated research staff and the removal of inter-operator variability of results interpretation (as all samples were analysed by the same scientists in the same laboratory) gives reassurance as to the robustness of the Ct result in this study.…”

Is Africa part of the partnership?

“…The data differs depending on the disease and/or country, and shows that some African and Western institutions are managing to reach a common interest where African researchers not only lead the research in the field but also tell the story. However, at the same time it was shocking to find articles published in prestigious peer-reviewed journals presenting results of studies of Ebola with data and/or samples collected in Africa without any African authors (McElroy et al 2014;Nouvellet et al 2015;Yan et al 2015). While I wonder if the authors had just 'fished' the data from Africa, I also question how a reputable and peer-reviewed journal can publish such unfair articles.…”