Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study

Mattia, John; Vandy, Mathew J; Chang, Joyce; Platt, Devin; Dierberg, Kerry; Bausch, Daniel G.; Brooks, Tim; Conteh, Sorie; Crozier, Ian; Fowler, Robert; Kamara, Amadu; Kang, Cindy; Mahadevan, Srividya; Mansaray, Yealie; Marcell, Lauren; McKay, Gillian; O’Dempsey, Tim; Parris, Victoria; Pinto, Ruxandra; Rangel, Audrey; Salam, Alex P.; Shantha, Jessica G.; Wolfman, Vanessa; Yeh, Steven; Chan, Adrienne K.; Mishra, Sharmistha

doi:10.1016/s1473-3099(15)00489-2

Cited by 153 publications

(181 citation statements)

References 24 publications

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“…Prolonged blood clotting times and increased circulating levels of D-dimers, tissue factor, thrombomodulin and von Willebrand factor have been reported with filovirus infections, and substantially abnormal values for some of these factors have been associated with a fatal outcome [18][19][20][21][22][23] . Complications collectively referred to as 'post-Ebola syndrome' , including musculoskeletal pain, headache and ocular problems, have been noted in a number of survivors of filovirus infection [24][25][26][27][28][29] . In rare cases, encephalitis has also been noted [30][31][32][33] .…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Post-exposure treatments for Ebola and Marburg virus infections

Cross

Mire

Feldmann

et al. 2018

Nat Rev Drug Discov

111

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| The filoviruses -Ebola virus and Marburg virus -cause lethal haemorrhagic fever in humans and non-human primates (NHPs). Filoviruses present a global health threat both as naturally acquired diseases and as potential agents of bioterrorism. In the recent 2013-2016 outbreak of Ebola virus, the most promising therapies for post-exposure use with demonstrated efficacy in the gold-standard NHP models of filovirus disease were unable to show statistically significant protection in patients infected with Ebola virus. This Review briefly discusses these failures and what has been learned from these experiences, and summarizes the current status of post-exposure medical countermeasures in development, including antibodies, small interfering RNA and small molecules. We outline how our current knowledge could be applied to the identification of novel interventions and ways to use interventions more effectively. R E V I E W SNATURE REVIEWS | DRUG DISCOVERY VOLUME 17 | JUNE 2018 | 413 © 2 0 1 8 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d . AstheniaMuscular weakness. MyalgiaMuscular pain. ArthralgiaJoint pain. LeukopeniaA condition of having a low number of circulating leukocytes, including neutrophils, eosinophils, basophils, lymphocytes and monocytes. LymphocytopeniaA condition of having a low number of circulating leukocytes, including natural killer cells, T cells and B cells. ThrombocytopeniaA condition of having a low number of circulating thrombocytes, also known as platelets.and Ebolavirus. The Marburgvirus genus contains a single species, Marburg marburgvirus, which contains two members, Marburg virus (MARV) and Ravn virus (RAVV). The Ebolavirus genus consists of five distinct species: Bundibugyo ebolavirus (BDBV), Reston ebolavirus (RESTV), Sudan ebolavirus (SUDV), Tai Forest ebolavirus (TAFV; previously termed 'Côte d'Ivoire ebolavirus' but more commonly known as 'Ivory Coast ebolavirus') and Zaire ebolavirus (EBOV). MARV, RAVV, BDBV, SUDV and EBOV are important human pathogens, with case fatality rates often up to 90% for MARV, RAVV and EBOV, and around 55% for SUDV 8,10 . On the basis of two small outbreaks in 2007 and 2012, BDBV seems to be the least pathogenic, with a case fatality rate of about 40-48% 11,12 . In 1994, TAFV was associated with a number of deaths in chimpanzees and a single symptomatic but non-lethal human infection in the Republic of Côte d'Ivoire 13,14 . RESTV is lethal for macaques but is not thought to cause disease in humans 15 . An outbreak of RESTV was reported in pigs in the Philippines in 2008; however, it remains uncertain whether the disease observed in the pigs was caused by RESTV or other agents reported to have co-infected the animals 16 . Clinical manifestationsClinical and laboratory signs of disease caused by filovirus infection are nonspecific and usually associated with an incubation period of 2-21 days (mean 4-10 days) 8,17 . Illness begins with an abrupt onset of fever, astheni...

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Section: Clinical Manifestationsmentioning

confidence: 99%

Post-exposure treatments for Ebola and Marburg virus infections

Cross

Mire

Feldmann

et al. 2018

Nat Rev Drug Discov

111

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“…New ocular symptoms were reported in 60%, and 18% had uveitis on slit-lamp and dilated fundus examinations. Furthermore, 24% reported tinnitus, aural fullness, or hearing loss [35].…”

Section: Clinical Sequelaementioning

confidence: 99%

Neurological Complications of Ebola Virus Infection

2016

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Ebola virus disease is one of the deadliest pathogens known to man, with a mortality rate between 25-90% depending on the species and outbreak of Ebola. Typically, it presents with fever, headache, voluminous vomiting and diarrhea, and can progress to a hemorrhagic illness; neurologic symptoms, including meningoencephalitis, seizures, and coma, can also occur. Recently, an outbreak occurred in West Africa, affecting > 28,000 people, and killing > 11,000. Owing to the magnitude of this outbreak, and the large number (>17,000) of Ebola survivors, the medical and scientific communities are learning much more about the acute manifestations and sequelae of Ebola. A number of neurologic complications can occur after Ebola, such as seizures, memory loss, headaches, cranial nerve abnormalities, and tremor. Ebola may also persist in some immunologically privileged sites, including the central nervous system, and can rarely lead to relapse in disease. Owing to these findings, it is important that survivors are evaluated and monitored for neurologic symptoms. Much is unknown about this disease, and treatment remains largely supportive; however, with ongoing clinical and basic science, the mechanisms of how Ebola affects the central nervous system and how it persists after acute disease will hopefully become more clear, and better treatments and clinical practices for Ebola patients will be developed.

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“…Interestingly, optic neuropathy without uveitis was also reported. [57][58][59][60] Uncertain Viral Anterior Uveitis Entities Epstein-Barr virus-associated anterior uveitis Epstein-Barr-virus (EBV) is also a member of the herpes virus family. It has repeatedly been reported as a cause of diverse types of uveitis, but the role of EBV in uveitis is not entirely clear, since PCR in aqueous fluid can be positive in EBV-infected patients without uveitis.…”

Section: 53mentioning

confidence: 99%

Challenges of Diagnosing Viral Anterior Uveitis

Groen-Hakan

Babu²,

Tuğal-Tutkun

et al. 2017

Ocular Immunology and Inflammation

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The viral causes of anterior uveitis (AU) emerged with the use of novel molecular diagnostic tests and serologic tests adapted for small volumes (Goldmann-Witmer Coefficient). The viral causes of AU may be underestimated, and some of the presumed idiopathic AU cases will probably be proven to be of viral origin in the coming years. So far, a viral origin of AU was suspected in patients who presented with unilateral hypertensive AU. It is not clear which clinical presentations should raise a suspicion of viral etiology. There is an overlap in the clinical manifestations of AU caused by viruses and other non-viral forms of AU. A viral cause of AU should be suspected in patients with unilateral AU, exhibiting small or medium sized KPs, some form of iris atrophy, high IOP and early development of a cataract and the definitive diagnosis can be proven by aqueous humor analysis.

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Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study

Cited by 153 publications

References 24 publications

Post-exposure treatments for Ebola and Marburg virus infections

Post-exposure treatments for Ebola and Marburg virus infections

Neurological Complications of Ebola Virus Infection

Challenges of Diagnosing Viral Anterior Uveitis

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