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Title: Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015

The current outbreak of Ebola virus disease (EVD) in West Africa has infected more than 28,000 people, killed more than 11,000 and disrupted social life. We studied retrospectively the clinical presentation and risk factors for fatal outcome among the 31 Ebola virus (EBV) positive patients admitted to the Ebola Treatment Center (ETC) in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the current outbreak. Significant predictors for fatal outcome were shorter time from onset to admission, male sex, high viral load on initial lab test, severe pain, diarrhea, bloody stools, and development of other bleeding manifestations during hospital admission. Awareness of risk factors for fatal outcome could be used to identify patients in need of more intensive medical support. The lack of fever in as much as a third of EVD cases may have implications for temperature screening practices and case definitions.
Authors:
 [1] ;  [2] ;  [2] ;  [3] ;  [4] ;  [2] ;  [5] ;  [1] ;  [6] ;  [7] ;  [5] ;  [3] ;  [8] ;  [9] ;  [10] ;  [10] ;  [11] ;  [3] ;  [3] ;  [12] more »;  [13] ;  [7] « less
  1. Haukeland Univ. Hospital, Bergen (Norway)
  2. St. Olav Hospital, Trondheim (Norway)
  3. Moyamba District Hospital (Sierra Leone)
  4. Oslo Univ. Hospital (Norway)
  5. Medicos del Mundo, Madrid (Spain)
  6. Haraldsplass Diaconal Hospital, Bergen (Norway)
  7. Haukeland Univ. Hospital, Bergen (Norway); Univ. of Bergen (Norway)
  8. Hospital Son Espases, Palma de Mallorca (Spain)
  9. Medicos del Mundo, Madrid (Spain); Inst. de Investigacion de Palma (Spain)
  10. MRIGlobal, Rockville, MD (United States)
  11. Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
  12. Public Health (Pakistan)
  13. Stavanger Univ. Hospital (Norway)
Publication Date:
Report Number(s):
SAND-2016-3865J
Journal ID: ISSN 1080-6040; 638710
Grant/Contract Number:
AC04-94AL85000
Type:
Accepted Manuscript
Journal Name:
Emerging Infectious Diseases
Additional Journal Information:
Journal Volume: 22; Journal Issue: 9; Journal ID: ISSN 1080-6040
Publisher:
Centers for Disease Control and Prevention
Research Org:
Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
Sponsoring Org:
USDOE National Nuclear Security Administration (NNSA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES
OSTI Identifier:
1431289

Haaskjold, Yngvar Lunde, Bolkan, Hakon Angell, Krogh, Kurt Osthuus, Jongopi, James, Lundeby, Karen Marie, Mellesmo, Sindre, Garces, Pedro San Jose, Josendal, Ola, Opstad, Asmund, Svensen, Erling, Fuentes, Luis Matias Zabala, Kamara, Alfred Sandy, Riera, Melchor, Izquierdo, Javier Arranz, Roberts, David P., Stamper, Paul D., Austin, Paula, Moosa, Alfredo J., Marke, Dennis, Hassan, Shoaib, Berg, Ase, and Blomberg, Bjorn. Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015. United States: N. p., Web. doi:10.3201/eid2209.151621.
Haaskjold, Yngvar Lunde, Bolkan, Hakon Angell, Krogh, Kurt Osthuus, Jongopi, James, Lundeby, Karen Marie, Mellesmo, Sindre, Garces, Pedro San Jose, Josendal, Ola, Opstad, Asmund, Svensen, Erling, Fuentes, Luis Matias Zabala, Kamara, Alfred Sandy, Riera, Melchor, Izquierdo, Javier Arranz, Roberts, David P., Stamper, Paul D., Austin, Paula, Moosa, Alfredo J., Marke, Dennis, Hassan, Shoaib, Berg, Ase, & Blomberg, Bjorn. Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015. United States. doi:10.3201/eid2209.151621.
Haaskjold, Yngvar Lunde, Bolkan, Hakon Angell, Krogh, Kurt Osthuus, Jongopi, James, Lundeby, Karen Marie, Mellesmo, Sindre, Garces, Pedro San Jose, Josendal, Ola, Opstad, Asmund, Svensen, Erling, Fuentes, Luis Matias Zabala, Kamara, Alfred Sandy, Riera, Melchor, Izquierdo, Javier Arranz, Roberts, David P., Stamper, Paul D., Austin, Paula, Moosa, Alfredo J., Marke, Dennis, Hassan, Shoaib, Berg, Ase, and Blomberg, Bjorn. 2016. "Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015". United States. doi:10.3201/eid2209.151621. https://www.osti.gov/servlets/purl/1431289.
@article{osti_1431289,
title = {Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015},
author = {Haaskjold, Yngvar Lunde and Bolkan, Hakon Angell and Krogh, Kurt Osthuus and Jongopi, James and Lundeby, Karen Marie and Mellesmo, Sindre and Garces, Pedro San Jose and Josendal, Ola and Opstad, Asmund and Svensen, Erling and Fuentes, Luis Matias Zabala and Kamara, Alfred Sandy and Riera, Melchor and Izquierdo, Javier Arranz and Roberts, David P. and Stamper, Paul D. and Austin, Paula and Moosa, Alfredo J. and Marke, Dennis and Hassan, Shoaib and Berg, Ase and Blomberg, Bjorn},
abstractNote = {The current outbreak of Ebola virus disease (EVD) in West Africa has infected more than 28,000 people, killed more than 11,000 and disrupted social life. We studied retrospectively the clinical presentation and risk factors for fatal outcome among the 31 Ebola virus (EBV) positive patients admitted to the Ebola Treatment Center (ETC) in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the current outbreak. Significant predictors for fatal outcome were shorter time from onset to admission, male sex, high viral load on initial lab test, severe pain, diarrhea, bloody stools, and development of other bleeding manifestations during hospital admission. Awareness of risk factors for fatal outcome could be used to identify patients in need of more intensive medical support. The lack of fever in as much as a third of EVD cases may have implications for temperature screening practices and case definitions.},
doi = {10.3201/eid2209.151621},
journal = {Emerging Infectious Diseases},
number = 9,
volume = 22,
place = {United States},
year = {2016},
month = {9}
}