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Clinical Management of Ebola Virus Disease in the United States and Europe

Published on Feb 18, 2016in The New England Journal of Medicine70.67
· DOI :10.1056/NEJMoa1504874
Timothy M. Uyeki71
Estimated H-index: 71
(CDC: Centers for Disease Control and Prevention),
Aneesh K. Mehta27
Estimated H-index: 27
(Emory University)
+ 14 AuthorsJulie Gutman17
Estimated H-index: 17
(CDC: Centers for Disease Control and Prevention)
Sources
Abstract
BackgroundAvailable data on the characteristics of patients with Ebola virus disease (EVD) and clinical management of EVD in settings outside West Africa, as well as the complications observed in those patients, are limited. MethodsWe reviewed available clinical, laboratory, and virologic data from all patients with laboratory-confirmed Ebola virus infection who received care in U.S. and European hospitals from August 2014 through December 2015. ResultsA total of 27 patients (median age, 36 years [range, 25 to 75]) with EVD received care; 19 patients (70%) were male, 9 of 26 patients (35%) had coexisting conditions, and 22 (81%) were health care personnel. Of the 27 patients, 24 (89%) were medically evacuated from West Africa or were exposed to and infected with Ebola virus in West Africa and had onset of illness and laboratory confirmation of Ebola virus infection in Europe or the United States, and 3 (11%) acquired EVD in the United States or Europe. At the onset of illness, the most common signs and sy...
  • References (25)
  • Citations (156)
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References25
Newest
#1Luke Hunt (Save the Children)H-Index: 1
#2Ankur Gupta-Wright (Lond: University of London)H-Index: 9
Last. Tom E. Fletcher (Defence Medical Services)H-Index: 14
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Summary Background Clinical management of Ebola virus disease remains challenging. Routine laboratory analytics are often unavailable in the outbreak setting, and few data exist for the associated haematological and biochemical abnormalities. We aimed to assess laboratory and clinical data from patients with Ebola virus disease to better inform clinical management algorithms, improve understanding of key variables associated with outcome, and provide insight into the pathophysiology of Ebola vir...
96 CitationsSource
#1Viranuj Sueblinvong (Emory University)H-Index: 9
#2Daniel W. Johnson (UNMC: University of Nebraska Medical Center)H-Index: 6
Last. Jonathan E. Sevransky (Emory University)H-Index: 30
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Ebola virus disease (EVD) is a severe illness primarily characterized by fever, fatigue, diarrhea, and vomiting. It was first identified in 1976 with several small, limited outbreaks occurring between 1976 and 2012 (1, 2). Since December 2013, a complex and wide-ranging outbreak of EVD centered in West Africa has primarily affected Guinea, Liberia, and Sierra Leone. As of March 11, 2015, the current outbreak has resulted in approximately 24,282 confirmed and suspected cases with 9,976 deaths glo...
22 CitationsSource
#1Diana F Florescu (UNMC: University of Nebraska Medical Center)H-Index: 23
#2Andre C. KalilH-Index: 31
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#1Manuel Schibler (Geneva College)H-Index: 11
#2Pauline Vetter (Geneva College)H-Index: 7
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Summary Background A detailed description of viral kinetics, duration of virus shedding, and intraviral evolution in different body sites is warranted to understand Ebola virus pathogenesis. Patients with Ebola virus infections admitted to university hospitals provide a unique opportunity to do such in-depth virological investigations. We describe the clinical, biological, and virological follow-up of a case of Ebola virus disease. Methods A 43-year-old medical doctor who contracted an Ebola vir...
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#1Colleen S. Kraft (Emory University)H-Index: 25
#2Angela L. HewlettH-Index: 1
Last. Katrina Peterson-PileriH-Index: 1
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Background. The current West Africa Ebola virus disease (EVD) outbreak has resulted in multiple individuals being medically evacuated to other countries for clinical management. Methods. We report two patients who were transported from West Africa to the United States for treatment of EVD. Both patients received aggressive supportive care measures, as well as an investigational therapeutic (TKM-100802) and convalescent plasma. Results. While one patient experienced critical illness with multi-or...
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#1Enqiang QinH-Index: 6
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Abstract Clinical and laboratory data available on patients with Ebola virus disease (EVD) remain extremely limited. We summarized the clinical characteristics of patients with EVD and analyzed the factors related to their death. Patients admitted for care at the Freetown China-Sierra Leone Friendship Hospital during 1 October-14 November 2014 were enrolled in this study. The clinical data of these patients were retrospectively analyzed. Sixty-one patients were confirmed to have EVD; 28 of them ...
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#2Richard T. Davey (NIH: National Institutes of Health)H-Index: 55
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Ebola virus (EBOV) infections have caused extraordinary morbidity and mortality among persons in Guinea, Sierra Leone, and Liberia since late 2013 (1–6). More than 850 cases of Ebola virus disease (EVD) have been reported among health care personnel in western Africa (5). On 30 September 2014, the first case of EVD identified in the United States was confirmed in a Liberian man who traveled from Liberia to Dallas, Texas, on 20 September and became ill 4 days later. He was admitted to an intensiv...
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Summary Background In the current epidemic of Ebola virus disease, health-care workers have been transferred to Europe and the USA for optimised supportive care and experimental treatments. We describe the clinical course of the first case of Ebola virus disease contracted outside of Africa, in Madrid, Spain. Methods Herein we report clinical, laboratory, and virological findings of the treatment of a female nurse assistant aged 44 years who was infected with Ebola virus around Sept 25–26, 2014,...
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Objective:This report will describe the preparations for and the provision of care of two patients with Ebola virus disease in the biocontainment unit at the University of Nebraska Medical Center.Data Sources:Patient medical records.Study Selection:Not applicable.Data Extraction:Not applicable.Data
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Viral pneumonia has a significant effect on the cardiovascular system through various mechanisms; even though it is traditionally regarded as a pulmonary disease characterized by dyspnoea and hypoxaemia. Recent research works have shown that cardiovascular events outweigh all other causes of death in various influenza pandemics. Therefore, the exploration of the effects of viral pneumonia on cardiovascular system becomes increasingly essential. The objective of this review is three-fold: first, ...
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