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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. Uyeki69
Estimated H-index: 69
(CDC: Centers for Disease Control and Prevention),
Aneesh K. Mehta25
Estimated H-index: 25
(Emory University)
+ 14 AuthorsJulie Gutman16
Estimated H-index: 16
(CDC: Centers for Disease Control and Prevention)
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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 (135)
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References25
Newest
Published on Nov 1, 2015in Lancet Infectious Diseases27.52
Luke Hunt1
Estimated H-index: 1
(Save the Children),
Ankur Gupta-Wright9
Estimated H-index: 9
(Lond: University of London)
+ 13 AuthorsSulaiman Conteh1
Estimated H-index: 1
(Save the Children)
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...
Published on Oct 1, 2015in Critical Care Medicine6.97
Viranuj Sueblinvong10
Estimated H-index: 10
(Emory University),
Daniel W. Johnson6
Estimated H-index: 6
(UNMC: University of Nebraska Medical Center)
+ 9 AuthorsMark Feldman47
Estimated H-index: 47
(Presbyterian Hospital of Dallas)
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...
Published on Sep 15, 2015in Clinical Infectious Diseases9.05
Diana F. Florescu23
Estimated H-index: 23
(UNMC: University of Nebraska Medical Center),
Andre C. Kalil30
Estimated H-index: 30
+ 4 AuthorsPhilip W. Smith33
Estimated H-index: 33
Published on Sep 1, 2015in Lancet Infectious Diseases27.52
Manuel Schibler11
Estimated H-index: 11
(Geneva College),
Pauline Vetter6
Estimated H-index: 6
(Geneva College)
+ 18 AuthorsJulie-Anne Dayer5
Estimated H-index: 5
(Geneva College)
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...
Published on Aug 15, 2015in Clinical Infectious Diseases9.05
Colleen S. Kraft23
Estimated H-index: 23
(Emory University),
Angela L. Hewlett1
Estimated H-index: 1
+ 259 AuthorsRachel J. Friedman-Moraco3
Estimated H-index: 3
(Emory University)
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...
Published on Aug 15, 2015in Clinical Infectious Diseases9.05
Enqiang Qin6
Estimated H-index: 6
,
Jingfeng Bi1
Estimated H-index: 1
+ 10 AuthorsSuhong Chen1
Estimated H-index: 1
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 ...
Published on Jul 21, 2015in Annals of Internal Medicine19.32
Allison M. Liddell4
Estimated H-index: 4
(Presbyterian Hospital of Dallas),
Richard T. Davey58
Estimated H-index: 58
(NIH: National Institutes of Health)
+ 24 AuthorsAnthony F. Suffredini54
Estimated H-index: 54
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...
Published on Jul 1, 2015in The Lancet Respiratory Medicine22.99
Marta Mora-Rillo2
Estimated H-index: 2
(ISCIII: Instituto de Salud Carlos III),
Marta Arsuaga2
Estimated H-index: 2
(ISCIII: Instituto de Salud Carlos III)
+ 16 AuthorsAurora Viejo2
Estimated H-index: 2
(ISCIII: Instituto de Salud Carlos III)
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,...
Published on Jun 15, 2015in Clinical Infectious Diseases9.05
Moumié Barry7
Estimated H-index: 7
,
A. Toure9
Estimated H-index: 9
+ 10 AuthorsSakoba Keita21
Estimated H-index: 21
Published on Jun 1, 2015in Critical Care Medicine6.97
Daniel W. Johnson6
Estimated H-index: 6
(UNMC: University of Nebraska Medical Center),
James Sullivan5
Estimated H-index: 5
(UNMC: University of Nebraska Medical Center)
+ 5 AuthorsSteven J. Lisco8
Estimated H-index: 8
Cited By135
Newest
Published on Dec 1, 2019in Intensive Care Medicine Experimental
Guillaume Poliquin1
Estimated H-index: 1
(UM: University of Manitoba),
Duane J. Funk14
Estimated H-index: 14
(UM: University of Manitoba)
+ 59 AuthorsAlexander Bello14
Estimated H-index: 14
(Public Health Agency of Canada)
Background There are currently limited data for the use of specific antiviral therapies for the treatment of Ebola virus disease (EVD). While there is anecdotal evidence that supportive care may be effective, there is a paucity of direct experimental data to demonstrate a role for supportive care in EVD. We studied the impact of ICU-level supportive care interventions including fluid resuscitation, vasoactive medications, blood transfusion, hydrocortisone, and ventilator support on the pathophys...
Published on Dec 1, 2019in BMC Infectious Diseases2.56
James S.J. Lee2
Estimated H-index: 2
(U of T: University of Toronto),
Neill K. J. Adhikari (Sunnybrook Health Sciences Centre)+ 12 AuthorsPeter Kiiza (Sunnybrook Health Sciences Centre)
Background Management of Ebola virus disease (EVD) has historically focused on infection prevention, case detection and supportive care. Several specific anti-Ebola therapies have been investigated, including during the 2014–2016 West African outbreak. Our objective was to conduct a systematic review of the effect of anti-Ebola virus therapies on clinical outcomes to guide their potential use and future evaluation.
Published on Apr 4, 2019in Journal of Translational Medicine4.10
A stroke caused by angiostenosis always has a poor prognosis. Bone marrow stromal cells (BMSC) are widely applied in vascular regeneration. Recently, thrombospondin-4 (TSP4) was reported to promote the regeneration of blood vessels and enhance the function of endothelial cells in angiogenesis. In this work, we observed the therapeutic effect of TSP4-overexpressing BMSCs on angiogenesis post-stroke. We subcloned the tsp4 gene into a lentivirus expression vector system and harvested the tsp4 lenti...
Published on Oct 1, 2019in Critical Care Clinics2.74
Peter Kiiza (Sunnybrook Research Institute), Neill K. J. Adhikari45
Estimated H-index: 45
(U of T: University of Toronto)
+ 2 AuthorsRobert Fowler48
Estimated H-index: 48
(U of T: University of Toronto)
Published on Aug 24, 2019in Viruses3.81
Eleonora Lalle12
Estimated H-index: 12
,
Mirella Biava3
Estimated H-index: 3
+ 10 AuthorsAlimuddin Zumla72
Estimated H-index: 72
Filoviruses have become a worldwide public health concern, especially during the 2013–2016 Western Africa Ebola virus disease (EVD) outbreak—the largest outbreak, both by number of cases and geographical extension, recorded so far in medical history. EVD is associated with pathologies in several organs, including the liver, kidney, and lung. During the 2013–2016 Western Africa outbreak, Ebola virus (EBOV) was detected in the lung of infected patients suggesting a role in lung pathogenesis. Howev...
Published on Aug 22, 2019in Viruses3.81
Theodore J. Cieslak12
Estimated H-index: 12
,
Jocelyn J. Herstein4
Estimated H-index: 4
+ 1 AuthorsAngela L Hewlett16
Estimated H-index: 16
Although the concept of high-level containment care (HLCC or ‘biocontainment’), dates back to 1969, the 2014–2016 outbreak of Ebola virus disease (EVD) brought with it a renewed emphasis on the use of specialized HLCC units in the care of patients with EVD. Employment of these units in the United States and Western Europe resulted in a significant decrease in mortality compared to traditional management in field settings. Moreover, this employment appeared to significantly lessen the risk of nos...
Published on Jul 3, 2019in Journal of Nutrition4.42
Adam R. Aluisio6
Estimated H-index: 6
(Brown University),
Shiromi M. Perera (International Medical Corps)+ 11 AuthorsFoday Sahr12
Estimated H-index: 12
(University of Sierra Leone)
Published on Jul 1, 2019in Clinical Microbiology and Infection6.42
Amanda M. Rojeck5
Estimated H-index: 5
(University of Oxford),
Alex P. Salam5
Estimated H-index: 5
(University of Oxford)
+ 9 AuthorsLang’o Odondi2
Estimated H-index: 2
(University of Oxford)
Abstract Background Over 28,000 patients were infected with Ebola virus disease (EVD) during the west Africa (2013-16) epidemic, yet there has been criticism of the lack of robust clinical descriptions of illness from that outbreak. Objectives To perform a meta-analysis of published data from the epidemic in order to describe the clinical presentation, evolution of disease, and predictors of mortality in patients with EVD. To assess the quality and utility of published data for clinical and publ...
Published on Feb 1, 2019in Journal of Infection and Chemotherapy1.54
Naoya Sakamoto42
Estimated H-index: 42
,
Atsushi Kosaka + 4 AuthorsHiroshi Fujita1
Estimated H-index: 1
Abstract Background Ebola virus disease (EVD) was endemic to Africa in 2014–2016. Supportive therapies have been shown to improve the outcome of EVD, and additional supportive therapy including blood transfusion therapy and external circulation could be needed in the event of a future global outbreak. However, pre-transfusion testing policies and guidelines have not yet been established in Japan. Methods We conducted a cross-sectional study of blood transfusion therapy for EVD patients at three ...
View next paperClinical Illness and Outcomes in Patients with Ebola in Sierra Leone