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

• Main Authors: Yngvar Lunde Haaskjold, Håkon Angell Bolkan, Kurt Østhuus Krogh, James Jongopi, Karen Marie Lundeby, Sindre Mellesmo, Pedro San José Garcés, Ola Jøsendal, Åsmund Øpstad, Erling Svensen, Luis Matias Zabala Fuentes, Alfred Sandy Kamara, Melchor Riera, Javier Arranz, David P. Roberts, Paul D. Stamper, Paula Austin, Alfredo J. Moosa, Dennis Marke, Shoaib Hassan, Geir Egil Eide, Åse Berg, Bjørn Blomberg
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2016-09-01
• Series: Emerging Infectious Diseases
• Subjects: Ebola hemorrhagic fever; Ebola virus disease; neglected diseases; Sierra Leone; viruses; fatal disease
• Online Access: https://wwwnc.cdc.gov/eid/article/22/9/15-1621_article

The 2013–2016 outbreak of Ebola virus disease (EVD) in West Africa infected >28,000 people, including >11,000 who died, and disrupted social life in the region. We retrospectively studied clinical signs and symptoms and risk factors for fatal outcome among 31 Ebola virus–positive patients admitted to the Ebola Treatment Center in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the outbreak. Significant predictors for death were shorter time from symptom onset to admission, male sex, high viral load on initial laboratory testing, severe pain, diarrhea, bloody feces, and development of other bleeding manifestations during hospitalization. These risk factors for death could be used to identify patients in need of more intensive medical support. The lack of fever in as many as one third of EVD cases may have implications for temperature-screening practices and case definitions.