1/9. Unexpected Ebola virus in a tertiary setting: clinical and epidemiologic aspects.OBJECTIVES: To describe the clinical manifestations of viral hemorrhagic fever, and to increase clinicians' awareness and knowledge of these illnesses. DESIGN: Retrospective study of the clinical and laboratory data and management of two cases of Ebola virus infection with key epidemiologic data provided. SETTING: Two tertiary care hospitals. patients: Two adult patients, the index case and the source patient, both identified as having Ebola, one of whom originated in gabon. INTERVENTIONS: One patient was admitted to the intensive care unit. The other was managed in a general ward. MEASUREMENT AND MAIN RESULTS: Clinical and laboratory data are reported. One patient, a healthcare worker who contracted this illness in the course of her work, died of refractory thrombocytopenia and an intracerebral bleed. The source patient survived. Despite a long period during which the diagnosis was obscure, none of the other 300 contacts contracted the illness. CONCLUSIONS: Identification of high-risk patients and use of universal blood and body fluid precautions will considerably decrease the risk of nosocomial spread of viral hemorrhagic fevers.- - - - - - - - - - ranking = 1keywords = fever, virus (Clic here for more details about this article) |
2/9. The outbreak and control of Ebola viral haemorrhagic fever in a Ugandan medical school.uganda has just experienced the largest outbreak of Ebola haemorrhagic fever (EHF) ever recorded. Mbarara University teaching Hospital (MUTH) is responsible for training approximately one-third of uganda's doctors. Mbarara is located in SouthWest uganda, 614 km from Gulu, the main epicentre of the outbreak. On 23 October a patient was admitted to the medical ward of MUTH with an acute fever. He soon exhibited haemorrhagic symptoms and died. He was later confirmed to have suffered Ebola. Three more patients subsequently contracted the disease. All died. There were no further cases in Mbarara. No members of staff or medical student was infected. We give details of the clinical features of those patients who contracted the disease, the setting up of an Ebola isolation unit, the case surveillance and the search for the source of the outbreak. The implications for similar institutions in East africa are discussed.- - - - - - - - - - ranking = 5914.1477148263keywords = haemorrhagic fever, fever (Clic here for more details about this article) |
3/9. Ebola haemorrhagic fever.This article focuses on the management of a patient who was admitted to The Aga Khan Hospital in Dar es Salaam, tanzania, with suspected Ebola haemorrhagic fever (Ebola HF). It defines the disease, symptoms and how it is spread, diagnosed, treated and prevented. Recommendations are made for management of Ebola HF in a hospital setting.- - - - - - - - - - ranking = 5913.955569093keywords = haemorrhagic fever, fever (Clic here for more details about this article) |
4/9. Late ophthalmologic manifestations in survivors of the 1995 Ebola virus epidemic in Kikwit, democratic republic of the congo.Three (15%) of 20 survivors of the 1995 Ebola outbreak in the democratic republic of the congo enrolled in a follow-up study and 1 other survivor developed ocular manifestations after being asymptomatic for 1 month. patients complained of ocular pain, photophobia, hyperlacrimation, and loss of visual acuity. Ocular examination revealed uveitis in all 4 patients. All patients improved with a topical treatment of 1% atropine and steroids.- - - - - - - - - - ranking = 0.49256682659328keywords = virus (Clic here for more details about this article) |
5/9. Isolated case of Ebola hemorrhagic fever with mucormycosis complications, Kinshasa, democratic republic of the congo.A patient with undiagnosed Ebola (EBO) hemorrhagic fever (EHF) was transferred from Kikwit to a private clinic in Kinshasa, democratic republic of the congo. A diagnosis of EHF was suspected on clinical grounds and was confirmed by detection of EBO virus-specific IgM and IgG in serum of the patient. During the course of the disease, although she had no known predisposing factors, the patient developed a periorbital mucormycosis abscess on eyelid tissue that was biopsied during surgical drainage; the abscess was histologically confirmed. Presence of EBO antigen was also detected by specific immunohistochemistry on the biopsied tissue. The patient survived the EBO infection but had severe sequelae associated with the mucormycosis. Standard barrier-nursing precautions were taken upon admission and upgraded when EHF was suspected; there was no secondary transmission of the disease.- - - - - - - - - - ranking = 1.0838703735443keywords = fever, virus (Clic here for more details about this article) |
6/9. Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee.Between 6 and 22 June 1995, 8 patients in Kikwit, democratic republic of the congo, who met the case definition used in Kikwit for Ebola (EBO) hemorrhagic fever, were transfused with blood donated by 5 convalescent patients. The donated blood contained IgG EBO antibodies but no EBO antigen. EBO antigens were detected in all the transfusion recipients just before transfusion. The 8 transfused patients had clinical symptoms similar to those of other EBO patients seen during the epidemic. All were seriously ill with severe asthenia, 4 presented with hemorrhagic manifestations, and 2 became comatose as their disease progressed. Only 1 transfused patient (12.5%) died; this number is significantly lower than the overall case fatality rate (80%) for the EBO epidemic in Kikwit and than the rates for other EBO epidemics. The reason for this low fatality rate remains to be explained. The transfused patients did receive better care than those in the initial phase of the epidemic. Plans should be made to prepare for a more thorough evaluation of passive immune therapy during a new EBO outbreak.- - - - - - - - - - ranking = 0.96072866689599keywords = fever (Clic here for more details about this article) |
7/9. Human infection due to Ebola virus, subtype cote d'ivoire: clinical and biologic presentation.In November 1994 after 15 years of epidemiologic silence, Ebola virus reemerged in africa and, for the first time, in West africa. In cote d'ivoire, a 34-year-old female ethologist was infected while conducting a necropsy on a wild chimpanzee. Eight days later, the patient developed a syndrome that did not respond to antimalarial drugs and was characterized by high fever, headache, chills, myalgia, and cough. The patient had abdominal pain, diarrhea, vomiting, and a macular rash, and was repatriated to switzerland. The patient suffered from prostration and weight loss but recovered without sequelae. Laboratory findings included aspartate aminotransferase and alanine aminotransferase activity highly elevated, thrombocytopenia, lymphopenia, and, subsequently, neutrophilia. A new subtype of Ebola was isolated from the patient's blood on days 4 and 8. No serologic conversion was detected among contact persons in cote d'ivoire (n = 22) or switzerland (n = 52), suggesting that infection-control precautions were satisfactory.- - - - - - - - - - ranking = 0.8078542666208keywords = fever, virus (Clic here for more details about this article) |
8/9. The reemergence of Ebola hemorrhagic fever, democratic republic of the congo, 1995. Commission de Lutte contre les Epidemies a Kikwit.In May 1995, an international team characterized and contained an outbreak of Ebola hemorrhagic fever (EHF) in Kikwit, democratic republic of the congo. Active surveillance was instituted using several methods, including house-to-house search, review of hospital and dispensary logs, interview of health care personnel, retrospective contact tracing, and direct follow-up of suspect cases. In the field, a clinical case was defined as fever and hemorrhagic signs, fever plus contact with a case-patient, or fever plus at least 3 of 10 symptoms. A total of 315 cases of EHF, with an 81% case fatality, were identified, excluding 10 clinical cases with negative laboratory results. The earliest documented case-patient had onset on 6 January, and the last case-patient died on 16 July. Eighty cases (25%) occurred among health care workers. Two individuals may have been the source of infection for >50 cases. The outbreak was terminated by the initiation of barrier-nursing techniques, health education efforts, and rapid identification of cases.- - - - - - - - - - ranking = 1.5371658670336keywords = fever (Clic here for more details about this article) |
9/9. Field investigations of an outbreak of Ebola hemorrhagic fever, Kikwit, democratic republic of the congo, 1995: arthropod studies.During the final weeks of a 6-month epidemic of Ebola hemorrhagic fever in Kikwit, democratic republic of the congo, an extensive collection of arthropods was made in an attempt to learn more of the natural history of the disease. A reconstruction of the activities of the likely primary case, a 42-year-old man who lived in the city, indicated that he probably acquired his infection in a partly forested area 15 km from his home. collections were made throughout this area, along the route he followed from the city, and at various sites in the city itself. No Ebola virus was isolated, but a description of the collections and the ecotopes involved is given for comparison with future studies of other outbreaks.- - - - - - - - - - ranking = 1.0838703735443keywords = fever, virus (Clic here for more details about this article) |