title: Unexpected Ebola virus in a tertiary setting: clinical and epidemiologic aspects.
abstract: OBJECTIVE
  To describe the clinical manifestations of viral hemorrhagic fever, and to increase clinicians' awareness and knowledge of these illnesses.
  
  
  METHODS
  Retrospective study of the clinical and laboratory data and management of two cases of Ebola virus infection with key epidemiologic data provided.
  
  
  METHODS
  Two tertiary care hospitals.
  
  
  METHODS
  Two adult patients, the index case and the source patient, both identified as having Ebola, one of whom originated in Gabon.
  
  
  METHODS
  One patient was admitted to the intensive care unit. The other was managed in a general ward.
  
  
  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.
authors.affiliation: Department of Pulmonology and Critical Care, Johannesburg Hospital, and University of the Witwatersrand, South Africa.
authors.forename: G A
authors.initials: GA
authors.lastname: Richards
authors.forename: S
authors.initials: S
authors.lastname: Murphy
authors.forename: R
authors.initials: R
authors.lastname: Jobson
authors.forename: M
authors.initials: M
authors.lastname: Mer
authors.forename: C
authors.initials: C
authors.lastname: Zinman
authors.forename: R
authors.initials: R
authors.lastname: Taylor
authors.forename: R
authors.initials: R
authors.lastname: Swanepoel
authors.forename: A
authors.initials: A
authors.lastname: Duse
authors.forename: G
authors.initials: G
authors.lastname: Sharp
authors.forename: I C
authors.initials: IC
authors.lastname: De La Rey
authors.forename: C
authors.initials: C
authors.lastname: Kassianides
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000517:prevention & control*; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000145:classification / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology