Clinical presentation of patients with Ebola virus disease in Conakry, Guinea.
BACKGROUND
In March 2014, the World Health Organization was notified of an outbreak of Zaire ebolavirus in a remote area of Guinea. The outbreak then spread to the capital, Conakry, and to neighboring countries and has subsequently become the largest epidemic of Ebola virus disease (EVD) to date.


METHODS
From March 25 to April 26, 2014, we performed a study of all patients with laboratory-confirmed EVD in Conakry. Mortality was the primary outcome. Secondary outcomes included patient characteristics, complications, treatments, and comparisons between survivors and nonsurvivors.


RESULTS
Of 80 patients who presented with symptoms, 37 had laboratory-confirmed EVD. Among confirmed cases, the median age was 38 years (interquartile range, 28 to 46), 24 patients (65%) were men, and 14 (38%) were health care workers; among the health care workers, nosocomial transmission was implicated in 12 patients (32%). Patients with confirmed EVD presented to the hospital a median of 5 days (interquartile range, 3 to 7) after the onset of symptoms, most commonly with fever (in 84% of the patients; mean temperature, 38.6°C), fatigue (in 65%), diarrhea (in 62%), and tachycardia (mean heart rate, >93 beats per minute). Of these patients, 28 (76%) were treated with intravenous fluids and 37 (100%) with antibiotics. Sixteen patients (43%) died, with a median time from symptom onset to death of 8 days (interquartile range, 7 to 11). Patients who were 40 years of age or older, as compared with those under the age of 40 years, had a relative risk of death of 3.49 (95% confidence interval, 1.42 to 8.59; P=0.007).


CONCLUSIONS
Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea. Despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.
The authors' affiliations are listed in the Appendix.
Elhadj Ibrahima
EI
Bah
Marie-Claire
MC
Lamah
Tom
T
Fletcher
Shevin T
ST
Jacob
David M
DM
Brett-Major
Amadou Alpha
AA
Sall
Nahoko
N
Shindo
William A
WA
Fischer
Francois
F
Lamontagne
Sow Mamadou
SM
Saliou
Daniel G
DG
Bausch
Barry
B
Moumié
Tim
T
Jagatic
Armand
A
Sprecher
James V
JV
Lawler
Thierry
T
Mayet
Frederique A
FA
Jacquerioz
María F
MF
Méndez Baggi
Constanza
C
Vallenas
Christophe
C
Clement
Simon
S
Mardel
Ousmane
O
Faye
Oumar
O
Faye
Baré
B
Soropogui
Nfaly
N
Magassouba
Lamine
L
Koivogui
Ruxandra
R
Pinto
Robert A
RA
Fowler
D000328:Adult; D000367:Age Factors; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003681:Dehydration / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology; D029043:Ebolavirus; D058872:Epidemics; D005260:Female; D005334:Fever / Q000209:etiology; D005440:Fluid Therapy; D016701:Guinea / Q000453:epidemiology; D019142:Hemorrhagic Fever, Ebola / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012306:Risk; D015996:Survival Rate; D013610:Tachycardia / Q000209:etiology; D014839:Vomiting / Q000209:etiology
D000890:Anti-Infective Agents