title: [Ebola virus disease in West Africa and Germany : clinical presentation, management and practical experience with medevacuated patients in Germany].
abstract: Ebolaviruses are the causative pathogens of a severe form of viral haemorrhagic fever with cytokine induced shock and multi-organ failure and a high case fatality rate in humans (50-90 %, more than 70 % in the beginning of the current outbreak), designated Ebola haemorrhagic fever or Ebola virus disease (EVD). Ebola is endemic in regions of Central and West Africa. Ebolavirus Zaire (EBOV) is the most aggressive Ebola virus species and is causing the current epidemic. Currently, beginning in late 2013, an unprecedented epidemic with several thousand cases and deaths (as per WHO report 24.12.2014: 19,497 documented cases, 7588 death, 2352 cases in past 3 weeks) is unfolding in Guinea, Liberia and Sierra Leone, and spreading to other countries in Africa, Europe and the USA, where isolated cases have occurred. Ebola transmission occurs exclusively through direct contact with body fluids through mucosal surfaces, skin abrasions, or by parenteral introduction-an aerolised transmission has not been reported so far. Infections in healthcare personnel have not only occurred after needle stick injuries but also after unsafe doffing procedures of personal protection equipment (PPE). The protection of healthcare personnel caring for Ebola patients, therefore, requires that high standards in the use of PPE are mandatory. In high-income countries the management and treatment of EVD patients in specialized centres is recommended. Using negative pressure rooms and positive pressure suits may provide additional safety. Due to the high degree of training and monitoring needed to prevent occupational risks, treatment of EVD patients in non-specialized hospitals should not take place.
authors.affiliation: Bernhard-Nocht-Klinik für Tropenmedizin, I. Medizinische Klinik und Poliklinik & Ambulanzzentrum Infektiologie, Universitätsklinikum Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland, s.schmiedel@uke.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schmiedel
authors.forename: B
authors.initials: B
authors.lastname: Kreuels
mesh_terms: D000354:Africa, Western; D019091:Critical Pathways / Q000458:organization & administration*; D005858:Germany; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000628:therapy*; D055819:Hospitals, Isolation / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D010356:Patient Isolation / Q000458:organization & administration*; D010357:Patient Isolators; D014187:Transportation of Patients / Q000458:organization & administration*