title: The etiology of Ebola virus disease-like illnesses in Ebola virusnegative patients from Sierra Leone.
abstract: During the 2014 Ebola virus disease (EVD) outbreak, less than half of EVD-suspected cases were laboratory tested as Ebola virus (EBOV)-negative, but disease identity remained unknown. In this study we investigated the etiology of EVD-like illnesses in EBOV-negative cases. From November 13, 2014 to March 16, 2015, EVD-suspected patients were admitted to Jui Government Hospital and assessed for EBOV infection by real-time PCR. Of 278 EBOV negative patients, 223 (80.21%), 142 (51.08%), 123 (44.24%), 114 (41.01%), 59 (21.22%), 35 (12.59%), and 12 (4.32%) reported fever, headache, joint pain, fatigue, nausea/vomiting, diarrhea, hemorrhage, respectively. Furthermore, 121 (43.52%), 44 (15.83%), 36 (12.95%), 33 (11.87%), 23 (8.27%), 10 (3.60%) patients were diagnosed as infection with malaria, HIV, Lassa fever, tuberculosis, yellow fever, and pneumonia, respectively. No significant differences in clinical features and symptoms were found between non-EVD and EVD patients. To the best of our knowledge, the present study is the first to explore the etiology of EVD-like illnesses in uninfected patients in Sierra Leone, highlighting the importance of accurate diagnosis to EVD confirmation.
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Wen-Gang
authors.initials: WG
authors.lastname: Li
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Chen
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Dong
authors.initials: D
authors.lastname: Ji
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Ying-Jie
authors.initials: YJ
authors.lastname: Ji
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Gao
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Li-Fu
authors.initials: LF
authors.lastname: Wang
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Xue-Zhang
authors.initials: XZ
authors.lastname: Duan
authors.affiliation: Military Hospital of PLA, Beijing, China.|Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone.
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000302:isolation & purification*; D005221:Fatigue / Q000209:etiology; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000209:etiology*; D006678:HIV / Q000302:isolation & purification; D006261:Headache / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology*; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007836:Lassa virus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009325:Nausea / Q000209:etiology; D010965:Plasmodium malariae / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D012807:Sierra Leone / Q000453:epidemiology; D014839:Vomiting / Q000209:etiology; D015005:Yellow fever virus / Q000302:isolation & purification; D055815:Young Adult
keywords: EVD-suspected cases; Ebola virus disease (EVD); HIV; Lassa fever; malaria