title: Clinical Chemistry of Patients With Ebola in Monrovia, Liberia.
abstract: The development of point-of-care clinical chemistry analyzers has enabled the implementation of these ancillary tests in field laboratories in resource-limited outbreak areas. The Eternal Love Winning Africa (ELWA) outbreak diagnostic laboratory, established in Monrovia, Liberia, to provide Ebola virus and Plasmodium spp. diagnostics during the Ebola epidemic, implemented clinical chemistry analyzers in December 2014. Clinical chemistry testing was performed for 68 patients in triage, including 12 patients infected with Ebola virus and 18 infected with Plasmodium spp. The main distinguishing feature in clinical chemistry of Ebola virus-infected patients was the elevation in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyltransferase levels and the decrease in calcium. The implementation of clinical chemistry is probably most helpful when the medical supportive care implemented at the Ebola treatment unit allows for correction of biochemistry derangements and on-site clinical chemistry analyzers can be used to monitor electrolyte balance.
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Emmie
authors.initials: E
authors.lastname: de Wit
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Shelby
authors.initials: S
authors.lastname: Kramer
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Joseph
authors.initials: J
authors.lastname: Prescott
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Kyle
authors.initials: K
authors.lastname: Rosenke
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Darryl
authors.initials: D
authors.lastname: Falzarano
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marzi
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fischer
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: David
authors.initials: D
authors.lastname: Safronetz
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoenen
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Allison
authors.initials: A
authors.lastname: Groseth
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Neeltje
authors.initials: N
authors.lastname: van Doremalen
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Trenton
authors.initials: T
authors.lastname: Bushmaker
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: McNally
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Friederike
authors.initials: F
authors.lastname: Feldmann
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Brandi N
authors.initials: BN
authors.lastname: Williamson
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Sonja M
authors.initials: SM
authors.lastname: Best
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ebihara
authors.affiliation: Médecins Sans Frontières, Operational Center of Brussels, Ixelles, Belgium.
authors.forename: Igor A C
authors.initials: IA
authors.lastname: Damiani
authors.affiliation: Médecins Sans Frontières, Operational Center of Brussels, Ixelles, Belgium.
authors.forename: Brett
authors.initials: B
authors.lastname: Adamson
authors.affiliation: Cytokine Biology Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Kathryn C
authors.initials: KC
authors.lastname: Zoon
authors.affiliation: Ministry of Health and Social Welfare/IMS, Greater Monrovia.
authors.forename: Tolbert G
authors.initials: TG
authors.lastname: Nyenswah
authors.affiliation: Liberian Institute for Biomedical Research, Charlesville.
authors.forename: Fatorma K
authors.initials: FK
authors.lastname: Bolay
authors.affiliation: Ministry of Health and Social Welfare/IMS, Greater Monrovia.
authors.forename: Moses
authors.initials: M
authors.lastname: Massaquoi
authors.affiliation: Médecins Sans Frontières, Operational Center of Brussels, Ixelles, Belgium.
authors.forename: Armand
authors.initials: A
authors.lastname: Sprecher
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Heinz
authors.initials: H
authors.lastname: Feldmann
authors.affiliation: Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Munster
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000032:analysis; D000469:Alkaline Phosphatase / Q000032:analysis; D001219:Aspartate Aminotransferases / Q000032:analysis; D002624:Chemistry, Clinical; D064790:Clinical Laboratory Services; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000276:immunology / Q000302:isolation & purification; D058872:Epidemics; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007988:Liberia / Q000453:epidemiology; D008111:Liver Function Tests; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D010961:Plasmodium / Q000302:isolation & purification / Q000378:metabolism; D019095:Point-of-Care Systems; D005723:gamma-Glutamyltransferase / Q000032:analysis
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase
keywords: Ebola virus; West Africa; clinical chemistry