Published in:
01-11-2014 | What's New in Intensive Care
Does this patient have Ebola virus disease?
Authors:
Pierre Tattevin, Emanuele Durante-Mangoni, Moses Massaquoi
Published in:
Intensive Care Medicine
|
Issue 11/2014
Login to get access
Excerpt
Ebola virus is one of the most virulent human pathogens. Since 1976, Ebola virus disease (EVD) has caused more than 20 outbreaks in Africa, with case fatality rates of 30–90 % in the absence of any approved treatment or vaccination [
1]. It is transmitted by direct contact through broken skin or mucous membranes with blood, urine, saliva, faeces, vomit, and other body fluids of symptomatic infected patients or convalescent persons, or through contaminated needle sticks [
1,
2]. The current outbreak in West Africa probably began in December 2013 in Guinea [
3], and is causing unprecedented concerns for the following reasons: (1) it is due to a strain with 97 % homology with
Zaire ebolavirus, the most virulent species, with prior fatality rates as high as 90 %; (2) as of August 22, 2014, four countries have been involved, with 2,615 suspected cases, 1,528 laboratory-confirmed cases, and 1,427 related deaths, which is already many more than the largest epidemic reported to date (425 cases in Uganda, 2000–2001), and the situation is unlikely to be resolved soon [
4,
5]; (3) the 2014 West Africa outbreak affects rural as well as urban areas, and recently reached the most populous African country (Nigeria); and (4) experienced governmental and non-governmental organizations, including Médecins Sans Frontières, have been active on the field since March 2014 [
3], but have failed to control the epidemic. …