Ebola outbreak in rural West Africa: epidemiology, clinical features and outcomes. Issue 4 (3rd February 2015)

• Record Type: Journal Article
• Authors: Dallatomasina, Silvia; Crestani, Rosa; Sylvester Squire, James; Declerk, Hilde; Caleo, Grazia Marta; Wolz, Anja; Stinson, Kathryn; Patten, Gabriela; Brechard, Raphael; Gbabai, Osman Bamba‐Moi; Spreicher, Armand; Van Herp, Michel; Zachariah, Rony
• Is Part Of: Tropical medicine & international health. Volume 20:Issue 4(2015:Apr.)
• Page Start: 448
• Page End: 454
• Publication Date: 2015-02-03
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12454
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12454-abs-0001"> <title>Abstract</title> <sec id="tmi12454-sec-0001" sec-type="section"> <title>Objective</title> <p>To describe Ebola cases in the district Ebola management centre of in Kailahun, a remote rural district of Sierra Leone, in terms of geographic origin, patient and hospitalisation characteristics, treatment outcomes and time from symptom onset to admission.</p> </sec> <sec id="tmi12454-sec-0002" sec-type="section"> <title>Methods</title> <p>Data of all Ebola cases from June 23rd to October 5th 2014 were reviewed. Ebola was confirmed by reverse‐transcriptase‐polymerase‐chain‐reaction assay.</p> </sec> <sec id="tmi12454-sec-0003" sec-type="section"> <title>Results</title> <p>Of 489 confirmed cases (51% male, median age 28 years), 166 (34%) originated outside Kailahun district. Twenty‐eight (6%) were health workers: 2 doctors, 11 nurses, 2 laboratory technicians, 7 community health workers and 6 other cadres. More than 50% of patients had fever, headache, abdominal pain, diarrhoea/vomiting. An unusual feature was cough in 40%. Unexplained bleeding was reported in 5%. Outcomes for the 489 confirmed cases were 227 (47%) discharges, 259 (53%) deaths and 3 transfers. Case fatality in health workers (68%) was higher than other occupations (52%, <italic>P </italic>=<italic> </italic>0.05). The median community infectivity time was 6.5 days for both general population and health workers (<italic>P </italic>=<italic> </italic>0.4).</p> </sec> <sec id="tmi12454-sec-0004" sec-type="section"> <title>Conclusions</title> <p>One in three admitted cases originated outside Kailahun district due to limited national access to Ebola management centres – complicating contact tracing, safe burial and disinfection measures. The comparatively high case fatality among health workers requires attention. The community infectivity time needs to be reduced to prevent continued transmission.</p> </sec> </abstract>