Health workers treating patients in Sierra Leone have published a detailed report on medical aspects of the Ebola epidemic that says young people have a lower fatality rate than adults.
The report, published online by the New England Journal of Medicine, was the work of physicans, nurses and others and others who reviewed available data on 106 patients diagnosed with Ebola virus disease at Kenema Government Hospital in Sierra Leone.
Among other things, the report shows the fatality rate was 57% for patients under age 21, compared to 94% for those over age 45.
Data on signs and symptoms in patients at the time of presentation were available for 44 of the 106 patients. Although the case count in this subset was low, common findings included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), sore throat (in 34%), vomiting (in 34%) and conjunctivitis (in 31%), according to the study.
Temperature was the only vital sign that correlated with survival, according to the study authors. The mean temperature at the time of admission was significantly higher among patients who died than among those who survived (37.5°C [99.5°F] vs. 35.9°C [96.6°F], P=0.001).
Weakness, dizziness and diarrhea were significantly associated with a fatal outcome. Among patients with diarrhea, 94% died, whereas only 65% of those without diarrhea on presentation died.
The study authors noted a positive correlation between the viral load and the risk of death. Patients who presented with fewer than 100,000 EBOV copies per milliliter of serum had a case fatality rate of 33%, whereas those with a viral load of 10 million EBOV copies per milliliter or more had a significantly higher case fatality rate of 94%, the authors wrote. Viral loads were quantified for a limited number of patients at multiple times during their hospitalization, with results suggesting that an inability to clear the virus was a risk factor for death, even though some patients with prolonged viremia survived.
Seven of the 47 study authors died six of them from Ebola and one from a stroke, according to a USA Today article. They included Sheik Humarr Khan, MD, a doctor who led Sierra Leones battle against Ebola until his death in July.
Read the full study: http://www.nejm.org/doi/full/10.1056/NEJMoa1411680#t=articleDiscussion