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Unexpected Ebola virus in a tertiary setting: clinical and epidemiologic aspects
G A Richards1, S Murphy, R Jobson
1Department of Pulmonology and Critical Care, Johannesburg Hospital, and University of the Witwatersrand, South Africa.
Objectives:
To describe the clinical manifestations of viral hemorrhagic fever, and to increase clinicians' awareness and knowledge of these illnesses.
Design:
Retrospective study of the clinical and laboratory data and management of two cases of Ebola virus infection with key epidemiologic data provided.
Setting:
Two tertiary care hospitals.
Patients:
Two adult patients, the index case and the source patient, both identified as having Ebola, one of whom originated in Gabon.
Interventions:
One patient was admitted to the intensive care unit. The other was managed in a general ward.
Measurement And Main Results:
Clinical and laboratory data are reported. One patient, a healthcare worker who contracted this illness in the course of her work, died of refractory thrombocytopenia and an intracerebral bleed. The source patient survived. Despite a long period during which the diagnosis was obscure, none of the other 300 contacts contracted the illness.
Conclusions:
Identification of high-risk patients and use of universal blood and body fluid precautions will considerably decrease the risk of nosocomial spread of viral hemorrhagic fevers.