Clinical Features of Patients With Ebola Virus Disease in Sierra Leone

Clinical and laboratory data available on patients with Ebola virus disease (EVD) remain extremely limited. We summarized the clinical characteristics of patients with EVD and analyzed the factors related to their death.

Patients admitted for care at the Freetown China-Sierra Leone Friendship Hospital during 1 October-14 November 2014 were enrolled in this study. The clinical data of these patients were retrospectively analyzed.

Sixty-one patients were confirmed to have EVD; 28 of them (45.9%) were male and 33 (54.1%) were female. Their median age was 28 years (range, 1.17-67 years). The median duration from symptom onset to clinic visit time was 5 days (range, 1-16 days). Among these patients, 42 of them (68.9%) died. Of the confirmed cases, 18.0% did not present with fever. Patients aged >30 years had a higher fatality rate than those <30 years (87.0% vs 57.9%; P = .0175). The mean duration from symptom onset to clinic presentation of the survivors (4.57 ± 2.79 days) was shorter than that of the nonsurvivors (6.34 ± 3.33 days). Clinical factors associated with a fatal outcome included weakness, extreme fatigue, vomiting, diarrhea, mental symptoms, bleeding, and loss of appetite. No statistical difference in the case fatality rate between males and females was found (P = .2061).

The mortality of patients with EVD was closely associated with age and duration from symptom onset to presentation for care. Patients with EVD identified in the current outbreak did not necessarily have fever. Early diagnosis of the disease and timely symptomatic treatment may greatly contribute to the reduction of fatality rate of patients with EVD.