AddisonRose
On loan from Heaven
Interesting study on Ebola patient through the disease process and corresponding treatment. Full article here:
http://www.nejm.org/doi/full/10.1056/NEJMoa1411677?query=featured_home&#Top
Fair use applies.
(Snip)
Since December 2013, a Zaire ebolavirus (EBOV) epidemic of unprecedented scale has ravaged West Africa, with a focus on Guinea, Sierra Leone, and Liberia.1-4 The current epidemic has led to a public health emergency in the region, exacerbated by high rates of infection among health care personnel. A substantial number of fatal cases are among health care workers.2 Several international health care workers have been evacuated to specialized centers in Europe and the United States. The patient transferred to our isolation unit worked for the World Health Organization (WHO) as an epidemiologist in Sierra Leone and was airlifted at the request of the WHO. Brief descriptions of the unit for the treatment of highly contagious infections (UTHCI) and the measures of infection control, which were similar to those used in biosafety level 4 laboratories, are included in the Supplementary Appendix, available with the full text of this article at NEJM.org.
History and Findings on Admission
The 36-year-old male patient had malaise, headache, myalgias, and arthralgias on day 1 of the illness (August 18, 2014). Fever developed on day 2, and the patient was treated empirically for malaria. On days 2 through 6, he also received empirical antimicrobial therapy with ceftazidime. On day 6, he tested positive for EBOV on real-time reverse-transcriptase–PCR (RT-PCR) assay. Nausea, vomiting, abdominal pain, and nonbloody diarrhea developed on day 7, prompting his admission to a treatment center in Sierra Leone. Single doses of ciprofloxacin and metronidazole were administered on day 8, and supportive therapy with intravenous fluids was initiated and maintained until day 10, when he was transferred to Hamburg.
On the basis of the patient's history, the most likely source of infection was contact with a colleague who had had symptoms of EVD and died 10 days before the onset of symptoms in our patient. The patient and his colleague shared an office for meetings and used the same restroom facilities until 3 days before the colleague died.
(The rest of the article is at link.)
http://www.nejm.org/doi/full/10.1056/NEJMoa1411677?query=featured_home&#Top
Fair use applies.
(Snip)
Since December 2013, a Zaire ebolavirus (EBOV) epidemic of unprecedented scale has ravaged West Africa, with a focus on Guinea, Sierra Leone, and Liberia.1-4 The current epidemic has led to a public health emergency in the region, exacerbated by high rates of infection among health care personnel. A substantial number of fatal cases are among health care workers.2 Several international health care workers have been evacuated to specialized centers in Europe and the United States. The patient transferred to our isolation unit worked for the World Health Organization (WHO) as an epidemiologist in Sierra Leone and was airlifted at the request of the WHO. Brief descriptions of the unit for the treatment of highly contagious infections (UTHCI) and the measures of infection control, which were similar to those used in biosafety level 4 laboratories, are included in the Supplementary Appendix, available with the full text of this article at NEJM.org.
History and Findings on Admission
The 36-year-old male patient had malaise, headache, myalgias, and arthralgias on day 1 of the illness (August 18, 2014). Fever developed on day 2, and the patient was treated empirically for malaria. On days 2 through 6, he also received empirical antimicrobial therapy with ceftazidime. On day 6, he tested positive for EBOV on real-time reverse-transcriptase–PCR (RT-PCR) assay. Nausea, vomiting, abdominal pain, and nonbloody diarrhea developed on day 7, prompting his admission to a treatment center in Sierra Leone. Single doses of ciprofloxacin and metronidazole were administered on day 8, and supportive therapy with intravenous fluids was initiated and maintained until day 10, when he was transferred to Hamburg.
On the basis of the patient's history, the most likely source of infection was contact with a colleague who had had symptoms of EVD and died 10 days before the onset of symptoms in our patient. The patient and his colleague shared an office for meetings and used the same restroom facilities until 3 days before the colleague died.
(The rest of the article is at link.)