Ebola Virus Disease, Democratic Republic of the Congo, 2014

• Published in: Emerging infectious diseases Vol. 22; no. 9; pp. 1579 - 1586
• Main Authors: Nanclares, Carolina, Kapetshi, Jimmy, Lionetto, Fanshen, de la Rosa, Olimpia, Tamfun, Jean-Jacques Muyembe, Alia, Miriam, Kobinger, Gary, Bernasconi, Andrea
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.09.2016; Centers for Disease Control and Prevention
• Subjects: Adolescent; Adult; Aged; Analysis; Care and treatment; Child; Child, Preschool; Democratic Republic of the Congo; Democratic Republic of the Congo - epidemiology; Diarrhea; Disease Outbreaks; Ebola virus; Ebola virus disease; Ebola Virus Disease, Democratic Republic of the Congo, 2014; Ebola virus infections; Ebolavirus - classification; Ebolavirus - genetics; Female; Hemorrhagic Fever, Ebola - epidemiology; Hemorrhagic Fever, Ebola - history; Hemorrhagic Fever, Ebola - mortality; Hemorrhagic Fever, Ebola - virology; History, 21st Century; Humans; Infant; Kaplan-Meier Estimate; Male; Medical research; Medicine, Experimental; Middle Aged; PCR; polymerase chain reaction; Proportional Hazards Models; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral; viruses; Young Adult; Congo (Kinshasa); Uganda; viruses; disease outbreaks; Democratic Republic of the Congo; PCR; polymerase chain reaction; Ebola virus disease
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2209.160354

During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.