scholarly journals 2311. Bacteremia Is Not Commonly Detected in Ebola Virus Disease

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S792-S792
Author(s):  
Matthew J Matson ◽  
Moses Massaquoi ◽  
Armand Sprecher ◽  
Ruggero Giuliani ◽  
Jeffrey K Edwards ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Treatment Guidelines ◽  
Virus Disease ◽  
Current Treatment ◽  
Ebola Virus Disease ◽  
Coagulase Negative Staphylococci ◽  
Treatment Unit ◽  
Blood Samples ◽  
16S Sequencing ◽  
Low Culture

Abstract Background Rates of bacteremia in Ebola virus disease (EVD) are not currently known. Given the potential for secondary bacterial infection during acute EVD, current treatment guidelines recommend empiric use of broad-spectrum antibiotics. We sought to determine rates of bacteremia among patients evaluated for EVD at the ELWA-3 Ebola Treatment Unit in Monrovia, Liberia during the 2013–16 West Africa epidemic. Methods Deidentified blood samples and matched clinical data from 235 Ebola virus (EBOV)-positive patients and 102 EBOV-negative patients were evaluated under a University of Liberia Pacific Institute for Research and Evaluation IRB-approved protocol. 0.2 mL aliquots of frozen whole blood samples collected at triage, prior to the administration of antibiotics, were inoculated into BD BACTEC Peds Plus bottles and incubated under aerobic conditions in a BD BACTEC FX40 for 5 days in the National Institute of Allergy and Infectious Disease Biosafety Level 4 laboratory in Hamilton, MT. Positive samples were sub-cultured on nonselective sheep blood agar and chocolate agar and pure colonies were selected for identification by 16S sequencing and by matrix assisted laser desorption ionization time-of-flight mass spectrometry. Results No difference in rates of bacteremia was detected among EBOV-positive vs. EBOV-negative patients – 3.8% and 3.9%, respectively. Predominant isolates included Staphylococcus epidermidis and other coagulase-negative staphylococci, thought consistent with contaminants. Pathogenic species included Staphylococcus aureus and possibly Paenibacillus spp. Conclusion These data suggest that bacteremia does not commonly complicate EVD. However, as both prolonged sample storage and low culture volume may negatively affect sensitivity, additional molecular analyses are needed to support this conclusion. The Intramural Research Program of the National Institutes of Health supported this work. Disclosures All authors: No reported disclosures.

Bacterial co-infection is rare in patients with Ebola virus disease in a military Ebola virus disease treatment unit in Sierra Leone

2015 ◽  
Vol 71 (3) ◽  
pp. 406-407 ◽  
Author(s):  
Lucy Lamb ◽  
Jack Robson ◽  
Christian Ardley ◽  
Mark Bailey ◽  
Stuart Dickson ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Disease Treatment ◽  
Treatment Unit

scholarly journals Clinical Evaluation of QuickNaviTM-Ebola in the 2018 Outbreak of Ebola Virus Disease in the Democratic Republic of the Congo

Viruses ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 589 ◽  
Author(s):  
Sheila Makiala ◽  
Daniel Mukadi ◽  
Anja De Weggheleire ◽  
Shino Muramatsu ◽  
Daisuke Kato ◽  
...  
Keyword(s):  
West Africa ◽  
Diagnostic Tests ◽  
Ebola Virus ◽  
Democratic Republic ◽  
Virus Disease ◽  
Point Of Care ◽  
Rapid Diagnostic Tests ◽  
Ebola Virus Disease ◽  
Blood Samples ◽  
Republic Of The Congo

The recent large outbreaks of Ebola virus disease (EVD) in West Africa and the Democratic Republic of the Congo (DRC) have highlighted the need for rapid diagnostic tests to control this disease. In this study, we clinically evaluated a previously developed immunochromatography-based kit, QuickNaviTM-Ebola. During the 2018 outbreaks in DRC, 928 blood samples from EVD-suspected cases were tested with QuickNaviTM-Ebola and the WHO-approved GeneXpert. The sensitivity and specificity of QuickNaviTM-Ebola, estimated by comparing it to GeneXpert-confirmed cases, were 85% (68/80) and 99.8% (846/848), respectively. These results indicate the practical reliability of QuickNaviTM-Ebola for point-of-care diagnosis of EVD.

scholarly journals Post-Ebola Syndrome among Ebola Virus Disease Survivors in Montserrado County, Liberia 2016

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Himiede W. Wilson ◽  
Maame Amo-Addae ◽  
Ernest Kenu ◽  
Olayinka Stephen Ilesanmi ◽  
Donne K. Ameme ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Psychological Symptoms ◽  
Virus Disease ◽  
Clinical Care ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Ebola Virus Disease ◽  
Cross Sectional ◽  
Treatment Unit ◽  
Health History

Introduction. An increased number of survivors have emerged from the 2014 West African Ebola Virus Disease (EVD) epidemic. Post-Ebola Syndrome (PES) is a group of physical and psychological symptoms affecting EVD survivors. This study aimed to estimate the prevalence of PES among EVD survivors in Montserrado County, Liberia. Method. A cross-sectional study design was conducted to determine the prevalence of PES, types, onset, and duration among survivors. Survivors in Montserrado County were recruited using multistage sampling methods. Quantitative data was collected using semistructured questionnaire. Variables were collected on EVD survivors demographics, pre- and post-Ebola health history. Result. Prevalence of Post-Ebola Syndrome was estimated to be 90% (242/268). PES was experienced by 67% (162/242) females. PES occurred mainly in the adult population between ages 25-34, 35% (84/242). The commonest symptoms were reported from the following systems of the human body: neurological system (eyes problem, headache, sleep disorder, and unusual tiredness) and musculoskeletal system (abdominal pain, chest pain, and joints pains). The onset of PES occurred between the first 1-12 weeks after being discharged from a treatment unit. Conclusion. Prevalence of PES is high. Clinical care for survivors should be strengthened.

scholarly journals Deep Sequencing of RNA from Blood and Oral Swab Samples Reveals the Presence of Nucleic Acid from a Number of Pathogens in Patients with Acute Ebola Virus Disease and Is Consistent with Bacterial Translocation across the Gut

mSphere ◽  
2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Miles W. Carroll ◽  
Sam Haldenby ◽  
Natasha Y. Rickett ◽  
Bernadett Pályi ◽  
Isabel Garcia-Dorival ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Acute Phase ◽  
Bacterial Translocation ◽  
Ebola Virus ◽  
Virus Disease ◽  
Adverse Outcomes ◽  
Ebola Virus Disease ◽  
Resource Poor Setting ◽  
Rna Seq ◽  
Blood Samples

ABSTRACT In this study, samples from the 2013–2016 West African Ebola virus outbreak from patients in Guinea with Ebola virus disease (EVD) were analyzed to discover and classify what other pathogens were present. Throat swabs were taken from deceased EVD patients, and peripheral blood samples were analyzed that had been taken from patients when they presented at the treatment center with acute illness. High-throughput RNA sequencing (RNA-seq) and bioinformatics were used to identify the potential microorganisms. This approach confirmed Ebola virus (EBOV) in all samples from patients diagnosed as acute positive for the virus by quantitative reverse transcription-PCR in deployed field laboratories. Nucleic acid mapping to Plasmodium was also used on the patient samples, confirming results obtained with an antigen-based rapid diagnostic test (RDT) conducted in the field laboratories. The data suggested that a high Plasmodium load, as determined by sequence read depth, was associated with mortality and influenced the host response, whereas a lower parasite load did not appear to affect outcome. The identifications of selected bacteria from throat swabs via RNA-seq were confirmed by culture. The data indicated that the potential pathogens identified in the blood samples were associated with translocation from the gut, suggesting the presence of bacteremia, which transcriptome data suggested may induce or aggravate the acute-phase response observed during EVD. Transcripts mapping to different viruses were also identified, including those indicative of lytic infections. The development of high-resolution analysis of samples from patients with EVD will help inform care pathways and the most appropriate general antimicrobial therapy to be used in a resource-poor setting. IMPORTANCE Our results highlight the identification of an array of pathogens in the blood of patients with Ebola virus disease (EVD). This has not been done before, and the data have important implications for the treatment of patients with EVD, particularly considering antibiotic stewardship. We show that EVD patients who were also infected with Plasmodium, particularly at higher loads, had more adverse outcomes than patients with lower levels of Plasmodium. However, the presence of Plasmodium did not influence the innate immune response, and it is likely that the presence of EBOV dominated this response. Several viruses other than EBOV were identified, and bacteria associated with sepsis were also identified. These findings were indicative of bacterial translocation across the gut during the acute phase of EVD.

scholarly journals Essential Medications for Patients With Suspected or Confirmed Ebola Virus Disease in Resource-Limited Environments

2017 ◽  
Vol 182 (9-10) ◽  
pp. e2006-e2016 ◽  
Author(s):  
William F. Pierce ◽  
Selena D. Ready ◽  
John Tyson Chapman ◽  
Corrinne Kulick ◽  
Anastasia Shields ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
World Health ◽  
Clinical Environment ◽  
Treatment Unit ◽  
Resource Limited ◽  
Pharmacy Dispensing Data ◽  
Dispensing Data ◽  
The U.S

ABSTRACT Background: In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services. From November 12, 2014, to April 30, 2015, 42 patients (18 confirmed Ebola virus disease [EVD] and 24 suspected EVD) from nine countries were treated by USPHS providers at the MMU. The medications used in the MMU were primarily procured from the EMEDS 25-bed pharmacy cache. However, specific formulary additions were made for treatment of EVD. Methods: Using the MMU pharmacy dispensing data, we compared and contrasted the medications used in the MMU with recommendations in published EVD treatment guidelines for austere settings. Findings: After comparing and contrasting the MMU pharmacy dispensing data with publications with EVD medication recommendations applicable to resource-limited settings, 101 medications were included in the USPHS Essential Medications for the Management of EVD List (EML) for an austere, isolated clinical environment. Discussion/impact/recommendations: Because Ebola outbreaks often occur in remote areas, proactive planning, improved preparedness, and optimal patient care for EVD are needed, especially in the context of austere environments with a scarcity of resources. We developed the EML to assist in the planning for future Ebola outbreaks in a remote clinical environment and to provide a list of medications that have been used in an ETU. The EML is a comprehensive medication list that builds on the existing publications with EVD treatment recommendations applicable to supply-constrained clinical environments. As well, it is a resource for the provision of medications when evaluating donations, procurement, and may help inform estimates for product inventory requirements for an ETU. We hope the EML will improve readiness and enhance the capabilities of local and regional international responders.

scholarly journals Rapid establishment of a frontline field laboratory in response to an imported outbreak of Ebola virus disease in western Uganda, June 2019

2021 ◽  
Vol 15 (12) ◽  
pp. e0009967
Author(s):  
Amy J. Schuh ◽  
Jackson Kyondo ◽  
James Graziano ◽  
Stephen Balinandi ◽  
Markus H. Kainulainen ◽  
...  
Keyword(s):  
United States ◽  
General Hospital ◽  
Ebola Virus ◽  
Virus Disease ◽  
Hemorrhagic Fever ◽  
The United States ◽  
Ebola Virus Disease ◽  
World Health ◽  
Treatment Unit ◽  
Field Laboratory

The Democratic Republic of the Congo (DRC) declared an Ebola virus disease (EVD) outbreak in North Kivu in August 2018. By June 2019, the outbreak had spread to 26 health zones in northeastern DRC, causing >2,000 reported cases and >1,000 deaths. On June 10, 2019, three members of a Congolese family with EVD-like symptoms traveled to western Uganda’s Kasese District to seek medical care. Shortly thereafter, the Viral Hemorrhagic Fever Surveillance and Laboratory Program (VHF program) at the Uganda Virus Research Institute (UVRI) confirmed that all three patients had EVD. The Ugandan Ministry of Health declared an outbreak of EVD in Uganda’s Kasese District, notified the World Health Organization, and initiated a rapid response to contain the outbreak. As part of this response, UVRI and the United States Centers for Disease Control and Prevention, with the support of Uganda’s Public Health Emergency Operations Center, the Kasese District Health Team, the Superintendent of Bwera General Hospital, the United States Department of Defense’s Makerere University Walter Reed Project, and the United States Mission to Kampala’s Global Health Security Technical Working Group, jointly established an Ebola Field Laboratory in Kasese District at Bwera General Hospital, proximal to an Ebola Treatment Unit (ETU). The laboratory consisted of a rapid containment kit for viral inactivation of patient specimens and a GeneXpert Instrument for performing Xpert Ebola assays. Laboratory staff tested 76 specimens from alert and suspect cases of EVD; the majority were admitted to the ETU (89.3%) and reported recent travel to the DRC (58.9%). Although no EVD cases were detected by the field laboratory, it played an important role in patient management and epidemiological surveillance by providing diagnostic results in <3 hours. The integration of the field laboratory into Uganda’s National VHF Program also enabled patient specimens to be referred to Entebbe for confirmatory EBOV testing and testing for other hemorrhagic fever viruses that circulate in Uganda.

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