Clinical illness and outcomes in patients with Ebola in Sierra Leone.

Order of authorship in the original paper: Schieffelin, Shaffer, Goba. The authors used "quantitative reverse-transcriptase-polymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients." Includes data on patient clinical characteristics and presentation of the illness, describes clinical pathology and lab abnormalities observed in the hot zone, presents management recommendations, special precautions and infection control advice. Digital facsimile from nejm.org at this link.

With: Chertow, Daniel S., Kleine, Christian, Edwards, Jeffrey K., "Ebola virus disease in West Africa--Clinical manifestations and management," New Eng. J. Med., 371 (2014) 2054-2057. Authors present a system of "phases of the illness", and practical information on the logistics of fighting it.

"In resource-limited areas, isolation of the sick from the population at large has been the cornerstone of control of Ebola virus disease (EVD) since the virus was discovered in 1976.1 Although this strategy by itself may be effective in controlling small outbreaks in remote settings, it has offered little hope to infected people and their families in the absence of medical care. In the current West African outbreak, infection control and clinical management efforts are necessarily being implemented on a larger scale than in any previous outbreak, and it is therefore appropriate to reassess traditional efforts at disease management. Having cared for more than 700 patients with EVD between August 23 and October 4, 2014, in the largest Ebola treatment unit in Monrovia, Liberia (see diagrams), we believe that our cumulative clinical observations support a rational approach to EVD management in resource-limited settings." Digital facsimile of the paper from nejm.org at this link.

(Thanks to Juan Weiss for this reference and its interpretation.)