Prognostic Indicators for Ebola Patient Survival

Crowe, Samuel J.; Maenner, Matthew J.; Kuah, Solomon; Erickson, Bobbie R.; Coffee, Megan; Knust, Barbara; Klena, John D.; Foday, Joyce; Hertz, Darren; Hermans, Veerle; Achar, Jay; Caleo, Grazia; Herp, Michel Van; Albariño, César G.; Amman, Brian R.; Basile, Alison Jane; Bearden, Scott W.; Belser, Jessica A.; Bergeron, Éric; Blau, Dianna M.; Brault, Aaron C.; Campbell, Shelley; Flint, Mike; Gibbons, Aridth; Goodman, Christin H.; McMullan, Laura K.; Paddock, Christopher D.; Russell, Brandy J.; Salzer, Johanna S.; Sanchez, Angela J.; Sealy, Tara K.; Wang, David; Saffa, Gbessay; Turay, Alhajie; Nichol, Stuart T.; Towner, Jonathan S.

doi:10.3201/eid2202.151250

Cited by 53 publications

(45 citation statements)

References 20 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Age of >45 years and a plasma EBOV load of >10 8 genomes/mL were also associated with fatal outcomes, findings that were subsequently confirmed in other cohorts [31][32][33]. Our clinical study showed that the West African variant of EBOV causes predominately a gastrointestinal illness and focused attention on this aspect for control of disease spread, rather than on bleeding manifestations that predominated in prior outbreaks.…”

Section: Contributions Of Kgh To the Scientific Understanding Of The supporting

confidence: 74%

An Outbreak of Ebola Virus Disease in the Lassa Fever Zone

Goba¹,

Khan²,

Fonnie³

et al. 2016

J Infect Dis.

View full text Add to dashboard Cite

Section: Contributions Of Kgh To the Scientific Understanding Of The supporting

confidence: 74%

An Outbreak of Ebola Virus Disease in the Lassa Fever Zone

Goba¹,

Khan²,

Fonnie³

et al. 2016

J Infect Dis.

View full text Add to dashboard Cite

“…However, we observed that EBOV concentrations of 3.4 × 10 5 genomes/mL were present in experimentally infected nonhuman primates prior to the development of hallmark signs. In agreement with nonhuman primate testing, subsequent clinical testing demonstrated that the ReEBOV RDTs range of 1.0 × 10 5 -1.0 × 10 9 genomes/mL correlated well with threshold cycle times observed in patients with EVD during the course of acute EVD [25,27,28]. The ReEBOV RDT analytical validation presented here for FDA and WHO applications demonstrated the capacity to accurately detect EVD and provide a rapid, point-of-care test for EVD case triage and management.…”

Section: Discussionmentioning

confidence: 60%

Analytical Validation of the ReEBOV Antigen Rapid Test for Point-of-Care Diagnosis of Ebola Virus Infection

et al. 2016

View full text Add to dashboard Cite

Background. Ebola virus disease (EVD) is a severe viral illness caused by Ebola virus (EBOV). The 2013-2016 EVD outbreak inWest Africa is the largest recorded, with >11 000 deaths. Development of the ReEBOV Antigen Rapid Test (ReEBOV RDT) was expedited to provide a point-of-care test for suspected EVD cases.Methods. Recombinant EBOV viral protein 40 antigen was used to derive polyclonal antibodies for RDT and enzyme-linked immunosorbent assay development. ReEBOV RDT limits of detection (LOD), specificity, and interference were analytically validated on the basis of Food and Drug Administration (FDA) guidance.Results. The ReEBOV RDT specificity estimate was 95% for donor serum panels and 97% for donor whole-blood specimens. The RDT demonstrated sensitivity to 3 species of Ebolavirus (Zaire ebolavirus, Sudan ebolavirus, and Bundibugyo ebolavirus) associated with human disease, with no cross-reactivity by pathogens associated with non-EBOV febrile illness, including malaria parasites. Interference testing exhibited no reactivity by medications in common use. The LOD for antigen was 4.7 ng/test in serum and 9.4 ng/test in whole blood. Quantitative reverse transcription-polymerase chain reaction testing of nonhuman primate samples determined the range to be equivalent to 3.0 × 10 5 -9.0 × 10 8 genomes/mL.Conclusions. The analytical validation presented here contributed to the ReEBOV RDT being the first antigen-based assay to receive FDA and World Health Organization emergency use authorization for this EVD outbreak, in February 2015.

show abstract

“…156), which were important for compassionate use but were not wellconducted clinical studies. However, these trials do provide valuable information that can be used to improve future clinical validation of experimental therapies, particularly reiteration of the association between high viral load and reduced survival [208][209][210] . A number of studies have correlated nonsurvival at 90% or more if the viral load exceeds 6 log copies per millilitre [210][211][212][213][214] in untreated patients.…”

Section: Discussionmentioning

confidence: 99%

Post-exposure treatments for Ebola and Marburg virus infections

Cross

Mire

Feldmann

et al. 2018

Nat Rev Drug Discov

107

View full text Add to dashboard Cite

| The filoviruses -Ebola virus and Marburg virus -cause lethal haemorrhagic fever in humans and non-human primates (NHPs). Filoviruses present a global health threat both as naturally acquired diseases and as potential agents of bioterrorism. In the recent 2013-2016 outbreak of Ebola virus, the most promising therapies for post-exposure use with demonstrated efficacy in the gold-standard NHP models of filovirus disease were unable to show statistically significant protection in patients infected with Ebola virus. This Review briefly discusses these failures and what has been learned from these experiences, and summarizes the current status of post-exposure medical countermeasures in development, including antibodies, small interfering RNA and small molecules. We outline how our current knowledge could be applied to the identification of novel interventions and ways to use interventions more effectively. R E V I E W SNATURE REVIEWS | DRUG DISCOVERY VOLUME 17 | JUNE 2018 | 413 © 2 0 1 8 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d . AstheniaMuscular weakness. MyalgiaMuscular pain. ArthralgiaJoint pain. LeukopeniaA condition of having a low number of circulating leukocytes, including neutrophils, eosinophils, basophils, lymphocytes and monocytes. LymphocytopeniaA condition of having a low number of circulating leukocytes, including natural killer cells, T cells and B cells. ThrombocytopeniaA condition of having a low number of circulating thrombocytes, also known as platelets.and Ebolavirus. The Marburgvirus genus contains a single species, Marburg marburgvirus, which contains two members, Marburg virus (MARV) and Ravn virus (RAVV). The Ebolavirus genus consists of five distinct species: Bundibugyo ebolavirus (BDBV), Reston ebolavirus (RESTV), Sudan ebolavirus (SUDV), Tai Forest ebolavirus (TAFV; previously termed 'Côte d'Ivoire ebolavirus' but more commonly known as 'Ivory Coast ebolavirus') and Zaire ebolavirus (EBOV). MARV, RAVV, BDBV, SUDV and EBOV are important human pathogens, with case fatality rates often up to 90% for MARV, RAVV and EBOV, and around 55% for SUDV 8,10 . On the basis of two small outbreaks in 2007 and 2012, BDBV seems to be the least pathogenic, with a case fatality rate of about 40-48% 11,12 . In 1994, TAFV was associated with a number of deaths in chimpanzees and a single symptomatic but non-lethal human infection in the Republic of Côte d'Ivoire 13,14 . RESTV is lethal for macaques but is not thought to cause disease in humans 15 . An outbreak of RESTV was reported in pigs in the Philippines in 2008; however, it remains uncertain whether the disease observed in the pigs was caused by RESTV or other agents reported to have co-infected the animals 16 . Clinical manifestationsClinical and laboratory signs of disease caused by filovirus infection are nonspecific and usually associated with an incubation period of 2-21 days (mean 4-10 days) 8,17 . Illness begins with an abrupt onset of fever, astheni...

show abstract

Prognostic Indicators for Ebola Patient Survival

Abstract: Odds of survival were greatest when first Ebola virus–positive blood sample collected had low viral load.

Cited by 53 publications

References 20 publications

An Outbreak of Ebola Virus Disease in the Lassa Fever Zone

An Outbreak of Ebola Virus Disease in the Lassa Fever Zone

Analytical Validation of the ReEBOV Antigen Rapid Test for Point-of-Care Diagnosis of Ebola Virus Infection

Post-exposure treatments for Ebola and Marburg virus infections

Contact Info

Product

Resources

About