Severe Ebola virus disease with vascular leakage and multiorgan failure: treatment of a patient in intensive care

Wolf, Timo; Kann, Gerrit; Becker, Stephan; Stephan, Christoph; Brodt, HR; Leuw, Philipp de; Grünewald, Thomas; Vogl, T. J.; Kempf, Volkhard A. J.; Keppler, Oliver T.; Zacharowski, Kai

doi:10.1016/s0140-6736(14)62384-9

Cited by 205 publications

(210 citation statements)

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“…The importance of advanced supportive care, including electrolyte balance, ventilation and dialysis, was likely pivotal in the successful treatment of individuals infected with EBOV in developed countries during the recent EBOV epidemic 32,[125][126][127]148,149,188,217,218 . Only two of the twelve patients with EBOV (17%) treated in the USA during this epidemic (two imported cases, two infections identified in the USA and eight medically evacuated patients) died.…”

Section: Discussionmentioning

confidence: 99%

“…Amiodarone was used to treat at least two individuals infected with EBOV during the 2013-2016 epidemic 148,188 . In the patient for which details are available, a Ugandan physician became infected with EBOV and self-initiated amiodarone therapy 188 .…”

Section: Buffy Coatmentioning

confidence: 99%

“…In the patient for which details are available, a Ugandan physician became infected with EBOV and self-initiated amiodarone therapy 188 . This patient was then medically evacuated to Germany, where amiodarone treatment was discontinued because of its potential cardiac side effects and unclear antiviral effectiveness in vivo 188 . The patient received advanced supportive care and other experimental therapies and survived.…”

Section: Buffy Coatmentioning

confidence: 99%

“…During the 2013-2016 EBOV epidemic, a fibrinderived peptide, FX06, was used to treat vascular leakage in a repatriated doctor in Germany 188 . On the 11th day after the onset of symptoms and demonstration of biophysical evidence of vascular leak syndrome, the patient received intravenous FX06.…”

Section: Modulation Of the Coagulation Systemmentioning

confidence: 99%

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Post-exposure treatments for Ebola and Marburg virus infections

Cross

Mire

Feldmann

et al. 2018

Nat Rev Drug Discov

107

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| 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...

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Section: Discussionmentioning

confidence: 99%

Section: Buffy Coatmentioning

confidence: 99%

Section: Buffy Coatmentioning

confidence: 99%

Section: Modulation Of the Coagulation Systemmentioning

confidence: 99%

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Post-exposure treatments for Ebola and Marburg virus infections

Cross

Mire

Feldmann

et al. 2018

Nat Rev Drug Discov

107

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“…Transmission of EVD by a route other than direct contact has been demonstrated in several nonhuman primate studies. 13,14 In one, two sets of monkeys occupied separate cages that were 3 m away from each other so that there was no direct contact between the monkeys. Two control monkeys died from EVD at 10 and 11 days after the last experimental inoculated monkey died.…”

mentioning

confidence: 99%

Aerosolization of Ebola Virus Surrogates in Wastewater Systems

Lin

Marr

2017

Environ. Sci. Technol.

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Academic AbstractRecent studies have shown that Ebola virus can persist in wastewater, and the potential for the virus to be aerosolized and pose a risk of inhalation exposure has not been evaluated.We considered this risk for three wastewater systems: toilets, a lab-scale model of an aeration basin, and a lab-scale model of converging sewer pipes. We measured the aeroso l size distribution generated by each system, spiked Ebola virus surrogates into each system, and determined the emission rate of viruses into the air. While the number of aerosols released ranged from 10 5 to 10 7 per flush from the toilets or per minute from the lab-scale models, the total volume of aerosols generated by these systems was ~10 -8 to 10 -7 mL per flush or per minute in all cases. The Ebola virus surrogates MS2 and Phi6, spiked into toilets at an initial concentration of 10 7 PFU mL -1 , were not detected in air after flushing.Airborne concentrations of MS2 and Phi6 were ~20 PFU L -1 and ~0.1 PFU L -1 , respectively, associated with the aeration basin and sewer models. This corresponds to emission rates of 547 PFU min -1 and 3.8 PFU min -1 of MS2 and Phi6, respectively, for the aeration basin and 79 PFU min -1 and 0.3 PFU min -1 for the sewer model. Since informa tio n on the aerosolization of Ebola virus is quite limited, these emission rates can greatly help inform risk assessment of inhalation exposure to Ebola virus.iii

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Systemic Infectious Emergencies

Ellis

2022

Emergency Medicine Simulation Workbook

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Severe Ebola virus disease with vascular leakage and multiorgan failure: treatment of a patient in intensive care

Cited by 205 publications

References 18 publications

Post-exposure treatments for Ebola and Marburg virus infections

Post-exposure treatments for Ebola and Marburg virus infections

Aerosolization of Ebola Virus Surrogates in Wastewater Systems

Systemic Infectious Emergencies

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