Unexpected Ebola virus in a tertiary setting: Clinical and epidemiologic aspects

Objectives: To describe the clinical manifestations of viral hemorrhagic fever, and to increase clinicians' awareness and knowledge of these illnesses. Design: Retrospective study of the clinical and laboratory data and management of two cases of Ebola virus infection with key epidemiologic data provided. Setting: Two tertiary care hospitals, Patients: Two adult patients, the index case and the source patient, both identified as having Ebola, one of whom originated in Gabon. Interventions: One patient was admitted to the intensive care unit, The other was managed in a general ward. Measurement and Main Results: Clinical and laboratory data are reported. One patient, a healthcare worker who contracted this illness in the course of her work, died of refractory thrombocytopenia and an intracerebral bleed. The source patient survived. Despite a long period during which the diagnosis was obscure, none of the other 300 contacts contracted the illness. Conclusions: Identification of high-risk patients and use of universal blood and body fluid precautions will considerably decrease the risk of nosocomial spread of viral hemorrhagic fevers.