Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Severe Ebola virus case with multiple complications effectively treated with routine intensive care

23.10.2014

After five weeks of treatment in an isolation unit, the University Medical Center Hamburg-Eppendorf (UKE) discharged a healthcare worker from the World Health Organization at the beginning of October.

The patient had been cured of an Ebola infection. As disclosed in a case report by doctors and epidemiologists from the UKE hospital, the Bernhard Nocht Institute (BNI), and the German Center for Infection Research (DZIF) that has been published in the New England Journal of Medicine (NEJM), the patient experienced severe complications, even as blood tests showed that the virus itself was diminishing.

Septicaemia in addition to the serious loss of fluid resulting from the Ebola virus necessitated further intensive care measures.

The patient had worked for the World Health Organization (WHO) as an epidemiologist in an Ebola treatment center in Sierra Leone. The most likely source of infection was close contact with a colleague who had shown symptoms of Ebola and died 10 days before the onset of the patient’s symptoms.

On day 10 of his infection, the patient was transferred to the UKE hospital’s special isolation facility in Hamburg for treatment. From the beginning, the patient’s condition was challenging. “The fluid balance was greatly disturbed; the digestive system was already under attack. Maximal supportive measures were initiated, with a primary goal of restoring volume and electrolyte balance.

In the first 72 hours high-volume intravenous fluid replacement of up to 10 liters per day was necessary to stabilize cardiocirculatory values", explains Dr. Benno Kreuels, physician at the First Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), and first author of the NEJM publication.

Typical symptoms of an Ebola infection, such as diarrhea and vomiting, were successfully treated after a few days. On day 13, however, the patient’s condition deteriorated again due to severe septicaemia, which was caused by gram-negative and multi-resistant bacteria. The patient’s chance of survival, which was threatened at this time by severe encephalopathy and increasingly impaired respiratory function, could be secured with a broad-spectrum antibiotic therapy and non-invasive ventilatory support.

„The patient fully recovered thanks to intensive care measures. Routine intensive care treatment and the quick initiation of intravenous rehydration seem to be particularly important for survival in Ebola patients, as long as no sufficiently effective and safe Ebola-specific therapies are available,” concludes Dr. Stefan Schmiedel, tropical medicine expert at the First Department of Medicine who led the patient’s course of treatment.

In agreement with local and national health authorities, the patient was discharged from the hospital on the fortieth day after the onset of his infection. At this time, all cultures of bodily fluid samples (blood, saliva, conjunctival swab, stool, urine, or sweat) had been free from infectious virus particles for at least 20 days. „Thanks to our close monitoring, we were able to learn much about the virus and the course of viral disease. For example, we were able to isolate infectious Ebola virus particles from urine days after plasma samples showed no signs of the virus”, explains Prof. Dr. Marylyn Addo, physician and head of the tropical medicine division at the First Department of Medicine, who also holds the DZIF professorship for Emerging Infections.

Prof. Dr. Ansgar Lohse, head of the First Department of Medicine at the University Medical Center Hamburg-Eppendorf (UKE), underscores Germany’s responsibility in the struggle against Ebola: „The most important measure in fighting the Ebola epidemic is certainly an improved health care system on site. But it is also important that we open our highly specialized isolation units to international health care workers who put their lives at risk to help the sick in regions where Ebola is epidemic. In this way, we can provide support to West Africa. In addition, this case shows how much can be learned by careful clinical and scientific observation of a single case, and – in agreement with our patient – we are now glad to share this knowledge.

Publication: Kreuels B, Wichmann D, Emmerich P, Schmidt-Chanasit J, de Heer G, Kluge S, Abdourahmane S, Renné T, Günther S, Lohse AW, Addo MM, Schmiedel S. (2014). A case of severe Ebola virus infection complicated by gram-negative septicemia. New England Journal of Medicine (online first release on October 22, 2014; DOI: 10.1056/NEJMbr1411677).

Christine Trowitzsch | idw - Informationsdienst Wissenschaft
Further information:
http://www.uke.uni-hamburg.de

Further reports about: Ebola Ebola infection Ebola virus Medicine epidemic health care tropical

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>