Recently a report of 106 patients with Ebolavirus disease who were treated in Kenema, Sierra Leone was published. The authors report on similar data from 631 patients admitted to the Ebola treatment centre in Freetown, Sierra Leone. This centre had a case fatality rate of 31%, less than the 74% rate reported in the previous article. The authors observed a decreasing case fatality rate from 47.7% among the first 151 patients (20th September to 13th October), to 31.7% among the next 126 patients (14th October to 4th November), to 23.4% among the next 304 patients (5th November to 7th December). The most common symptoms reported at the time of admission were: fatigue, anorexia, fever, vomiting and nausea, diarrhoea, muscle pain, joint pain and headache. Patients were typically admitted 3 or 4 days after the onset of symptoms. The patients that died usually did so within 3 or 4 days of admission. Survivors were hospitalised for about 2 weeks. The treatment protocol used was 1 g of ceftriaxone iv BD and 500 mg of metronidazole iv TDS for 72 hours, together with 500 ml of Ringer’s lactate every 8 or 12 hours and 500 ml of dextrose saline (5% and 0.9%, respectively) intravenously every 8 or 12 hours. All patients also received 10 mg of vitamin K and 160 mg of artemether intramuscularly immediately on admission, as well as a 20 mg zinc sulphate OD, 400 mg ibuprofen BD and 10 mg of metoclopramide iv as needed for nausea or vomiting. After the first 3 days, continuing therapy included 400 mg metronidazole TDS for 7 days, 500 mg cefuroxime BD for 5 days, artesunate–lumefantrine combination-therapy OD for 3 days, 400 mg ibuprofen BD and one capsule of nutrition supplement daily.
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