Dallatomasina Silvia, Crestani Rosa, Sylvester Squire James, Declerk Hilde, Caleo Grazia Marta, Wolz Anja, Stinson Kathryn, Patten Gabriela, Brechard Raphael, Gbabai Osman Bamba-Moi, Spreicher Armand, Van Herp Michel, Zachariah Rony
Médecins Sans Frontières, Freetown, Sierra Leone.
Trop Med Int Health. 2015 Apr;20(4):448-54. doi: 10.1111/tmi.12454. Epub 2015 Feb 3.
To describe Ebola cases in the district Ebola management centre of in Kailahun, a remote rural district of Sierra Leone, in terms of geographic origin, patient and hospitalisation characteristics, treatment outcomes and time from symptom onset to admission.
Data of all Ebola cases from June 23rd to October 5th 2014 were reviewed. Ebola was confirmed by reverse-transcriptase-polymerase-chain-reaction assay.
Of 489 confirmed cases (51% male, median age 28 years), 166 (34%) originated outside Kailahun district. Twenty-eight (6%) were health workers: 2 doctors, 11 nurses, 2 laboratory technicians, 7 community health workers and 6 other cadres. More than 50% of patients had fever, headache, abdominal pain, diarrhoea/vomiting. An unusual feature was cough in 40%. Unexplained bleeding was reported in 5%. Outcomes for the 489 confirmed cases were 227 (47%) discharges, 259 (53%) deaths and 3 transfers. Case fatality in health workers (68%) was higher than other occupations (52%, P = 0.05). The median community infectivity time was 6.5 days for both general population and health workers (P = 0.4).
One in three admitted cases originated outside Kailahun district due to limited national access to Ebola management centres - complicating contact tracing, safe burial and disinfection measures. The comparatively high case fatality among health workers requires attention. The community infectivity time needs to be reduced to prevent continued transmission.
描述在塞拉利昂一个偏远农村地区凯拉洪区埃博拉管理中心的埃博拉病例，内容包括地理来源、患者及住院特征、治疗结果以及从症状出现到入院的时间。
回顾了2014年6月23日至10月5日期间所有埃博拉病例的数据。通过逆转录聚合酶链反应检测确诊埃博拉。
在489例确诊病例中（51%为男性，中位年龄28岁），166例（34%）来自凯拉洪区以外。28例（6%）为卫生工作者：2名医生、11名护士、2名实验室技术人员、7名社区卫生工作者和6名其他干部。超过50%的患者有发热、头痛、腹痛、腹泻/呕吐。一个不寻常的特征是40%的患者有咳嗽。5%的患者报告有不明原因出血。489例确诊病例的结果为227例（47%）出院、259例（53%）死亡和3例转院。卫生工作者的病死率（68%）高于其他职业（52%，P = 0.05）。普通人群和卫生工作者的社区感染时间中位数均为6.5天（P = 0.4）。
由于全国范围内埃博拉管理中心的可及性有限，三分之一的入院病例来自凯拉洪区以外，这使得接触者追踪、安全埋葬和消毒措施变得复杂。卫生工作者中相对较高的病死率需要关注。需要缩短社区感染时间以防止持续传播。
