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For Ebola patients, a few signs mean treatment’s needed — stat

New scorecard could help doctors quickly prioritize who needs help

By
7:00am, February 16, 2017
Ebola scorecard

EBOLA BY THE NUMBERS  Looking at some key risk factors may help health care workers triage Ebola patients.

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A new scorecard, devised by analyzing Ebola patients from the most recent outbreak in West Africa, may help doctors quickly decide who needs additional care to survive the virus in future epidemics.

In the latest outbreak, which raged in Guinea, Liberia and Sierra Leone from 2014 to 2016, 28,616 people were infected with virus and 11,310 people died. Doctors might be able to improve the odds of surviving by looking for a few warning signs in people who need to be treated more intensively, Mary-Anne Hartley, of the international charity GOAL Global and the University of Lausanne in Switzerland, and colleagues report February 2 in PLOS Neglected Tropical Diseases.

“It can be very difficult to avoid bias when choosing which Ebola patient should be given extra care when you have limited time and resources,” Hartley says. “Should it be that sweet 7-year-old girl in the corner with a bad cough or the really athletic 45-year-old man who was a bit confused earlier? Our score suggests that it should be the latter.” 

Top risk factors for dying from Ebola:

  • High viral load — Patients with lots of virus in their blood were 12.6 times as likely to die as those with a low viral load.
  • Age — Children under 5 were 5.4 times as likely to die as were people between 5 and 25; people over age 45 were 11.6 times as likely to die.
  • Disorientation — The symptom was associated with more than 94 percent of Ebola fatalities and increased the risk of dying by 13.1 times.
  • Hiccups
  • Diarrhea
  • Red, inflamed eyes
  • Labored breathing or shortness of breath
  • Muscle pain
  • Delayed treatment — The risk of dying increased 12 percent each day an infected person put off treatment for the first 10 days after symptoms started.

Earlier treatment, better outcome

probability of death versus time of treatment following symptomsPeople who sought treatment soon after symptoms of Ebola appeared were more likely to recover from the infection. For each day treatment was delayed in the first 10 days of the illness, a patient’s chance of dying rose 12 percent.

Source: M.-A. Hartley et al/PLOS Neglected Tropical Diseases 2017

Citations

M.-A. Hartley et al. Predicting Ebola severity: A clinical prioritization score for Ebola virus disease. PLOS Neglected Tropical Diseases. Vol. 11, February 2, 2017, p. e0005265. doi:10.1371/journal.pntd.0005265.

Further Reading

M. Rosen. Ebola vaccine proves effective, final trial results show. Science News. Vol. 191, February 4, 2017, p. 15.

T. H. Saey. Liberia’s Ebola outbreak largely traced to one source. Science News. Vol. 189, January 9, 2016, p. 10.

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