![]() ![]() On November 26, he had nausea, diarrhea, melena, jaundice, conjunctival injection, epistaxis, and abdominal, chest, and spinal pain. He was seen at a local health center, where he received unspecified treatment. On November 25, 2019, a total of 149 days after discharge from the ETU, headache, asthenia, myalgia, polyarthralgia, and anorexia developed in the patient. The patient did not undergo follow-up for additional semen testing. On August 27, a semen sample was collected as part of the national program to monitor EVD survivors, and the test result was negative for EBOV RNA ( Table 1). The patient was discharged from the ETU on June 29 after two consecutive negative results on a polymerase-chain-reaction assay ( Figure 1 and Table 1). 8 In addition, we provided standard supportive care that included an antibiotic agent (intravenous ceftriaxone), an antimalarial agent (artesunate–amodiaquine), a proton-pump inhibitor (omeprazole), and magnesium supplementation. We initiated treatment with the experimental mAb114 monoclonal antibody 7 on June 16, 2019, under the Monitored Emergency Use of Unregistered and Investigational Interventions protocol. Timeline of the First and Second Episodes of EVD in the Patient, from December 2018 through December 2019.ĮTU denotes Ebola treatment unit, EVD Ebola virus disease, MEURI Monitored Emergency Use of Unregistered and Investigational Interventions, RT-PCR reverse transcriptase–polymerase chain reaction, and rVSV-ZEBOV recombinant vesicular stomatitis virus–based vaccine expressing a ZEBOV glycoprotein. Despite his previous vaccination, we detected EBOV RNA in the patient’s serum with the use of the GeneXpert platform (Xpert Ebola Assay, Cepheid) ( Table 1), and EVD was diagnosed. According to the patient’s medical record, he had received the recombinant vesicular stomatitis virus–based vaccine expressing a ZEBOV glycoprotein (rVSV-ZEBOV) 6 (Merck, lot number WL00064825) 6 months previously (on December 6, 2018) because he was a contact of a person with confirmed EVD. ![]() Diagnostic Test Results in Samples Obtained during the First and Second Episodes of EVD in the Patient in 2019.Ī 25-year-old man who worked as a motorcycle taxi driver presented to the Ebola treatment unit (ETU) in Mangina, DRC, on June 15, 2019, with a 2-day history of fever, nausea, vomiting, asthenia, anorexia, myalgia, and chest pain. ![]() ![]() Patient History and Epidemiologic Findings Table 1. and Jean-Jacques Muyembe Tamfum, M.D., Ph.D.Original Article Brief Report Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease List of authors. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making. ![]()
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