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Study: Young people more likely to survive Ebola. T X8 N9 l9 f) T
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AP 8 p.m. EDT October 29, 20148 F" B3 C& T" d1 p8 o5 j
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Who survives Ebola and why? Health workers treating patients in Sierra Leone, including some who died doing that work, have published the most detailed report yet on medical aspects of the epidemic. The research suggests young people are less likely to perish, fever is the most common symptom when victims first seek care, and early help is crucial.# ]0 f, y# Z! }; [
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The report, published online Wednesday by the New England Journal of Medicine, is from 47 doctors, nurses and others who cared for 106 patients at Kenema Government Hospital in Sierra Leone, one of the West African countries hardest hit by the Ebola epidemic.7 n$ q" w0 c0 C9 F1 h
9 T5 h4 t) \0 `# m; Y, sTheir work adds new knowledge about the disease, which has killed more than 5,000 since early this year,the largest outbreak ever of Ebola, said one study leader, Dr. John Schieffelin, an infectious diseases specialist from Tulane University School of Medicine.
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8 k: E2 i. Y8 G1 U2 W( `2 oEBOLA: IRS gives tax relief to victims1 S$ t7 ^" g6 w% n S5 m/ N/ f
3 S4 P4 p. ~/ ^8 R* R- k# |In particular, it shows the advantage of youth — the fatality rate was only 57 percent for patients under 21, but a whopping 94 percent for those over 45.. t7 e' ^3 H& ]9 B
0 T0 u; M; `7 _% J+ w1 I"They're more resilient and younger and tougher," Schieffelin said.
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, {( h% _1 I$ z0 F"This is definitely the most detailed analysis" of symptoms and factors related to survival, he added.& G( s" B8 r' C+ A- }
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One striking factor was how devastating the severe diarrhea is from the disease.
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1 A% F$ p: k Y1 @; o2 j"It requires a lot of intensive fluid therapy," and replacement of body salts called electrolytes, to help people survive, he said.
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Key findings:
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It can be hard even in an outbreak setting to tell who has Ebola. Of the 213 people initially tested for signs of a hemorrhagic fever, about half, or 106, turned out to have Ebola.: {% P9 y: I2 Y. l
The estimated incubation period was 6 to 12 days, similar to what has been seen elsewhere in this outbreak.9 T: y, k6 T" A" h
Fever was the most common symptom — 89 percent had it when diagnosed. Other symptoms were headache (80 percent), weakness (66 percent), dizziness (60 percent), diarrhea (51 percent), abdominal pain (40 percent), and vomiting (34 percent). Only one patient had bleeding, one of the most gruesome symptoms, but researchers say other cases may have been missed through incomplete record-keeping. Patients with weakness, dizziness and diarrhea were more likely to die.& [/ u: s+ {3 H7 Y/ @5 V; w
Those with more virus in their blood when they sought medical care, indicating more advanced infections, were more likely to die than those who got help when their illness was less far along.$ C" I7 `/ N4 L# i; w/ D
Seven of the 47 study authors died — six of them from Ebola and one from a stroke. They included Dr. Sheik Humarr Khan, a doctor who led Sierra Leone's battle against Ebola until his death in July.
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/ H. C: f: V0 H8 bhttp://www.usatoday.com/story/news/world/2014/10/29/ebola-study-young-people/18139135/
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0 G$ N7 C) |+ i4 O! tShe survived. He died. Why can some people beat Ebola?
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/ b8 ~2 ^1 _7 OIs it genes? Is it age? Competing studies examine the issue/ A$ P. a. d9 B: @% Z$ d6 E
7 u0 o) t7 e! d; O10:23 AM - October 31, 2014
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One challenge facing public health officials is that the Ebola virus seems to strike unpredictably, with some family members surviving the virus—or not even contracting it at all—even as their siblings or parents die from it.
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A pair of studies published in the New England Journal of Medicine and Science, respectively, examine why some people are more prone to contracting Ebola than others, and, among those who do develop the virus, why some have a greater risk of dying.' n" Y% ]# s0 F2 i, k& J4 R" j4 f
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" H( V. r2 w1 G( q: l3 [Four maps that explain the Ebola outbreak / Y( g1 m3 J" ~+ I/ \( O7 G
Age, early diagnosis keys to Ebola survival, NEJM study finds# A$ `" }$ {$ N8 I8 E) Z3 h
6 s4 k. W# G; T3 V7 |The first study examined data from 44 patients diagnosed with Ebola in Sierra Leone's Kenema Government Hospital from May 25 to July 18.7 F! y: c# |, M4 q8 g/ I2 _
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This is the first time anybody has had this much data collected on any Ebola patients," says John Schieffelin of New Orleans-based Tulane University, one of the study authors. (Six of the 47 study authors died from Ebola.) j) F& I4 d0 a3 V* p
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The study found that in all cases studied, the virus took about six to 12 days to incubate and about 74% of those infected died. However, the age of the infected person and the pace at which the Ebola virus replicated within the person's body were found to play a significant role in whether he or she survived. Specifically, just 57% of infected persons under age 21 died, compared with 94% of those over age 45.
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What's more contagious than Ebola? Panic. 8 s/ W. i0 R* p' q8 H# {
) _. p& C6 q5 R4 p! J! ASimilarly, 33% of patients with fewer than 100,000 copies of the virus per milliliter of blood at diagnosis died, while 94% of individuals with more than 10 million copies of the virus per milliliter of blood at diagnosis did so. Thus, those who were diagnosed early on had a greater chance of survival.3 E! G, d, q: ]# q7 |
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The researchers also looked at the symptoms that patients with the virus experienced, and found that:
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5 H+ Y& P/ P9 F& U6 |& b89% of patients experienced a fever;
# }$ q$ _2 }# _8 Z4 k$ l6 V, f80% had a headache;
7 H. H' n& l7 M. Y66% felt weak;: S2 k8 x, R1 r1 l
60% felt dizzy;$ W& J# p6 A3 M/ K' f! A, O! j
51% had diarrhea;
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k6 D Q3 {3 w34% experienced vomiting.) c; h0 K- J& O* D
Just 1% of patients experienced bleeding, which had been a key feature of the virus in previous Ebola outbreaks.# l6 n& `- o5 @/ L/ _; g& \
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' A% W8 H! b8 X* }/ gAccording to Scheiffelin, diarrhea was a "really big feature of" the virus in the patients studied and caregivers should be aware of this and be aggressive in administering intravenous fluids.- y) t; `( c' l3 g
, h. t& x8 b S, JWhile some observers have questioned the necessity of allocating resources to such a study during the middle of an outbreak, the researchers defend their analysis and note that the information gathered will help health care workers currently fighting the outbreak to develop new diagnostic approaches based on data.
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# V9 w B5 e3 D- X9 e% M5 L" @: zNew York City confirms its first Ebola case. Mayor: 'There is no cause for alarm.' . m0 Z! a/ d! m( R7 Q8 z4 p7 d
- w0 n: s2 K$ D) p7 D1 g/ Q! cCould contracting Ebola be based on genetics? Science study examines. c$ S# w- `4 g! G1 n) j. L
' Q9 y. d! d- v0 t5 E I, ?A second study conducted by researchers from the University of Washington, the University of North Carolina, and the National Institutes of Health in Montana examined mice to find out if their genetics played a role in the likelihood of them contracting the disease.
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* \$ v2 D: _3 iFor the study, the mice were all injected with the same strain of virus that is currently plaguing West Africa. All of the mice lost weight within the first few days after injection. However, nearly 20% of mice regained that weight within two weeks and did not develop symptoms of the disease.6 D3 ]. ?3 [% [4 N
% b+ d$ h9 z' l* C6 }4 l9 iEbola in the U.S. is worrying. But in West Africa, the situation is downright dire.
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Contrastingly, about 70% of mice became very sick, showing symptoms of liver inflammation., Even more had issues with blood clotting, internal bleeding, and swollen spleens. Such mice had about a 50% chance of dying from the virus.
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& w- g$ ^2 f( G r uAccording to the researchers, the reason some mice remained immune to the deadly virus was because of how the disease reacted to the specific hosts' genes—something also seen in many other viruses.
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Jonathan Ball, professor of molecular virology at the University of Nottingham, calls the study "intriguing," but notes that the association of the mice's genes and how the virus affected them "needs to be explored more to know definitively how expression is controlled and how it might influence the disease."6 K: o4 e% @8 v0 a' A
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However, Andrew Easton, a virology professor at the University of Warwick says the study could not be directly be applied to humans because our genetic makeup is much more complex than that of mice. Additionally, he notes, the study did not assess the role environmental factors played.
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' c& B( {6 u t( r' rEaston did note that the data show it "may not be necessary to completely eliminate Ebola virus from the body during infection to ensure there is no disease, and that reduction of virus growth in the body may offer alleviation from some aspects of the disease." That natural reaction may reduce the pressure on new treatments to be thorough (Steenhuysen, Reuters, 10/29; BBC News, 10/30).9 S& a# i: }7 R0 [5 B
$ [( Z8 R m* h! g, ?, G, e# Shttp://www.advisory.com/daily-briefing/2014/10/31/why-some-people-can-beat-ebola
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[size=1.083em]Friday, October 31, 2014, 00:01 by Julie Steenhuysen, Reuters% s9 l8 a* M% ]& I8 h6 R' `& z
Why do some survive Ebola?Sierra Leone study provides some important clues as to how virus kills ; Z8 F4 ^& V4 g0 H: C% |
Masks used by volunteers who will be sent to Africa. Photo: Philippe Wojazer/Reuters An analysis of the first Ebola cases in Sierra Leone helps draw a clearer picture of why some people survive the disease, while others do not, including their age and the pace at which the virus replicates within their body. The study is based on data gathered from 106 patients diagnosed with Ebola at the Kenema Government Hospital in Sierra Leone from May 25 to July 18. Some of the data on this group was incinerated because of fears that the nurses’ station where the records were kept became contaminated. But the team managed to analyse detailed clinical records from a total of 44 Ebola patients, the biggest trove yet from the outbreak in West Africa that has killed nearly 5,000 people. [size=1.5em]74 per cent of the patients in the study died, similar to what has been seen in prior outbreaks
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“This is the first time anybody has had this much data collected on any Ebola patients,” said John Schieffelin of Tulane University in New Orleans, an author of the study published in the New England Journal of Medicine. He said the findings help confirm some of the observations seen by doctors treating patients with Ebola. It shows, for example, that 57 per cent of people under age 21 who were treated for Ebola died from their infections, compared with 94 per cent of those over the age of 45. In the cases studied, the virus took six to 12 days to incubate before patients developed symptoms, and 74 per cent of the patients in the study died, similar to what has been seen in prior outbreaks.  [size=1em]A man looking after his children as they await transport to the holding centre in the Port Loko Government Hospital in Sierra Leone. Photo: Christopher Black/Reuters/WHO 4 V8 M! p& Z$ l# t- W: R* _! X; G/ h
Fever was the most common symptom, occurring in 89 per cent of patients, followed by headache (80 per cent), weakness (66 per cent), dizziness (60 per cent) diarrhoea (51 per cent), abdominal pain (40 per cent) and vomiting (34 per cent). However, there were some big differences in how individual patients responded to the virus, Schieffelin said. One surprise was the significant difference in the amount of virus present in patients when they came in for treatment, a factor that affected whether or not they survived. For example, 33 per cent of patients with less than 100,000 copies of the virus per millilitre of blood at diagnosis ultimately died, compared with 94 per cent mortality in those whose hadmore than 10 million copies per millilitre. Among the various symptoms in this outbreak, Schieffelin said diarrhoea is a “really big feature of it”, suggesting that doctors treating Ebola patients need to be very aggressive in administering intravenous fluids. Bleeding, a key feature of Ebola in prior outbreaks, was rare among this population, with only one patient having this symptom, the study found. Some researchers have questioned the value of spending resources on studying Ebola during the outbreak rather than using those funds to help curb the epidemic directly. Schieffelin said the analysis offers important insights for healthcare workers fighting the current outbreak, including data that can be used to determine new treatment and diagnostic approaches.
% P; H8 a% }. ~- qhttp://www.timesofmalta.com/articles/view/20141031/world/Why-do-some-survive-Ebola-.542048
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Why do some survive Ebola? Sierra Leone study offers cluesBY JULIE STEENHUYSEN9 L2 B# R( v# g! `6 H
Wed Oct 29, 2014 5:00pm EDT$ s; x' @" | m
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(Reuters) - An analysis of the first Ebola cases in Sierra Leone helps draw a clearer picture of why some people survive the disease, while others do not, including their age and the pace at which the virus replicates within their body. V0 T: y: E7 z7 D& Q- L
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The study published Wednesday is based on data gathered from 106 patients diagnosed with Ebola at the Kenema Government Hospital in Sierra Leone from May 25 to July 18. Some of the data on this group was incinerated because of fears that the nurses' station where the records were kept became contaminated.5 Z, @' F# X$ m$ a/ D/ L+ {; c% w
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But the team managed to analyze detailed clinical records from a total of 44 Ebola patients, the biggest trove yet from the outbreak in West Africa that has killed nearly 5,000 people.+ M7 ~4 \3 G/ Q1 u5 v
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"This is the first time anybody has had this much data collected on any Ebola patients," said Dr. John Schieffelin of Tulane University in New Orleans, an author of the study published in the New England Journal of Medicine.4 c- R/ l3 ^- ?4 k0 ^
$ ^7 ?, Y% B% R8 v+ Y0 lHe said the findings help confirm some of the observations seen by doctors treating patients with Ebola.
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It shows, for example, that 57 percent of people under age 21 who were treated for Ebola died from their infections, compared with 94 percent of those over the age of 45.6 c9 c8 l3 |2 C/ S2 g; G
: N4 M( O2 y2 ]8 l9 I* H+ W+ H, CIn the cases studied, the virus took six to 12 days to incubate before patients developed symptoms, and 74 percent of the patients in the study died, similar to what has been seen in prior outbreaks.
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, Z3 o) M, M; |' N6 B) m9 B2 `' J+ O7 uFever was the most common symptom, occurring in 89 percent of patients, followed by headache (80 percent), weakness (66 percent), dizziness (60 percent) diarrhea (51 percent), abdominal pain (40 percent) and vomiting (34 percent).* G, [0 x, G2 n% W, L" H/ x3 Z# m
/ N! i0 H& ~# X8 E4 u+ J( a7 gHowever, there were some big differences in how individual patients responded to the virus, Schieffelin said.6 |4 _+ M& `' P. c3 B+ |
" S+ l5 F3 M+ r" I$ G( J" `"There were people who had very mild cases, and there are people who have very severe cases and they go downhill quickly," he said.
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- @! A7 Q; X" E7 m1 |* E6 }; {! WOne surprise was the significant difference in the amount of virus present in patients when they came in for treatment, a factor that affected whether or not they survived.
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: G; j- {" v/ zFor example, 33 percent of patients with less than 100,000 copies of the virus per milliliter of blood at diagnosis ultimately died, compared with 94 percent mortality in those whose had more than 10 million copies per milliliter.
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3 z1 R0 x6 p. O5 fAmong the various symptoms in this outbreak, Schieffelin said diarrhea is a "really big feature of it," suggesting that doctors treating Ebola patients need to be very aggressive in administering intravenous fluids.1 v- E& {* g# `( M
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Bleeding, a key feature of Ebola in prior outbreaks, was rare among this population, with only 1 patient having this symptom, the study found.
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Some researchers have questioned the value of spending resources on studying Ebola during the outbreak rather than using those funds to help curb the epidemic directly. Schieffelin said the analysis offers important insights for healthcare workers fighting the current outbreak, including data that can be used to determine new treatment and diagnostic approaches.
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(Reporting by Julie Steenhuysen; Editing by Jonathan Oatis)
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[p=23, null, left](Reporting by Julie Steenhuysen; Editing by Jonathan Oatis)' F) Q$ t% {9 p' ^2 Y" e. I
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F' J% w' T) Z5 z. j3 @http://www.reuters.com/article/2014/10/29/us-health-ebola-outcomes-idUSKBN0II2DG20141029
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/ T6 Z+ n% R7 k( R; ~+ O# r+ V' DWho Survives Ebola? Analysis Of First Cases In Sierra Leone Reveals InsightsReuters; P$ \' n8 r2 ?% Q0 ~+ j
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. X% F0 H3 [! V5 D' B+ N7 m6 dPosted: 10/29/2014 4:58 pm EDT Updated: 10/29/2014 5:59 pm EDT8 {9 c# D& o: Y- ]+ I, H( D
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By Julie Steenhuysen* _) c t# Z& M2 k3 ~) b' p7 Y
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CHICAGO, Oct 29 (Reuters) - An analysis of the first Ebola cases in Sierra Leone helps draw a clearer picture of why some people survive the disease, while others do not, including their age and the pace at which the virus replicates within their body.' q. _2 |- c% L' ]1 g- o
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The study published Wednesday is based on data gathered from 106 patients diagnosed with Ebola at the Kenema Government Hospital in Sierra Leone from May 25 to July 18. Some of the data on this group was incinerated because of fears that the nurses' station where the records were kept became contaminated.
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- q) T5 w& b u. Y4 w& q- Y1 EBut the team managed to analyze detailed clinical records from a total of 44 Ebola patients, the biggest trove yet from the outbreak in West Africa that has killed nearly 5,000 people.
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* j7 k1 K" v; ^"This is the first time anybody has had this much data collected on any Ebola patients," said Dr. John Schieffelin of Tulane University in New Orleans, an author of the study published in the New England Journal of Medicine.
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$ ?& t4 h' V' Y, |He said the findings help confirm some of the observations seen by doctors treating patients with Ebola.
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It shows, for example, that 57 percent of people under age 21 who were treated for Ebola died from their infections, compared with 94 percent of those over the age of 45.
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In the cases studied, the virus took six to 12 days to incubate before patients developed symptoms, and 74 percent of the patients in the study died, similar to what has been seen in prior outbreaks.
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" }4 J. `/ a+ ]: i- qFever was the most common symptom, occurring in 89 percent of patients, followed by headache (80 percent), weakness (66 percent), dizziness (60 percent) diarrhea (51 percent), abdominal pain (40 percent) and vomiting (34 percent).
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However, there were some big differences in how individual patients responded to the virus, Schieffelin said.
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"There were people who had very mild cases, and there are people who have very severe cases and they go downhill quickly," he said.
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One surprise was the significant difference in the amount of virus present in patients when they came in for treatment, a factor that affected whether or not they survived.
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9 S8 |" j) v5 b" @; s; ^: A. ]# _For example, 33 percent of patients with less than 100,000 copies of the virus per milliliter of blood at diagnosis ultimately died, compared with 94 percent mortality in those whose had more than 10 million copies per milliliter.
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Among the various symptoms in this outbreak, Schieffelin said diarrhea is a "really big feature of it," suggesting that doctors treating Ebola patients need to be very aggressive in administering intravenous fluids. b( b9 m# ?) C. }) u
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Bleeding, a key feature of Ebola in prior outbreaks, was rare among this population, with only 1 patient having this symptom, the study found.9 _$ Z. d O! q" n6 k8 m
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Some researchers have questioned the value of spending resources on studying Ebola during the outbreak rather than using those funds to help curb the epidemic directly. Schieffelin said the analysis offers important insights for healthcare workers fighting the current outbreak, including data that can be used to determine new treatment and diagnostic approaches. (Reporting by Julie Steenhuysen; Editing by Jonathan Oatis)
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http://www.huffingtonpost.com/2014/10/29/survive-ebola-sierra-leone-cases-study_n_6070972.html , u A9 R5 ^; c! v& [, m: q: w) J
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发表于 2014-10-30 16:17
