The aim of this study is to analyze the clinical features of patients with Ebola virus (EBOV) infection at admission and to provide information for clinicians to manage patients with suspected Ebola virus disease (EVD).

Sixty-two suspected EVD cases visited China-Sierra leone Friendship Hospital which was set up by the first medical team from the Chinese People′s Liberation Army in Africa were enrolled in this study. Demographic information, medical history and symptoms were collected for all the patients at admission. Reverse transcription polymerase chain reaction (RT-PCR) was used to confirm or exclude the diagnosis. Data were compared between patients with or without EBOV infection by t test for ages, days from symptoms onset to admission, and χ² test for proportion of symptoms.

Of 62 patients, 35 were male and 27 were female, average age was (27.3±15.4) years. Forty cases were diagnosed with EVD, and 22 were excluded. The incubation period for EVD patients was estimated to be 2 to 24 days with an average of (8.8±5.7) days. EBOV positive patients showed higher proportions of fever, nausea/vomiting, diarrhea, fatigue/weakness, loss of appetite and sore throat than those of EBOV negative patients (all P<0.05). The proportions of eye pain, hiccup and insomnia were low in EBOV positive patients, while none was in EBOV negative patients. Only one patient had bloody stool at admission. An average of (8±5) symptoms were noted in EVD patients at admission compared with (4±3) symptoms in non-EVD patients (t=8.46, P=0.001). The number of symptoms at admission was optimal in diagnosing EVD with cut-off value of 6. The sensitivity, specificity, positive predictive value and negative predictive value were 50.0%, 86.4%, 87.0% and 48.7%, respectively. Thirty-six out of 62 patients had a history of contact with confirmed or suspected EVD cases, including 22(55.0%) in EBOV positive patients and 14(63.6%) in EBOV negative patients (χ²=0.44, P=0.596). Among 36 cases with definite EVD contact history, 19(86.4%) presented with fever and 20(90.9%) presented with fatigue in EBOV positive patients, while 6(42.9%) presented with fever and 5(35.7%) presented with fatigue in EBOV negative patients (both P<0.05).

Among suspected EVD patients, those who are diagnosed with EVD by RT-PCR have more symptoms than those with negative results, including fever, nausea/vomiting, diarrhea, fatigue/weakness, loss of appetite and sore throat, etc. Though these symptoms are not specific, they provide clues for diagnose EVD in the very early stage for clinicians.

Hemorrhagic fever, ebola; Holding center; Clinical features