The etiology of Ebola virus disease-like illnesses in Ebola virusnegative patients from Sierra Leone

// Wen-Gang Li 1, 2, * , Wei-Wei Chen 1, 2, * , Lei Li 1, 2 , Dong Ji 1, 2 , Ying-Jie Ji 1, 2 , Chen Li 1, 2 , Xu-Dong Gao 1, 2 , Li-Fu Wang 1, 2 , Min Zhao 1, 2 , Xue-Zhang Duan 1, 2 , Hui-Juan Duan 1, 2 1 302 Military Hospital of PLA, Beijing, China 2 Sierra Leone-China Friendship Hospital, Freetown, Sierra Leone * These authors have contributed equally to this work Correspondence to: Hui-Juan Duan, e-mail: duane8699@sina.com Xue-Zhang Duan, e-mail: duanxuezhang2006@163.com Keywords: Ebola virus disease (EVD), EVD-suspected cases, malaria, HIV, Lassa fever Received: January 14, 2016      Accepted: March 18, 2016      Published: April 02, 2016 ABSTRACT During the 2014 Ebola virus disease (EVD) outbreak, less than half of EVD-suspected cases were laboratory tested as Ebola virus (EBOV)-negative, but disease identity remained unknown. In this study we investigated the etiology of EVD-like illnesses in EBOV-negative cases. From November 13, 2014 to March 16, 2015, EVD-suspected patients were admitted to Jui Government Hospital and assessed for EBOV infection by real-time PCR. Of 278 EBOV negative patients, 223 (80.21%), 142 (51.08%), 123 (44.24%), 114 (41.01%), 59 (21.22%), 35 (12.59%), and 12 (4.32%) reported fever, headache, joint pain, fatigue, nausea/vomiting, diarrhea, hemorrhage, respectively. Furthermore, 121 (43.52%), 44 (15.83%), 36 (12.95%), 33 (11.87%), 23 (8.27%), 10 (3.60%) patients were diagnosed as infection with malaria, HIV, Lassa fever, tuberculosis, yellow fever, and pneumonia, respectively. No significant differences in clinical features and symptoms were found between non-EVD and EVD patients. To the best of our knowledge, the present study is the first to explore the etiology of EVD-like illnesses in uninfected patients in Sierra Leone, highlighting the importance of accurate diagnosis to EVD confirmation.