New tool predicts Ebola infection risk

Washington: A US-based doctor, who treated Ebola-infected patients in Liberia last year, has developed a tool that can predict whether suspected Ebola patients would actually carry the virus.

Ebola Virus Disease (EVD) has affected 24,000 persons during the current epidemic, which is the largest recorded outbreak of EVD in history. Over 10,000 people have died in West Africa, mainly in Sierra Leone, Liberia and Guinea.

Because the initial symptoms are not specific to EVD, diagnosing EVD remains a significant challenge.

This is the first time that researchers scientifically derived a clinical prediction model, the Ebola Prediction Score, for patients with suspected EVD who await laboratory
confirmation.

“There is a lag time between a suspected case and a confirmation,” said Adam C Levine, an emergency medicine physician at Rhode Island Hospital and The Miriam Hospital.

“The Ebola Prediction Score will help clinicians risk-stratify patients already meeting one or more suspect definitions of EVD,” said Levine.

Typical predictors for EVD include fever, nausea/vomiting, diarrhoea, fatigue, abdominal pain, loss of appetite, muscle pain, joint pain, headache, difficulty breathing, difficulty swallowing, hiccups, unexplained bleeding, and exposure to a suspected or confirmed EVD patient within 21 days.

In Levine’s Ebola Prediction Score tool, six of those symptoms create the model – sick contact, diarrhoea, loss of appetite, muscle pain, difficulty swallowing and absence of abdominal pain.

A scoring system based on these signs may help clinicians determine who is most likely to require isolation while laboratory tests confirm diagnosis.

Patient data was collected during routine clinical care at the 52-bed Bong County Ebola Treatment Unit (ETU) in Liberia during its first 16 weeks of operation.

EVD testing results were available for 382 of the 395 patients admitted to the ETU during the study period.

Forty-two percent, or 160 patients, tested positive for EVD.

According to Levine, while the Ebola Prediction Score can help determine who is more likely to have EVD and treat them accordingly, better testing needs to be a focus.

The research was published in the journal Annals of Emergency Medicine.