A Modified Case Definition to Facilitate Essential Hospital Care During Ebola Outbreaks

Clin Infect Dis. 2019 May 2;68(10):1763-1768. doi: 10.1093/cid/ciy798.


During the late phase of the large West-African Ebola virus disease (EVD) outbreak, the majority of patients were cared for in designated treatment centers. However, the preexisting healthcare infrastructure was already overwhelmed by the outbreak. This had a huge impact on other, non-EVD-related diseases, causing an unprecedented increase in morbidity and mortality, which most likely exceeded the toll due to EVD directly. Consequently, a crucial question is how to provide appropriate healthcare and safeguard functionality of a healthcare system that also serves patients not suspected or diagnosed to have EVD. Here, we report on the Lion Heart Medical Center's experience in Sierra Leone and note that a case definition of Ebola that is broader than those commonly applied may be better suited when it is necessary to identify atypically presenting, pauci-symptomatic cases.

Keywords: Ebola virus disease; Sierra Leone; case definition; essential patient care; fever.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disease Management
  • Disease Outbreaks / prevention & control*
  • Health Plan Implementation*
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Hospitals / standards
  • Hospitals / statistics & numerical data*
  • Humans
  • Patient Care / methods
  • Patient Care / standards*
  • Sierra Leone / epidemiology
  • World Health Organization