Intensive Care Unit-Like Care of Nonhuman Primates with Ebola Virus Disease

J Infect Dis. 2021 Aug 16;224(4):632-642. doi: 10.1093/infdis/jiaa781.


Background: Ebola virus disease (EVD) supportive care strategies are largely guided by retrospective observational research. This study investigated the effect of EVD supportive care algorithms on duration of survival in a controlled nonhuman primate (NHP) model.

Methods: Fourteen rhesus macaques were challenged intramuscularly with a target dose of Ebola virus (1000 plaque-forming units; Kikwit). NHPs were allocated to intensive care unit (ICU)-like algorithms (n = 7), intravenous fluids plus levofloxacin (n = 2), or a control group (n = 5). The primary outcome measure was duration of survival, and secondary outcomes included changes in clinical laboratory values.

Results: Duration of survival was not significantly different between the pooled ICU-like algorithm and control groups (8.2 vs 6.9 days of survival; hazard ratio; 0.50; P = .25). Norepinephrine was effective in transiently maintaining baseline blood pressure. NHPs treated with ICU-like algorithms had delayed onset of liver and kidney injury.

Conclusions: While an obvious survival difference was not observed with ICU-like care, clinical observations from this model may aid in EVD supportive care NHP model refinement.

Keywords: Ebola virus disease; Filoviridae; Mononegavirales; animal; hemorrhagic fevers; intensive care; models; viral.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Critical Care*
  • Disease Models, Animal
  • Ebolavirus
  • Hemorrhagic Fever, Ebola* / therapy
  • Intensive Care Units*
  • Macaca mulatta
  • Primates
  • Retrospective Studies