Evaluation of convalescent whole blood for treating Ebola Virus Disease in Freetown, Sierra Leone

• Published in: The Journal of infection Vol. 74; no. 3; pp. 302 - 309
• Main Authors: Sahr, F., Ansumana, R., Massaquoi, T.A., Idriss, B.R., Sesay, F.R., Lamin, J.M., Baker, S., Nicol, S., Conton, B., Johnson, W., Abiri, O.T., Kargbo, O., Kamara, P., Goba, A., Russell, J.B.W., Gevao, S.M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2017; The British Infection Association. Published by Elsevier Ltd
• Subjects: Adolescent; Adult; Blood Transfusion; Child; Convalescence; Convalescent whole blood; Disease Outbreaks; EVD; Female; Hemorrhagic Fever, Ebola - epidemiology; Hemorrhagic Fever, Ebola - mortality; Hemorrhagic Fever, Ebola - therapy; Hospitalization; Humans; Immune Sera - administration & dosage; Immunization, Passive; Infectious Disease; Male; Middle Aged; Odds Ratio; Sierra Leone; Sierra Leone - epidemiology; Treatment; Viral Load - drug effects; Young Adult; EVD; Sierra Leone; Treatment; Convalescent whole blood
• ISSN: 0163-4453; 1532-2742; 1532-2742
• DOI: 10.1016/j.jinf.2016.11.009

Convalescent blood therapy has been a promising form of treatment for Ebola Virus Disease (EVD), but less attention has been focused on it for treatment. We assessed the effectiveness of convalescent whole blood (CWB) in the treatment of consented EVD patients. We recruited 69 subjects in December 2014 up to April 2015, at the 34 Military Hospital in Wilberforce and the PTS 1 Ebola Treatment Unit in Hastings, Freetown. Forty-four were given CWB, and 25 who consented but preferred to be exempted from the CWB treatment were used to compare clinical outcomes. All were given routine treatment used at the Ebola Treatment Unit. One of 44 subjects treated with CWB dropped out of the study and 31 recovered while 12 succumbed to the disease with a case fatality rate of 27.9%. For the group that was given routine treatment without CWB, 11 died with a case fatality rate of 44%. There was a significant difference between admission viral load and viral load after the first 24 h of treatment with convalescent whole blood (P < 0.01). The odds ratio for survival with CWB was 2.3 (95% CI, 0.8–6.5). CWB is promising for treating EVD in resource-poor settings, especially in the early phases of outbreaks when resource-mobilization is done. Even though our sample size was small and the evaluation was not randomised, our results contribute to existing evidence that convalescent whole blood could be considered as a useful candidate for treating EVD. Further studies that are randomised will be required to further assess the efficacy of CWB as treatment option during any EVD outbreak. •We evaluated convalescent whole blood (CWB) to treat EVD.•We recruited 69 subjects: 44 were enrolled on CWB.•There was a significant difference between admission viral load and viral load after 24 h of treatment with CWB.•Case fatality rates were 27.9% for the CWB group and 44% for the control group.•CWB could still be important in the treatment of EVD.