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Abstract

Background: The current outbreak of Ebola virus disease has claimed over 11,000 lives1. Little dialogue exists on care of the
dying patient in an Ebola setting. Here we consider demographic data, and discuss our experiences of delivering palliative care
at a flagship Ebola Treatment Centre (ETC) in Sierra Leone.
Results: The data collection period was 8th December 2014 to 9th January 2015. Case fatality rate was 34.7% (41/118). Of those
who died, the mean age was 30.3 years and 19.5 % (8/14) under 16 years. The mean time from symptom onset to death of 9.1
days (sd 4.4) with a mean time from admission onset to death of 3.7 days (sd 3.2). 2
Discussion: Patient infectivity in life and death and necessary infection control procedures delay symptom management,
limit clinician time onwards and present physical barriers to non-verbal communication. Clinician inexperience and short
admission time makes diagnosis of death challenging in this young cohort, while patient isolation prevents contact with
relatives and restricted burial practices cause bereavement upset.
Conclusions: Introduction of pre emptive medication preparation, employment of a clinical psychologist, 24 hour clinician
presence, palliation decisions made by the senior physician and body bags with viewing panels appears to improve palliative
care provision reducing patient distress and improving acceptance of death by relatives.
References
1. World Health Organization. WHO Ebola Situational Report- 8th July 2015. Geneva: 2015.
2. Hunt L et al, “Biochemical and Haematological Abnormalities and Risk Factors for Mortality in Patients with Ebola Virus
Disease”. Pre-Publication (Accepted by Lancet Infectious Disease) 2015.

Biography

Victoria Knott completed her MBCHB in 2011 and DTMH in 2014. She has recently spent 4 months working in the Ebola response at Kerry Town Ebola Treatment
Centre in Sierra Leone. During this time she was actively involved in clinical case management of patients with EVD and has a keen research interest.