Treatment of Ebola

To the Editor: We were struck by the similarity of transient vascular leak in Ebola virus disease (EVD), as reported by Lyon et al. (Dec. 18 issue),¹ with that which occurs in dengue. When severe dengue was first described, uncorrected hypovolemia often led to shock, hemorrhage, and death.² A study involving children with dengue showed that fluid loss from the vascular compartment was indicated by a 20% increase in packed-cell volume.³ Pulse pressure was determined to be the most clinically significant marker of the severity of leakage.⁴ Frequent hematocrit and blood-pressure monitoring are essential in correcting plasma leakage while preventing . . .