Ebola: Bleeding Less Common but More Deadly


Although bleeding is generally considered one of the most tell-tale signs of Ebola, recent data collected on patients in West Africa suggest that bleeding is less common but more deadly, at least with the strain in West Africa. The report, published by the New England Journal of Medicine, contains data on 1,415 Ebola patients from Liberia, Sierra Leone, Guinea and Nigeria, with an onset of symptoms as recent as August 17.

The data consists of 685 males (48.5 percent) and 730 females (51.6 percent), which suggests males and females are about equally likely to contract Ebola in the West Africa epidemic. Of the 685 male patients, 75 percent died and of the 730 female patients, 74 percent died, which suggests that males and females are about equally likely to die from Ebola. The data also suggests that the patients in West Africa who have contracted Ebola are more likely to die from it than previously reported. Among the patients who were sampled, nearly 75 percent died, while only about 25 percent recovered.

Among the symptoms, bleeding amongst patients was less common than previously reported outbreaks, but seemingly increases the risk of death from Ebola. Before the current outbreak in West Africa, approximately 50 percent of those infected with Ebola reportedly experienced unexplained bleeding of some sort. As a result, when the mysterious disease going around in West Africa was finally discovered to be Ebola, locals were told to watch out for a number of symptoms, but most notably bleeding. However, since bleeding is less common in patients in West Africa affected by the Ebola outbreak, many did not feel a need to seek treatment.

This contributed to the spread of Ebola that has now become an epidemic in West Africa. Only 18 percent of Ebola patients sampled in the West Africa outbreak experienced unexplained bleeding. About 83 percent of those who did died compared to the 71 percent of patients who did not experience unexplained bleeding who did not survive. In addition, 20 percent of the sampled Ebola patients who died suffered from unexplained bleeding, compared to approximately 12 percent of patients who recovered from the disease.

The risk of death is especially prevalent in Ebola patients who experience blood in their urine and bleed from areas such as the gums, injection site, nose and underneath the skin. While only 1 percent of patients experienced blood in their urine, 90 percent died. The death rate is similar for those who bleed from their gums, injection site and nose. Only 2 percent of patients sampled experienced bleeding from the gums, but 95 percent of them died. The same is true for those who experienced bleeding at the injection site. Only 2 percent of the patients experienced bleeding from the nose, but 94 percent died. Bleeding underneath the skin, while one of the most well-known symptoms, in part due to the countless photos published of Ebola patients who experience this, was the least common symptom of all. Less than 1 percent of the Ebola patients sampled experienced bleeding underneath the skin, but all who did died.

Overall, the data suggests that bleeding, while apparently less common in West Africa than previous outbreaks, increases the risk of death from Ebola by a minimum of 10 percent. While only one in six Ebola patients in West Africa will experience unexplained bleeding, more than eight out of 10 patients who suffer from it will die. This is compared to approximately seven out of 10 patients who do not. The data suggests that Ebola patients in West Africa that experience unexplained bleeding appear to have a worse prognosis than those who do not. It also suggests that while unexplained bleeding is a symptom of Ebola, it is not the most common one among patients in West Africa, and thus is not the only sign to watch out for.

By Lindsey Dow

New England Journal of Medicine
Society for Science
Center for Disease Control

3 Responses to "Ebola: Bleeding Less Common but More Deadly"

  1. Kevin Bond (@Cancerkiller543)   September 30, 2014 at 12:05 am

    There can be no more Ebola deaths – I can eliminate the Ebola crisis in West Africa and around the world, for I got the Ebola virus lethal weapon – Once I am paid the corresponding funds for that.

  2. Phaeton Rudegar   September 29, 2014 at 7:54 pm

    It also suggests that controlling bleeding might be the best way to save lives.
    Is anyone looking at this?

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