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A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness
  1. Andrew T Cox1,2,
  2. I Schoonbaert3,
  3. T Trinick4,
  4. A Phillips5 and
  5. D Marion6
  1. 1St George's, University of London, London, UK
  2. 2Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  3. 326/27 CF H Svcs C, CFS St. John's, St. John's, Newfoundland, Canada
  4. 4Ulster Hospital, Belfast, UK
  5. 5York District Hospital, York, UK
  6. 6Misericordia Community Hospital, Edmonton, Alberta, Canada
  1. Correspondence to Maj Andrew Cox, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; acox{at}


We present a 27-year old British nurse admitted to the Kerry Town Ebola Treatment Unit, Sierra Leone, with symptoms fitting suspect-Ebola virus disease (EVD) case criteria. A diagnosis of Plasmodium falciparum malaria and heat illness was ultimately made, both of which could have been prevented through employing simple measures not utilised in this case. The dual pathology of her presentation was atypical for either disease meaning EVD could not be immediately excluded. She remained isolated in the red zone until 72 h from symptom onset. This case highlights why force protection measures are important to reduce the incidence of both malaria and heat illness in deployed military and civilian populations. These prevention measures are particularly pertinent during the current EVD epidemic where presenting with these pathologies requires clinical assessment in the ‘red zone’ of an Ebola treatment unit.


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