ICU-like Care of Nonhuman Primates with Ebola Virus Disease

Background: Ebola virus disease (EVD) supportive care strategies are largely guided by retrospective observational research. This study investigated the effect of EVD supportive care algorithms on duration of survival in a controlled nonhuman primate (NHP) model.

Methods: Fourteen rhesus macaques were challenged intramuscularly (IM) with a target dose of 1000 PFU Zaire ebolavirus (Kikwit). NHPs were allocated to intensive care unit (ICU)-like algorithms (n=7), intravenous fluids (IVF) plus levofloxacin (n=2), or a control group (n=5). The primary outcome measure was duration of survival, and secondary outcomes included changes in clinical laboratory values.

Results: Duration of survival was not significantly different between the pooled ICU-like algorithm and control groups (8.2 vs 6.9 days of survival, hazard ratio 0.50, p = 0.25). Norepinephrine was effective in transiently maintaining baseline blood pressure. NHPs treated with ICU-like algorithms had delayed onset of liver and kidney injury.

Conclusions: While an obvious survival difference was not observed with ICU-like care, clinical observations from this model may aid in EVD supportive care NHP model refinement.