Ebola and Cholera

Dear Sir: The description of the clinical course of Ebola virus disease (EVD) provided by Igonoh1 is consistent with mounting evidence indicating that a significant proportion of Ebola mortality is attributable to diarrheal dehydration with severe electrolyte losses.2–6 It is likely that EVD mortality could be reduced below reported levels if therapy could be streamlined as it has been for treatment of cholera. Reports of severe hyponatremia and hypokalemia in EVD suggest that stool sodium and potassium losses may exceed those in the current World Health Organization (WHO) low-sodium oral rehydration solution (ORS). Analysis of EVD stool electrolyte content would help define optimal ORS salt formulations for EVD, but unfortunately have not been reported. Such data are needed to identify the optimal standard ORS composition for EVD treatment.