Table 2 Suggested treatment protocol to EBOV infection

I. 2–3 days after onset

Nausea and vomiting, diarrhea and mucobloody stool, long-lasting diarrhea [46]

a) Miglustat (100 mg each at an interval of 4 hours)

a,b) Until fully viral clearance. c) If haemorrhage occurs, see Stage II.

b) Toremifene (600 mg/day for 5 consecutive days, 2 days rest)

c) Water and electrolyte supply

II. 4–5 days after onset

Hematemesis and melena, injection area bleeding, hemorrhinia, hemoptysis, sustained fever, accompanying myocarditis or pneumonia [46]

a) Miglustat (6 × 100 mg/day)

a,b) Until fully viral clearance. c) One or two more blood transfusions in the later days, if symptoms persist. If acute DIC occurs, see Stage III.

b) Toremifene (600 mg, 5 days)

c) 200–400 ml blood transfusion

III. 6–7 days after onset

Measles-like maculopapular rash at shoulders, palms and feet, then spreading throughout the body, desquamation several days later [46]

a) Miglustat (6 × 100 mg/day)

a,b) Until fully viral clearance. c) One or two more blood transfusions. DIC must be treated to prevent multiple organ failures.

b) Toremifene (600 mg, 5 days)

c) 400–800 ml blood transfusion (heparin and tranexamic acid may be used)

IV. 8–9 days after onset

Possible kidney failure or liver failure, orchitis, orchiatrophy, et al. [46]

a) Miglustat (6 × 100 mg/day)

a,b) Until fully viral clearance. c) One or two more blood transfusions. Massive blood transfusion or hemodialysis may be adopted if available.

b) Toremifene (600 mg, 5 days)

c) 800 ml or more blood transfusion (heparin and tranexamic acid should be used)

d) 6–20 g human plasma haptoglobin (if available) [51]