The global case fatality rate of the infectious diseases department was 3.1%, but the ICU fatality rate was 15.2% (nine patients). Eight were workers: seven returned from Angola, one from Thailand and the 9th was a tourist who returned from Mozambique. Death occurred between the second and 28th day. In all but three patients death occurred in the acute phase of the illness. One of them was a male nurse who, despite compliance to mefloquine chemoprophylaxis, had malaria with 30% of parasitaemia; he was conscious when he was admitted but had a rapid neurologic deterioration in some hours with severe intracranial hypertension and an irreversible brain swelling on cerebral computerized tomography image, with brain death in the first 24 hours. In the other three patients, who died later on, death was related to ARDS complications.