Ebola (Ebola Virus Disease)

Ebola virus disease (EVD), Ebola hemorrhagic fever (EHF), or simply Ebola is a disease of humans and other primates caused by an ebola virus. Symptoms start two days to three weeks after contracting the virus, with a fever, sore throat, muscle pain, and headaches. Typically, vomiting, diarrhea, and rash follow, along with decreased function of the liver and kidneys. Around this time, affected people may begin to bleed both within the body and externally.

According to the CDC:

Symptoms

Symptoms of Ebola include

  • Fever (greater than 38.6°C or 101.5°F)
  • Severe headache
  • Muscle pain
  • Weakness
  • Diarrhea
  • Vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

Recovery from Ebola depends on the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

Transmission

Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers believe that the first patient becomes infected through contact with an infected animal.

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes) with

  • blood or body fluids (including but not limited to urine, saliva, feces, vomit, and semen) of a person who is sick with Ebola
  • objects (like needles and syringes) that have been contaminated with the virus
  • infected animals
  • Ebola is not spread through the air or by water, or in general, food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats.

Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.

During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.

Dedicated medical equipment (preferable disposable, when possible) should be used by healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.

Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.

Risk of Exposure

Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks of Ebola among humans have appeared sporadically in Africa.

Risk

All cases of human illness or death from Ebola have occurred in Africa (with the exception of several laboratory contamination cases: one in England and two in Russia). No cases have been reported in the United States.

Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with the blood or body fluids of sick patients. People also can become sick with Ebola after coming in contact with infected wildlife. For example, in Africa, Ebola may spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats.

Past Ebola Outbreaks

Past Ebola outbreaks have occurred in the following countries:

  • Democratic Republic of the Congo (DRC)
  • Gabon
  • South Sudan
  • Ivory Coast
  • Uganda
  • Republic of the Congo (ROC)
  • South Africa (imported)

Current Ebola Outbreak in West Africa

The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first in West Africa. The current outbreak is affecting multiple countries in West Africa

Prevention

There is no FDA-approved vaccine available for Ebola.

If you travel to or are in an area affected by an Ebola outbreak, make sure to do the following:

  • Practice careful hygiene. Avoid contact with blood and body fluids.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
  • Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.
  • Avoid hospitals where Ebola patients are being treated. The U.S. embassy or consulate is often able to provide advice on facilities.
  • After you return, monitor your health for 21 days and seek medical care immediately if you developsymptoms of Ebola.

Healthcare workers who may be exposed to people with Ebola should follow these steps:

  • Wear protective clothing, including masks, gloves, gowns, and eye protection.
  • Practice proper infection control and sterilization measures. For more information, see “Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting”.
  • Isolate patients with Ebola from other patients.
  • Avoid direct contact with the bodies of people who have died from Ebola.
  • Notify health officials if you have had direct contact with the blood or body fluids, such as but not limited to, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola. The virus can enter the body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth

Diagnosis

Diagnosing Ebola in an person who has been infected for only a few days is difficult, because the early symptoms, such as fever, are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever.

However, if a person has the early symptoms of Ebola and has had contact with the blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with the blood or body fluids of a person sick with Ebola, or contact with infected animals, they should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.

Laboratory tests used in diagnosis include:

Timeline of Infection Diagnostic tests available
Within a few days after symptoms begin
  • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
  • IgM ELISA
  • Polymerase chain reaction (PCR)
  • Virus isolation
Later in disease course or after recovery
  • IgM and IgG antibodies
Retrospectively in deceased patients
  • Immunohistochemistry testing
  • PCR
  • Virus isolation

Treatment

No specific vaccine or medicine (e.g., antiviral drug) has been proven to be effective against Ebola.

Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:

  • Providing intravenous fluids (IV)and balancing electrolytes (body salts)
  • Maintaining oxygen status and blood pressure
  • Treating other infections if they occur

Some experimental treatments developed for Ebola have been tested and proven effective in animals but have not yet been tested in randomized trials in humans.

Recovery from Ebola depends on the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer.

The above information was collected from the CDC website, for further information consult: http://www.cdc.gov/vhf/ebola/symptoms/index.html

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2 thoughts on “Ebola (Ebola Virus Disease)

  1. Pingback: Ebola (Ebola Virus Disease) | Dr. Zachary Lahlou

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