Ebola Hemorrhagic Fever

Ebola virus disease is a viral disease that occurs primarily in remote villages in Central and West Africa, near tropical rain forests. It is passed to humans from infected animals and animal materials, and spread between humans by close contact with infected body fluids or through infected needles in the hospital.

Symptoms commonly appear 8-10 days after exposure to Ebola virus. Some early symptoms of Ebola include: fever, headache, nausea, and diarrhea.

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five different subspecies of this virus and four of them cause disease in humans. Researchers believe the natural hosts of the virus are animals, most likely bats. When an infection does occur in humans, the virus can be transmitted to others by direct contact with the blood or secretions of an infected person, and exposure to objects (such as needles) that have been contaminated with infected secretions.

Currently, there is no known cure for Ebola. Standard treatment for Ebola is still limited to supportive therapy which includes balancing the patients fluids and electrolytes, maintaining oxygen status and blood pressure, treating any complicating infections, and transfusion of platelets or fresh blood. A Vaccine for Ebola virus is being tested.

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola virus, although 8 to 10 days after exposure is most common.

• Fever
• Headache
• Chills
• Joint and muscle aches
• Backache (low-back pain)
• Weakness
• Nausea
• Diarrhea
• Vomiting
• Sore throat
• Stomach pain
• Lack of appetite

In later stages of the infection, patients may experience swelling of the eyes or genitals (labia and scrotum), rashes, and/or profuse bleeding. 

The Ebola virus causes bleeding by affecting the blood’s ability to clot. As the disease progresses, the Ebola virus causes liver injury which leads to a decline in plasma levels of certain clotting factors. The virus eventually infects the microvascular endothelial cells and compromises their integrity. As a result, platelets do not promptly aggregate therefore can not prevent blood loss and promote wound repair as they usually do. In addition, blood begins to leak out of the vessels. As a result, bleeding occurs.

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five different subspecies of this virus and four of them cause disease in humans. Researchers believe the natural hosts of the virus are animals, most likely bats. 

In Africa, confirmed cases of Ebola have been reported in:

• Guinea
• Liberia
• Sierra Leone
• Democratic Republic of the Congo (DRC)
• Gabon
• South Sudan
• Ivory Coast
• Uganda
• Republic of the Congo (ROC)
• South Africa

When an infection does occur in humans, there are several ways in which the virus can be transmitted to others. These include: 

• direct contact with the blood or secretions of an infected person 
• exposure to objects (such as needles) that have been contaminated with infected secretions 

The viruses that cause Ebola are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.

During outbreaks of Ebola, the disease can spread quickly within health care settings if adequate precautions are not taken. Precautions include wearing appropriate protective equipment (ex: gowns, mask, gloves), proper cleaning and disposal of needles and syringes, and sterilization of instruments.

It is difficult to diagnose Ebola in someone who has been infected for only a few days. Since early symptoms such as headache, fever, red eyes, and skin rash are not specific to Ebola viruses, Ebola may initially be misdiagnosed.

If there is reason to believe that an individual might have Ebola, certain tests may be performed to aid in diagnosis and confirm infection:

• Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
• IgM ELISA
• Polymerase chain reaction (PCR)
• Virus isolation
• Virus specific antibodies

Although some people recover from Ebola, certain complications can occur. Survivors may have unusual problems, such as hair loss and sensory changes.

Call your doctor if you have traveled to Africa (or if you know you have been exposed to Ebola fever) and you develop symptoms of the disorder.

Avoid areas in which there are epidemics. Wear a gown, gloves, and mask around sick patients. These precautions will greatly decrease the risk of transmission.

Currently, there is no known cure for Ebola. Existing medications that fight against viruses (antivirals) do not work well against Ebola virus. 

Standard treatment for Ebola is still limited to supportive therapy which includes:

• Balancing the patients fluids and electrolytes 
• Maintaining oxygen status and blood pressure
• Treating any complicating infections
• Transfusion of platelets or fresh blood 

There is not a specific treatment or licensed vaccine for Ebola virus that is available.

There is not a licensed vaccine for Ebola virus that is available. Several vaccines are being tested, but none are available for clinical use.

New drug therapies, for treating Ebola virus, are being evaluated.

Some people who become sick with Ebola are able to recover, while others are not. The reason behind this is not understood.

As many as 90% of patients die from the disease. Early diagnosis and treatment may improve the chances of survival.