Ebola history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.; Guillermo Rodriguez Nava, M.D. [2]; Yazan Daaboul, M.D.
Overview
Patients who present with fever and have a recent travel to endemic countries, particularly to West Africa including Sierra Leone,Liberia, Guinea, and Nigeria, should be suspected to have Ebola virus infection. The history of a patient with suspected Ebola virus infection requires a clear assessment of exposure. Incubation period ranges from 2 to 21 days prior to development of symptoms. The majority of symptomatic patients have fatal outcomes. Patients often initially develop flu-like or malaria-like symptoms before multisystem organ failure and bleeding diasthesis take place.
History
Ebola hemorrhagic fever should be suspected in patients with acute febrile illness, hemorrhagic symptoms, and a history of travel to an endemic area. As such, patients who present with fever and have a recent travel to endemic countries, particularly to West Africa including Sierra Leone, Liberia, Guinea, and Nigeria, should be suspected to have Ebola virus infection. The history of a patient with suspected Ebola virus infection requires a clear assessment of exposure. Exposure to Ebola virus include direct contact, exposure to blood or body fluids of infected patients, processing of blood or body fluids of a patient with suspected or confirmed Ebola virus infection, and contact with a dead body without appropriate personal protective equipment in an endemic country. Other important clues during history-taking include: duration and character of fever and other constitutional symptoms, presence of systemic manifestations, appearance of any hemorrhagic symptoms, and presence of sick contacts and their symptoms.
Early Symptoms
Incubation period ranges from 2 to 21 days. The majority of symptomatic patients have fatal outcomes. Patients often initially develop flu-like or malaria-like symptoms before multisystem organ failure and bleeding diasthesis take place.
Constitutional symptoms
- Fever and chills are the most common presenting features of Ebola virus infection
- Headache
- Weight loss
- Anorexia
- Asthenia
Skin
- Characteristic maculopapular, non-pruritic rash with erythema. Skin rash typically appears within 5-7 days of disease onset and has a centripetal distribution.
- Desquamation
Musculoskeletal
Respiratory
Gastrointestinal
- Abdominal pain
- Nausea
- Vomiting
- Diarrhea, which may be bloody even in the early phase of the disease
Ophthalmological
Hemorrhagic disease
- Epistaxis
- Mucosal bleeding
Late Symptoms
Respiratory
Cardiovascular
Gastrointestinal
- Abdominal pain that may be related to pancreatitis, intestinal wall swelling, or mesenteric lymphadenopathy
- Abdominal distention
Neurological
- Hiccups, which classically herald worse outcomes and death
- Confusion
- Tinnitus
- Hearing loss
- Dysphagia
- Convulsions
Hemorrhagic Disease
- Jaundice
- Petechiae
- Ecchymoses
- Epistaxis
- Mucosal bleeding
- Hematemesis
- Melena
- Hematuria
- Vaginal bleeding
- Uncontrolled bleeding from venipuncture sites
- Hemorrhagic shock