Ebola history and symptoms: Difference between revisions

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__NOTOC__
__NOTOC__
{{Ebola}}
{{Ebola}}
{{CMG}}; {{AE}} {{MJM}}; {{GRN}}
{{CMG}}; {{AE}} {{MJM}}; {{GRN}}; {{YD}}
==Overview==
==Overview==
Ebola causes a variety of [[symptoms]] which may include [[fever]], [[chills]] [[vomiting]], [[diarrhea]], generalized [[pain]] or [[malaise]], and sometimes [[internal bleeding|internal]] and [[hemorrhage|external bleeding]], that follow an [[incubation period]] of 2-21 days.  These [[symptoms]] are common to all [[species]] of ''[[Ebola virus]]'', but the different [[species]] may present with differences in the severity of [[symptoms]].
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==
==History==
Ebola hemorrhagic fever should be suspected in patients with acute febrile illness, hemorrhagic symptoms, and a history of travel to an endemic area. The history of a patient with suspected Ebola virus infection requires a clear assessment of exposure. Travel to endemic countries particularly in West Africa including Sierra Leone, Liberia, Guinea, and Nigeria is important to note. Other exposure to Ebola virus including direct contact, or exposure to blood or body fluids of infected patients, processing 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 questions include: duration of fever, systemic manifestations, and appearance of any hemorrhagic symptoms.
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 [[Ebola primary prevention|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.


==Symptoms==
==Early Symptoms==
Once [[infection]] occurs, it commonly takes 2 - 21 days for [[symptoms]] to develop. Patients who have fatal [[outcome]]s, often develop earlier [[symptoms]], and die between the first and second week of disease from [[shock]] and [[multiorgan failure]]. Although different [[species]] of [[Ebola virus]] have different clinical manifestations, a common progression of [[symptoms]] is observed:<ref name="pmid9988156">{{cite journal| author=Ndambi R, Akamituna P, Bonnet MJ, Tukadila AM, Muyembe-Tamfum JJ, Colebunders R| title=Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S8-10 | pmid=9988156 | doi=10.1086/514297 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988156  }} </ref><ref name="pmid9988155">{{cite journal| author=Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y et al.| title=Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S1-7 | pmid=9988155 | doi=10.1086/514308 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988155  }} </ref><ref name="pmid21084112">{{cite journal| author=Feldmann H, Geisbert TW| title=Ebola haemorrhagic fever. | journal=Lancet | year= 2011 | volume= 377 | issue= 9768 | pages= 849-62 | pmid=21084112 | doi=10.1016/S0140-6736(10)60667-8 | pmc=PMC3406178 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21084112  }} </ref>
Incubation period ranges from 2 to 21 days. The majority of symptomatic patients have fatal [[outcome]]s. 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]]


* '''Incubation Period''' - characterized by general [[symptoms]], such as: [[fever]], [[chills]], [[asthenia]] and [[headache]]. Other systemic symptoms are commonly seen. After the incubation period, a ''pseudoremission phase'' may be observed, in which a patient's clinical status improves for 24 - 48 hours.
* '''Hemorrhagic Disease''' - characterized by severe [[symptoms]] particularly hemorrhagic manifestations
Without treatment, patients' clinical status may deteriorate to the point of [[shock]] and [[multiorgan failure]].<ref name="pmid21084112">{{cite journal| author=Feldmann H, Geisbert TW| title=Ebola haemorrhagic fever. | journal=Lancet | year= 2011 | volume= 377 | issue= 9768 | pages= 849-62 | pmid=21084112 | doi=10.1016/S0140-6736(10)60667-8 | pmc=PMC3406178 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21084112  }} </ref><ref name="pmid2749110">{{cite journal| author=Sureau PH| title=Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire. | journal=Rev Infect Dis | year= 1989 | volume= 11 Suppl 4 | issue=  | pages= S790-3 | pmid=2749110 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2749110  }} </ref>
===Incubation Period===
The [[incubation period]] lasts approximately 2 - 21 days and is classically characterized by fever, chills, malaise, and myalgia. Systemic manifestations include:
====Skin====
====Skin====
* Maculopapular [[rash]] appearing at 5-7 days
* Characteristic [[maculopapular]], non-[[pruritic]] [[rash]] with [[erythema]]. Skin rash typically appears within 5-7 days of disease onset and has a [[centripetal]] distribution.
* [[Desquamation]]
* [[Desquamation]]
====Musculoskeletal====
*[[Arthralgia]]
*[[Myalgia]]


====Respiratory====
====Respiratory====
* [[Chest pain]]
* [[Sore throat]]
* [[Dyspnea]]
* [[Cough]]
* [[Cough]]
* [[Nasal discharge]]
* [[Nasal discharge]]


====Gastrointestinal====  
====Gastrointestinal====  
* [[Abdominal pain]] (often related to pancreatitis)
* [[Abdominal pain]]
* [[Nausea]]
* [[Nausea]]
* [[Dysphagia]]
* [[Vomiting]]
* [[Vomiting]]
* [[Diarrhea]]
* [[Diarrhea]], which may be bloody even in the early phase of the disease
 
====Ophthalmological====
* [[Eye pain]]
* [[Conjunctivitis]]
 
====Hemorrhagic disease====
*Epistaxis
*Mucosal bleeding
 
==Late Symptoms==
====Respiratory====
*[[Dyspnea]]
 
====Cardiovascular====
*[[Chest pain]]
 
====Gastrointestinal====
*[[Abdominal pain]] that may be related to pancreatitis, intestinal wall swelling, or mesenteric lymphadenopathy
*[[Abdominal distention]]


====Neurological====
====Neurological====
* [[Headache]]
* [[Hiccups]], which classically herald worse outcomes and death
* [[Confusion]]
* [[Confusion]]
* [[Tinnitus]]
* [[Tinnitus]]
 
* [[Hearing loss]]
====Ophthalmological====
* [[Dysphagia]]
* [[Conjunctivitis]]
*[[Convulsions]]


===Hemorrhagic Disease===
===Hemorrhagic Disease===
* [[Jaundice]]
* [[Petechiae]]
* [[Petechiae]]
* [[Ecchymoses]]
* [[Ecchymoses]]
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* [[Melena]]
* [[Melena]]
* [[Hematuria]]
* [[Hematuria]]
* [[Vaginal bleeding]]
* Uncontrolled [[bleeding]] from venipuncture sites
* Uncontrolled [[bleeding]] from venipuncture sites
 
*[[Hemorrhagic shock]]
===End-Stage Disease===
* Metabolic disturbances
* [[Convulsions]]
* [[Hypovolemic shock]]
* [[Coma]]


==References==
==References==
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[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Hemorrhagic fevers]]
[[Category:Hemorrhagic fevers]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 17:37, 18 September 2017

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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

Skin

Musculoskeletal

Respiratory

Gastrointestinal

Ophthalmological

Hemorrhagic disease

  • Epistaxis
  • Mucosal bleeding

Late Symptoms

Respiratory

Cardiovascular

Gastrointestinal

Neurological

Hemorrhagic Disease

References

Template:WH Template:WS

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