Ebola history and symptoms: Difference between revisions

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{{Ebola}}
{{Ebola}}
{{CMG}}
{{CMG}}; {{AE}} {{MJM}}; {{GRN}}; {{YD}}
==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 [[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.
 
==Early Symptoms==
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]]
 
====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====
*[[Arthralgia]]
*[[Myalgia]]
 
====Respiratory====
* [[Sore throat]]
* [[Cough]]
* [[Nasal discharge]]
 
====Gastrointestinal====
* [[Abdominal pain]]
* [[Nausea]]
* [[Vomiting]]
* [[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]]


==Overview==
====Cardiovascular====
[[Image:7042 lores-Ebola-Zaire-CDC Photo.jpg|thumb|right|200px|1976 photograph of two nurses standing in front of Kinshasa case #3 ([[Nurse Mayinga]]) who was treated and later died in Ngaliema Hospital, in [[Kinshasa]], [[Zaire|Zaïre]]]]
*[[Chest pain]]
Symptoms are varied and often appear suddenly. Initial symptoms include high:
 
*[[Fever]] (at least 38.8°C; 101.8°F)
====Gastrointestinal====
*[[headache|Severe headache]]
*[[Abdominal pain]] that may be related to pancreatitis, intestinal wall swelling, or mesenteric lymphadenopathy
*[[myalgia|Muscle pain]]
*[[Abdominal distention]]
*[[Arthralgia|Joint pain]]
 
*[[Abdominal pain]]
====Neurological====
*[[Muscle weakness|Severe weakness]]
* [[Hiccups]], which classically herald worse outcomes and death
*[[Exhaustion]]
* [[Confusion]]
*[[Pharyngitis|Sore throat]]
* [[Tinnitus]]
*[[nausea]]
* [[Hearing loss]]
*[[Dizziness]]
* [[Dysphagia]]
*[[Convulsions]]
 
===Hemorrhagic Disease===
* [[Jaundice]]
* [[Petechiae]]
* [[Ecchymoses]]
* [[Epistaxis]]
* [[Mucosal bleeding]]
* [[Hematemesis]]
* [[Melena]]
* [[Hematuria]]
* [[Vaginal bleeding]]
* Uncontrolled [[bleeding]] from venipuncture sites
*[[Hemorrhagic shock]]


==References==
{{Reflist|2}}


Ebola may progress to cause more serious symptoms, such as [[diarrhea]], dark or bloody [[feces]], [[Coffee ground vomiting|vomiting blood]], red eyes due to [[Distension]] and hemorrhage of [[Sclerosis|sclerotic arterioles]], [[petechia]], [[maculopapular rash]], and [[purpura]]. Other secondary symptoms include [[hypotension]] (less than 90 mm Hg systolic /60 mm Hg diastolic), [[hypovolemia]], [[tachycardia]], organ damage (especially the [[kidneys]], [[spleen]], and [[liver]]) as a result of disseminated systemic [[necrosis]], and [[proteinuria]]. The interior bleeding is caused by a chemical reaction between the virus and the platelets which creates a chemical that will cut cell sized holes into the capillary walls. After 5-7 days the person will die of "a million cuts."
[[Category:Mononegavirales]]
Occasionally, [[internal bleeding|internal]] and external hemorrhage from [[orifice]]s, such as the nose and mouth may also occur, as well as from incompletely healed injuries such as needle-puncture sites. Ebola virus can affect the levels of [[white blood cells]] and [[platelets]], disrupting [[thrombosis|clotting]].{{Fact|date=May 2007}} Fewer than 50 percent of patients will not develop any hemorrhaging.
[[Category:Viral diseases]]
[[Category:Biological weapons]]
[[Category:Zoonoses]]
[[Category:Hemorrhagic fevers]]


Methods of diagnosis of Ebola include testing saliva and urine samples. The span of time from onset of symptoms to death is usually between 7 and 14 days. By the second week of infection, patients will either [[defervescence|defervesce]] (the fever will lessen) or undergo systemic multi-organ failure. Mortality rates are generally high, ranging from 50% - 90%.<ref name="WHO" /> The cause of death is usually due to [[Hypovolemia|hypovolemic shock]] or [[multiple organ dysfunction syndrome|organ failure]].<ref>{{cite journal |last=Bray |first=Mike |authorlink= |coauthors=Geisbert, Thomas W |year=2005 |month= |title=Ebola virus: The role of macrophages and dendritic cells in the pathogenesis of Ebola hemorrhagic fever |journal=International Journal of Biochemistry & Cell Biology |volume=37 |issue=8 |pages=1560-1566 |doi=10.1016/j.biocel.2005.02.018 |url= |accessdate= |quote= }}</ref> 
[[Category:Disease]]


Filoviruses replicate well in a wide range of organs and cell types such as hepatocytes, epithelial cells, fibroblasts, fibroblastic reticular cells and adrenal cortical cells.<ref name="Klenk2004" />  Most notably, the susceptibility of human [[endothelial cells]] is likely the cause of the symptoms that appear in the late stages of the infection such as shock syndrome and hemorrhaging.<ref name="Klenk2004" />
{{WH}}
{{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

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