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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. 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.


==Symptoms==
==Early Symptoms==
Incubation period ranges from 2 to 21 days. The majority of symptomatic patients have fatal [[outcome]]s, often initially develop initially flu-like or malaria-like symptoms before multisystem organ failure and bleeding diasthesis take place. Symptoms onset often correlates with outcomes, where patients with fatal outcomes usually have early symptoms, while patients with non-fatal outcomes have delayed onset of symptoms.<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>. Classically, patients' symptoms may be distinguished by non-specific mild to moderate symptoms early in the course of the disease, followed by a phase of pseudoremission in the minority of patients, and eventually advanced disease characterized by hemorrhagic and neurological complications that eventually lead to multiorgan failure, coma, and death. Notably, not all patients follow the classical sequence of the clinical disease.
Incubation period ranges from 2 to 21 days. The majority of symptomatic patients have fatal [[outcome]]s, often initially develop initially flu-like or malaria-like symptoms before multisystem organ failure and bleeding diasthesis take place.  
 
===Early Symptoms===
====Constitutional symptoms====
====Constitutional symptoms====
*Fever and chills are the most common presenting features of Ebola virus infection
*Fever and chills are the most common presenting features of Ebola virus infection
Line 43: Line 41:
*Mucosal bleeding
*Mucosal bleeding


===Late Symptoms===
==Late Symptoms==
====Respiratory====
====Respiratory====
*Dyspnea
*Dyspnea

Revision as of 17:43, 27 October 2014

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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]

Overview

Ebola causes a variety of symptoms which may include fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and 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.

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.

Early Symptoms

Incubation period ranges from 2 to 21 days. The majority of symptomatic patients have fatal outcomes, often initially develop initially 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

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

Gastrointestinal

Ophthalmological

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

Hemorrhagic Disease

References

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