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]
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 haemorrhagic fever should be suspected in patients with acute febrile illness, hemorrhagic symptoms, and a history of travel to an endemic area. Once infection occurs, it commonly takes 2 - 21 days for symptoms to develop. Patients who have fatal outcomes, often develop earlier symptoms, dying between the 6th and 16th day of disease from shock and multiorgan failure. Although different species of Ebola virus have different clinical manifestations, a common progression of symptoms includes 2 phases:[1][2][3]
- Phase 1 or Incubation Period - characterized by general symptoms, such as: fever, chills, asthenia and headache
After phase 1, there is a pseudoremission phase, in which patients' clinical status improve for 24 - 48 hours.
- Phase 2 - characterized by severe symptoms, such as neuropsychiatric changes and hemorrhagic manifestations
Patients who only manifest phase 1 symptoms have better survival rates than those who develop phase 2 symptoms. Without treatment, patients' clinical status may deteriorate to the point of shock and multiorgan failure. The fatal cases usually occur within the first two weeks of symptoms.[3][4]
If a patient with fever, who is being treated for a different condition, remains febrile after 3 days, and if bleeding or shock occur, then VHF should be considered.
Symptoms
- Symptoms are varied and often appear suddenly.
Phase 1
Incubation period - duration approximately 2 - 21 days, followed by an abrupt onset of symptoms, which include:
General
Skin
Respiratory
Gastrointestinal
- Nausea
- Trouble swallowing
- Vomiting
- Abdominal pain - often related with true pancreatitis
- Diarrhea
Vascular
Neurological
Osteoarticular
Phase 2
Generally preceded by a short pseudoremission period, which lasts about 24 - 48 hours
Haemorrhagic manifestations
- Small red spots on the body
- Bruises
- Nasal bleeding
- Mucosal bleeding
- Bloody vomiting
- Bloody stools
- Bloody urine
- Uncontroled bleeding from venepuncture sites
Multiorgan failure and abnormalities
- Convulsions
- Metabolic disturbances
- Shock
- Coma
References
- ↑ Ndambi R, Akamituna P, Bonnet MJ, Tukadila AM, Muyembe-Tamfum JJ, Colebunders R (1999). "Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995". J Infect Dis. 179 Suppl 1: S8–10. doi:10.1086/514297. PMID 9988156.
- ↑ Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y; et al. (1999). "Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients". J Infect Dis. 179 Suppl 1: S1–7. doi:10.1086/514308. PMID 9988155.
- ↑ 3.0 3.1 Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.
- ↑ Sureau PH (1989). "Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire". Rev Infect Dis. 11 Suppl 4: S790–3. PMID 2749110.