Ebola history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S. Guillermo Rodriguez Nava, M.D. [2]
Overview
Ebola hemorrhagic fever is potentially lethal and encompasses a range of symptoms including fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and external bleeding, that follow an incubation period of 2-21 days.
Case definition recommendations
- Standard case definition recommended by WHO-AFRO for the notification of Ebola or Marburg cases:[1]
- Suspected Ebola or Marburg cases for routine surveillance: Illness with onset of fever and no response to treatment for usual causes of fever in the area, and at least one of the following signs: bloody diarrhea, bleeding from gums, bleeding into skin (purpura), bleeding into eyes and urine.
- Confirmed Ebola or Marburg cases for routine surveillance: A suspected case with laboratory confirmation (positive IgM antibody, positive PCR or viral isolation).
History and Symptoms
- In an outbreak situation, several cases occur around the same time. They may be grouped together, and there may be person-to-person transmission. An initial diagnosis of a viral hemorrhagic fever (VHF) can be made based on the signs and symptoms of the specific VHF.
- Suspecting a VHF during a non-outbreak situation in a single case is more difficult. The early symptoms of a VHF include high fever and headache. These are also symptoms for many infections seen at the health facility.
- Most patients who present with fever do not have a VHF. Their fever is more often caused by malaria, typhoid fever, dysentery,severe bacterial infection or other fever-producing illnesses usually seen in the area.
- When a patient presents with fever, exclude other causes of fever. For example, do a malaria smear or take a stool culture as soon as possible.
- Treat the most likely cause of the fever according to the appropriate treatment guidelines.
- If the fever continues after 3 days of recommended treatment, and if the patient has signs such as bleeding or shock, consider a VHF.
- Review the patient’s history for any contact with someone who was ill with fever and bleeding or who died from an unexplained illness with fever and bleeding.
- If no other cause is found for the patient’s signs and symptoms, suspect a VHF. Begin VHF Isolation Precautions.[2]
- Symptoms are varied and often appear suddenly.
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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." Occasionally, internal and external hemorrhage from orifices, 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 clotting. Fewer than 50 percent of patients will not develop any hemorrhaging.
References
- ↑ "Case definition recommendations for Ebola or Marburg Virus Diseases" (PDF).
- ↑ "Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting" (PDF). line feed character in
|title=at position 75 (help) - ↑ 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.
- ↑ 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.