Ebola (patient information)
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Ebola |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ebola hemorrhagic fever is a severe and often deadly illness (death rate up to 90%) that can occur in humans and in primates (monkeys, gorillas). Ebola hemorrhagic fever has made worldwide news, first appearing in 1976, because of its destructive potential. Although the origin of the virus is not known, fruit bats are considered the likely host.
What causes Ebola?
Ebola hemorrhagic fever (Ebola fever) is caused by a virus belonging to the family called Filoviridae. Scientists have identified four types of the Ebola virus. Three have been reported to cause disease in humans: Ebola-Zaire virus, Ebola-Sudan virus, and Ebola-Ivory Coast virus. The human disease has so far been limited to parts of Africa. A very small number of people in the United States who were infected with the fourth type of the virus, known as Ebola Reston, did not develop any signs of disease. The disease can be passed to humans from infected animals and animal materials. Ebola can also be spread between humans by close contact with infected bodily fluids or through infected needles in the hospital. A person infected with Ebola is contagious from the moment he/she begins to show symptoms.
What are the symptoms of Ebola?
During the incubation period, which can last from 2 to 21 days, symptoms may include:
- Muscle pain
- Backache (low back pain)
- Headache
Late symptoms include:
- Depression
- Eye inflammation (conjunctivitis)
- Genital swelling (labia and scrotum)
- Increased feeling of pain in skin
- Rash over the entire body that often contains blood (hemorrhagic)
- Roof of mouth looks red
- Seizures, coma, delirium
As many as 90% of patients die from the disease. Patients usually die from shock rather than from blood loss
Who is at highest risk?
Persons at an increased risk for Ebola include:
- If you have traveled to an area of the world where Ebola occurs frequently (such as Central Africa)
- Hospital staff/caregivers for patients with Ebola
- Family members or close contacts of infected people
- People who have close contact with the body of a deceased person, infected with ebola virus, during burial ceremonies
- Hunters in rain forests who contact with dead animals abandoned in the forest
- Research is being conducted to evaluate the risk of immunocompromised people or those with underlying diseases, to contacting the Ebola virus
When to seek urgent medical care?
A person should seek urgent medical care when:
- Has traveled to Africa
- Has been in an area known to have Ebola virus disease
- Has been in contact with another person who is known or suspected to have Ebola and is starting to show symptoms
- Has been exposed to Ebola fever
- Develops symptoms of the disorder.
Urgent medical care is fundamental to improve survival rate, as well as to control the spread of the disease. Early diagnosis and treatment may improve the chances of survival.
Infection control procedures need to be started promptly
Diagnosis
There may be signs and symptoms of:
Ebola virus infection can only be identified through laboratory testing. Tests used to diagnose Ebola fever include:
- CBC, commonly showing:
- Low platelet count
- Elevated liver enzymes
- Electrolytes
- Tests of how well the blood will clot (coagulation studies)
- Tests to show whether someone has been exposed to the Ebola virus
Treatment options
Currently there is no specific treatment for Ebola fever, since current antiviral drugs do not work on the Ebola virus. The patient is usually hospitalized and will most likely need intensive care. For patients with the disease, the available supportive care measures include:
- Oral rehydration and/or intravenous fluids, with solutions containing electrolytes, for dehydrated patients
- Bleeding problems may require transfusions of platelets or fresh blood
To avoid the spread of the disease, patients who are suspected of being infected, or those who have the confirmed diagnosis, should be isolated and treated by healthcare practitioners, under strict infection control precautions.
Some patients will recover with the appropriate medical care.
Where to find medical care for Ebola?
Directions to Hospitals Treating Ebola
What to expect (Outlook/Prognosis)?
As many as 90% of patients die from the disease. Patients usually die from shock rather than blood loss.
Possible complications
Survivors may have hair loss and sensory changes.
Prevention
Communities
Currently there is no approved vaccine to prevent disease by Ebola virus. The only way to prevent infection and reduce the number of deaths, is by being aware of the risk factors and following protective measures for individual safety, which include:
- Follow directions issued by your country's Ministry of Health
- Animal meat should be thoroughly cooked before eating
- Reduce contact with high risk animals in rainforest areas, such as
- Fruit bats
- Monkeys
- Apes
- Avoid handling infected animals or carcasses. If you suspect an animal is infected, do not touch it
- Wash hands with soap and water frequently, particularly when visiting patients at hospitals or caring for someone at home. Do so specially after touching a patient, bodily fluids or patient's personal items and surroundings
- Avoid areas in which there are epidemics
- Avoid direct contact with the bodily fluids of ill persons, either through unsafe case management or unsafe burial practices
- Wear a gown, gloves, and mask around sick patients
- Protective measures at healthcare facilities, social gatherings and at home
- In case of suspicion of someone infected by Ebola virus in your community, encourage and support them to seek medical attention
- If you want to care for a person with the disease in hour home, notify public health officials of your intention, in order for them to provide adequate training, protective equipment and instructions to care for the patient and protect yourself, your family and to properly dispose of the used materials
- Deceased persons, who died from Ebola virus infection should be handled with appropriate equipment and buried immediately
Health Care Workers
Healthcare workers treating patients with suspected or confirmed illness are at higher risk of infection than other groups.
In addition to standard healthcare precautions, healthcare workers should apply rigorous recommended infection control measures to avoid exposure to infected blood, fluids, or contaminated environments or objects, such as the patient’s soiled linens or used needles. Additionally they should:
- Use personal protection equipment such as individual gowns, gloves, masks and goggles or face shields
- Not reuse protective equipment or clothing unless they have been properly disinfected
- Change gloves between caring for each patient suspected of having Ebola
- Carry out invasive procedures, that can expose medical doctors, nurses and others to infection, under strict and safe conditions
Alternative names
Ebola virus infection; Viral hemorrhagic fever
Sources
http://www.cdc.gov/vhf/ebola/
http://www.nlm.nih.gov/medlineplus/ency/article/001339.htm
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