Ebola virus disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 11, 2016
StartDiseasesEbola virus disease

Ebola virus disease (abbreviated to EVD and also simply called Ebola) is often fatal in humans, monkeys, and chimpanzees. Since it is a viral hemorrhagic fever, it used to be known as Ebola hemorrhagic fever. It was first discovered in Africa in 1976 and there was a major outbreak of the disease in West Africa in 2014.

Contents

Definition & Facts

First discovered in Africa, scientists believe that it initially began in fruit bats. It can be transmitted between a number of different animals, including humans, primates, forest antelopes, and porcupines. EVD is caused by the Ebolavirus genus which belongs to the Filoviridae family of viruses. There are five strains of Ebolavirus and they include Zaire (also termed Ebola virus), Bundibugyo ebolavirus, Sudan ebolavirus, Reston ebolavirus and Taï Forest ebolavirus. The Reston virus is communicable among chimpanzees, gorillas and monkeys but not among human beings.

Symptoms & Complaints

The onset of symptoms after exposure is varied among patients. Some have symptoms within just two days after exposure. Others do not have symptoms until three weeks after exposure. In most cases, if an individual has EVD, they can expect symptoms within eight days.

The most prominent symptom that the patient can expect is extreme fatigue. Other accompanying symptoms will include a high grade fever, a headache, muscle pain, and stomach pain, vomiting and diarrhea. In many cases, individuals with EVD exhibit unexplained bleeding. This bleeding will occur about a week after the onset of the initial symptoms. It will often occur at the site of needle punctures or mucous membranes.

Bleeding in the skin can also lead to a number of other medical conditions, such as discolored spots or scabs and bruising. Some patients have internal bleeding. They may show symptoms such as coughing up blood, a bloody stool, or bleeding in the eyes.

In rare but serious cases, patients have heavy bleeding in the gastrointestinal tract. Bleeding is often one of the most fatal symptoms that accompanies the EVD, as some patients who do not have access to treatment succumb to death by blood loss.

Causes

While the virus is not airborne, it is highly contagious. Somebody can be infected by contact with bodily fluids of an infected person or animal. If an individual comes in contact with blood, diarrhea, breast milk, feces, saliva, semen, sweat, urine, or vomit, they will be at risk. If any of these are ingested (via the eyes, mouth, lesions, nose, or sexual contact) EVD will spread.

This means that people who work closely with animals will be at particular risk. Infected animals can spread Ebola to humans as easily as they can spread them to other animals. Individuals who work closely with animals (especially in areas were Ebola is not contained) will be at risk.

Healthcare workers are also at risk. This is particularly true if a healthcare worker is traveling to an area where medical equipment is not available and unsanitary medical practices are exhibited. Certain objects may be infected (particularly needles). Areas where there was recently a breakout will be full of contagions. Funeral mourners who handle corpses are also at high risk for contracting Ebola because the virus survives after its host has perished.

Diagnosis & Tests

People who have Ebola will often just think that they have the flu and that it will go away in a few days. But if patients do detect that something is amiss and go to the doctor, blood tests can detect Ebola's antibodies. They can also detect factors that correlate to Ebolavirus, such as an usually low white blood cell count or high white blood cell count. They may detect abnormal coagulation levels or elevated liver enzymes or a low platelet count.

If blood tests are not available, the doctor will consider the conditions in which the patient lives. He or she will ask if this patient is in close contact with the Ebola virus. The patient may also be isolated for observation for three weeks. If after three weeks, they are not exhibiting any of the symptoms of Ebola, doctors will safely rule out a possible Ebola infection (as symptoms always arise within three weeks). Thus, the patient will either be diagnosed with Ebola or cleared, and if the patient does have Ebola, he or she can continue to be isolated to prevent transmission to other people.

Treatment & Therapy

Ebola virus research has not yet found a definitive cure or vaccine at this time. But in July of 2015, patients were responding positively to the vaccine known as VSV-EBOV. Nonetheless, there are several approaches that physicians have taken that have demonstrated success and prevented patient fatality. They may consider the following:

  • Treat other infections that increase the patient's discomfort.
  • Provide the patient with extra oxygen.
  • Balance the patient's electrolytes.
  • Manage any bleeding.
  • Manage the patient's blood pressure.
  • Prevent dehydration.

Prevention & Prophylaxis

While there is no vaccine for Ebola, people will be able to take measures for prevention by avoiding any form of contact with an individual diagnosed with Ebola. People also need to avoid handling the corpse of an individual who has died from Ebola. One should also don the appropriate clothing around animals who may have Ebola. Healthcare workers usually go to extreme measure to wear proper equipment when handling objects that an Ebola patient has handled.