Ebola hemorrhagic fever

Definition

Ebola hemorrhagic fever is a severe illness that can be transmitted to humans from infected animals and animal materials. Ebola can also be transmitted from human to human by close contact with infected bodily fluids, or through infected needles in the hospital. The virus causes severe bleeding abnormalities and shock.

Causes, incidence, and risk factors

Ebola hemorrhagic fever (Ebola fever) is a viral disease. The human form of this disease has so far been limited to parts of Africa. Four people in the United States, who were infected with a subtype of the virus (known as Ebola Reston), did not develop any signs of disease. Ebola hemorrhagic fever has been newsworthy worldwide because of its destructive potential.

Transmission can occur from contact with infected animals, humans, or contaminated needles. The incubation period appears to be up to 1 week, at which time the patient develops  fatigue, malaise, headache, backache, vomiting, and diarrhea.

Within a week, a raised rash appears over the entire body. The rash is often hemorrhagic (contains blood). Hemorrhaging generally occurs from the gastrointestinal tract, causing the patient to bleed from both the mouth and rectum. Mortality is high, reaching 90%. Patients usually die from shock rather than blood loss.

Symptoms

Early symptoms:

• Malaise
• Fatigue
• Headache
• Sore throat
• Backache (low)
• Nausea
• Vomiting
• Diarrhea
• Arthritis

Late symptoms:

• Conjunctivitis (eye inflammation)
• Generalized rash, hemorrhagic
• Roof of mouth looks red
• Genital swelling (labia and scrotum)
• Depression
• Increased sense of pain in skin
• Gastrointestinal bleeding (from mouth and rectum)
• Bleeding from eyes, ears, and nose
• Seizures, coma, delirium

Signs and tests

There may be signs and symptoms of:

• Disseminated intravascular coagulation
• Shock
• Coma

Tests used in the diagnosis of Ebola fever include:

• Coagulation studies (tests of how well the blood will clot)
• Studies to demonstrate exposure to the Ebola virus
• CBC may demonstrate a low white blood cell count and low platelet count (thrombocytopenia)
• Electrolytes

Treatment

There is no known cure for the disorder at this time. No antivirals (medications that fight viruses) have yet been developed that show good activity against this virus. More recently, however, vaccines have been developed that are very effective in protecting monkeys against the virus, and trials in humans are underway.

The main course of treatment at this time is supportive care. The patient is usually hospitalized and will most likely need intensive care. Supportive measures for shock will be used (including medications and intravenous fluids).

There will be an attempt to correct bleeding abnormalities, often including transfusions of platelets and/or fresh blood.

Expectations (prognosis)

There is a high fatality rate for this disease (80% to 90%).

Complications

Survivors may have unusual problems, such as hair loss and sensory changes.

Calling your health care provider

Call your health care provider if you have traveled to Africa (or if you know you have been exposed to Ebola fever) and you develop symptoms of the disorder. Early diagnosis and treatment may help improve the chances of survival.

Prevention

Avoid areas of epidemics. Absolute gown, glove, and mask precautions are necessary around sick patients. These precautions will greatly decrease the risk of transmission.

Illustrations

Ebola virus

Antibodies

Page Content:

Ebola virus infection; Viral hemorrhagic fever ; fever hemorrhagic viral