Ebola Haemorrhagic Fever
|Common Name(s)||Ebola Haemorrhagic Fever|
|Scientific Name(s)||One of two members of the filovirus family; RNA viruses|
|Physical Attributes||Single negative strand RNA|
|Geography||Jungles of Africa and West Pacific|
|Mode(s) of Transmission||Direct contact with the blood and/or secretions of an infected person; handling of chimpanzees, gorillas, forest antelopes; contaminated medical equipment and other objects|
|Likely BW Form(s)||Possibly aerosol|
|Pathology||Fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain; some show rash, red eyes, hiccups and internal and external bleeding|
|Vector/Dormant Form||Some men, primates; others unknown|
|Incubation Period||2-21 days|
|Treatment||None besides supportive therapy|
The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo (formerly Zaire) in Africa, where it was first recognized. The virus is one of two members of a family of RNA viruses called the Filoviridae. There are four identified subtypes of Ebola virus. Three of the four have caused disease in humans: Ebola-Zaire, Ebola-Sudan, and Ebola-Ivory Coast. The fourth, Ebola-Reston, has caused disease in nonhuman primates, but not in humans. The natural reservoir of the virus is unknown.
The Ebola virus is transmitted by direct contact with the blood, secretions, organs or semen of infected persons. People can also be exposed to Ebola virus through contact with objects, such as needles, that have been contaminated with infected secretions. Transmission through semen may occur up to 7 weeks after clinical recovery, as with Marburg hemorrhagic fever. Health care workers have frequently been infected while attending patients. In the 1976 epidemic in Zaire, every Ebola case caused by contaminated syringes and needles died.
After an incubation period of 2 to 21 days, Ebola is often characterized by the sudden onset of fever, weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, limited kidney and liver functions, and both internal and external bleeding. Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA, polymerase chain reaction (PCR), and virus isolation can be used to diagnose a case of Ebola HF within a few days of the onset of symptoms.
No specific treatment or vaccine exists for Ebola hemorrhagic fever. Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids. Experimental studies involving the use of hyper immune sera on animals demonstrated no long-term protection against the disease after interruption of therapy.
Suspected cases should be isolated from other patients and strict barrier nursing techniques practiced. All hospital personnel should be briefed on the nature of the disease and its routes of transmission. Particular emphasis should be placed on ensuring that high-risk procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are done under barrier nursing conditions. Hospital staff should have individual gowns, gloves and masks. Gloves and masks must not be reused unless disinfected. Patients who die from the disease should be promptly buried or cremated.
As the primary mode of person-to-person transmission is contact with contaminated blood, secretion or body fluids, any person who has had close physical contact with patients should be kept under strict surveillance, i.e. body temperature checks twice a day, with immediate hospitalization and strict isolation recommended in case of temperatures above 38.3 C (101 F). Casual contacts should be placed on alert and asked to report any fever. Surveillance of suspected cases should continue for three weeks after the date of their last contact. Hospital personnel who come into close contact with patients or contaminated materials without barrier nursing attire must be considered exposed and put under close supervised surveillance.
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