Ebola virus disease (EVD)

Notes
  • Ebola virus (family Filoviridae) have five species: Zaire (cause of 2014 outbreak in West Afica)), Bundibugyo, Sudan, Reston and Taï Forest.
  • The name of the virus was derived from Ebola river, a tributary of river Congo, that is near Yambuku where the virus was first dscovered.
  • The worst outbreak of Ebola in history started in march 2014 in West Africa with the worst effected countries being Liberia, Sierra Leone and Guinea. Other countries that were affected were Nigeria, Senegal and Mali. In total 28,652 cases and 11,325 deaths were reported. Prior to this, the worst outbreak had been the one in Uganda in  2007 with 149 cases and 37 fatalities, with the second wost outbreak being that of Democratic  Republic of Congo (56 cases and 43 fatalities). Before  2007 the annual incidence of Ebola globally was less than three cases.
  • Statistics: Fatality rate - about 50%. Incubation period - 2 to 21 days. Time to monitor suspected exposed case.
  1. Transmission
  • The first human infection occurs through contact with an infected animal e.g. fruit bat and primate. This is followed by the person-to-person transmissions.
Symptoms
  • Severe fever
  • Headache
  • Red eyes
  • Hiccups
  • Joint pain
  • Myalgia
  • Diarrhea
  • Nausea
  • Vomiting
  • Sore throat
  • Expressionless facies
  • Hepatic and renal disorders
  • External and internal hemorrhage
  • Myocarditis
  • Pulmonary edema
  • Anuria
  • Coma
  • Death is caused by multiple organ dysfunction syndrome as a result of fluid redistribution, hypotension, disseminated intravascular coagulation (DIC), and focal tissue necroses.
Diagnosis
  • ELISA - for antigens or for IgM and IgG antibodies
  • RT-PCR
  • Cell & culture viral isolation
  • General tests – Full blood counts, urea, pH, BUN and liver tests.
Differential
  • Malaria
  • Typhoid fever
  • Meningitis
Management
  • Supportive treatment that include rehydration
  • Ebola survivors and their sexual partners should use condom or abstain from sex until their semen has twice tested negative.
  • Non-inactivated samples to be tested under maximum biological containment conditions.
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