Ebola Virus Disease In

Ebola Virus Disease (EVD), also known as Ebola Hemorrhagic Fever (EHF), is a severe, often fatal illness in humans caused by the Ebola virus. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. The average EVD case fatality rate is around 50%, although it can vary from 25% to 90% in different outbreaks.

Etiology

The disease is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified species of the Ebolavirus, four of which are known to cause disease in humans: Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, and Bundibugyo ebolavirus. The fifth, Reston ebolavirus, has caused disease in nonhuman primates but not in humans.

Transmission

EVD is transmitted through direct contact with blood, secretions, organs or other bodily fluids of infected animals, such as fruit bats or nonhuman primates. It can also spread through contact with surfaces and materials contaminated with these fluids. Human-to-human transmission occurs through direct contact with the blood, secretions, organs, or other bodily fluids of infected people, and with surfaces and materials (e.g., bedding, clothing) contaminated with these fluids.

Symptoms

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache, and sore throat. This is followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g., oozing from the gums, blood in the stools).

Diagnosis

Diagnosing EVD in an individual who has been infected for only a few days is difficult, as the early symptoms are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever. However, if a person has the early symptoms of EVD and has had contact with the blood or bodily fluids of a person sick with EVD or has been in an area known to have EVD, samples from the patient can be collected and tested to confirm infection.

Treatment

Supportive care—rehydration with oral or intravenous fluids—and treatment of specific symptoms, improves survival. There is no licensed treatment proven to neutralize the virus but a range of blood, immunological, and drug therapies are under development. There are also two potential vaccines currently being evaluated for their safety and efficacy to prevent EVD.

Prevention

Prevention includes reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Measures to prevent human-to-human transmission include regular hand washing, wearing protective clothing, and avoiding contact with the bodily fluids of individuals infected with EVD. Outbreak containment measures include prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with EVD, and monitoring their health for 21 days.

Epidemiology

Since its discovery in 1976, the virus has led to numerous outbreaks, primarily in sub-Saharan Africa. The largest outbreak to date occurred in West Africa from 2014 to 2016, which led to more than 28,000 cases and 11,000 deaths.

See Also

• Viral hemorrhagic fever
• Infectious disease
• Outbreak

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