Ebola Hemorrhagic Fever

Ebola hemorrhagic fever (EHF) is a life-threatening contagious disease in humans as well as animals (monkeys). Get complete information about the disease, including its cause, symptoms, diagnosis, treatment options and more.

Ebola Hemorrhagic Fever Definition

It is a fatal disease caused by any of the identified Ebola viruses. Till date, 5 types of Ebola viruses have been identified, among which only 4 are known to cause this disease in humans. This disease is characterized by varied symptoms which worsen with the progress of the disease.

Ebola Hemorrhagic Fever ICD 9 Code

This ICD9 code of this fever is 065.8.

Ebola Hemorrhagic Fever Synonyms

It is also known as:

  • Ebola virus disease
  • Viral hemorrhagic fever
  • Ebola virus infection

Ebola Hemorrhagic Fever History

The Ebola virus gets its name from the Ebola River situated in Republic of the Congo. The Ebola virus was discovered in the year 1976, after which it has continued to result in Ebola Hemorrhagic fever in thousands of humans and non-human primates.

Picture of Ebola Hemorrhagic Fever

Picture 1 – Ebola Hemorrhagic Fever

Since the discovery of the virus in the Democratic Republic of the Congo in Africa, it has struck around 18 times and killed many people. Ebola-Ivory Coast, Ebola-Sudan and Ebola-Zaire are the common names of the virus that have been identified to affect humans.

However, recently in the year 2007, another new species called Bundibugyo ebolavirus has been identified to cause an outbreak in the Bundibugyo region. Ebola-Reston is another subtype which has been recognized as the virus causing infection in the primates. The origin or natural reservoir of the Ebola virus is unknown. Taking the data of its occurrences into account, it can be believed that the disease is basically animal-borne.

Ebola Hemorrhagic Fever Incidence

Several outbreaks of this disease have been reported from equatorial Africa. Around 300 cases of SEBOV had occurred in the first outbreak in 1976, in Sudan, Nzara, Maridi, Juba and Tembura. More than 300 cases occurred in the Zaire region in the same year, among which almost 280 patients died. In the mid nineties, similar cases were reported with around 77% mortality. SUDV caused havoc in Uganda by infecting 425 people and killing 224 out of them. Cases reported in 2002 and 2003 have almost 91% mortality rate. Recent news from Uganda confirmed an outbreak in August, 2012 which includes 16 deaths from 23 reported cases.

Ebola Hemorrhagic Fever Outbreaks

Confirmed outbreaks of this disease have been reported from:

  • Yambuku – From this village the first outbreak of the Zaire virus reported on 26th August, 1976. This virus had been responsible for more cases of EHF, with high mortality rates.
  • Sudan – From here the first outbreak of Sudan ebolavirus was reported in 1976, with another recent occurring in the year 2004.
  • Cote d’Ivoire or Ivory Coast – It was reported to have occurred in the monkeys first in the year 1994, from which a scientist had contacted the disease. She recovered after receiving treatment from Switzerland.
  • Bundibugyo district – A new species of Ebola was reported from this Ugandan district in the year 2007. Confirmed reports about another outbreak in the year 2012 have also been reported from Congo.
  • Reston, Virginia – An Ebola outbreak in the native monkeys was reported in the year 1989 after which similar cases were found in Texas, Pennsylvania, Italy and Siena. However, the outbreak was constrained only in the monkeys and humans were not affected.

This viral disease seems to occur more in the faraway villages of West and Central Africa, which are close to the tropical rainforests.

What Causes Ebola Hemorrhagic Fever?

There are five classified viruses from the family of Filoviridae and genus Ebolavirus, among which four have been recognized to cause EHF in humans. The four Ebola species has been classified into:

  • Zaire ebolavirus (ZEBOV)
  • Sudan ebolavirus (SEBOV)
  • Côte d’Ivoire ebolavirus (CIEBOV)
  • Bundibugyo ebolavirus (BEBOV)

Researchers have assumed that humans get infected by coming in contact with an infected animal. Fruit bats, belonging to the Pteropodidae family, may be the possible natural hosts of this virus. Once a case is reported, it can spread amongst the other human members in the setting of the outbreak. One can be exposed to the virus by coming in direct contact with the blood or secretions of an infected person. The family members caring for a patient usually come under risk of developing this disease.

It can also spread due to a contact with needles that carry the secretions of infected patients. This outbreak may often occur in health-care settings such as hospitals. Known as nosocomial transmission, it takes place due to a lack of protective gear while caring for the patients. Working without gloves, masks or gowns and using contaminated needles (instead of disposable ones) on the part of medical workers are some of the reasons why the disease spreads in facilities in Africa.

Symptoms of Ebola Hemorrhagic Fever

Distinguishing the symptoms of EHF from other African viral diseases or Marburg virus disease (MVD) may be complicated due to the similarities displayed. Yet, on the basis of the studies for determining the symptoms of EVD performed in Zaire outbreak in the year 1995, these signs can be ascertained for EHF:

Some common symptoms noted in patients within a short time after infections are:

  • Discomfort/uneasiness
  • Severe headaches
  • Fever, along with chills
  • Muscle pain
  • Pain in the joints
  • Pain in the stomach
  • Nausea
  • Loose bowel movements/diarrhea

Although uncommon, the following symptoms may also show up in some of the patients:

  • Decreased appetite
  • Bloody diarrhea.
  • Cough/sore throat/Pharyngitis
  • Hiccups
  • Feeling confused
  • Fits

Symptoms which occur in a week include:

  • Depression
  • Chest pain
  • Hematoma or bruises
  • Petechia or red spots due to broken blood vessels.
  • Other forms of rashes and skin ailments
  • Swelling in the eyes
  • Blood loss from nose, eyes and ears
  • Swelling of genitals

In severe cases a patient may enter a coma, which is rare.

Ebola Hemorrhagic Fever Diagnosis

The diagnosis of EVD is made critical by the clinical similarities with MVD, typhoid fever, falciparum malaria, EHEC enteritis and different viral hemorrhagic fevers prevalent in sub-Saharan Africa crossed by the equator. Hence these procedures may be adopted for correct diagnosis:

  • Most importantly, the patient’s medical history is taken into consideration. This includes investigating aspects like possible animal contacts, places visited by the patient and so on.
  • Secondly, by collecting blood samples from the patient a confirmed report can be generated. If it displays ebolavirus antigen or RNA ( subgenomic or genomic), EHF can be diagnosed.
  • Laboratory tests like ELISA – Antigen-captureenzyme-linked immunosorbent assay, PCR- polymerase chain reaction, virus isolation process and IgG ELISA are performed to detect acute EHF.
  • Tests which can be performed later after recovery or when the disease has progressed include IgG and IgM antibodies.

Ebola Hemorrhagic Fever Treatment

There is no standard treatment for EBH that has been approved by FDA. This is why patients are provided with supportive treatments. Until now, there are no vaccines for preventing this disease. Some of the supportive treatments include:

  • Checking dehydration by using therapies which balance electrolytes and fluids.
  • In the early stages, anticoagulants are administered in order to stop disseminated intravascular coagulation from occurring.
  • Antibiotics are given to heal secondary infections.
  • In later stages of infection, procoagulants are administered with an aim to control hemorrhages.
  • Oxygen levels should be maintained.
  • Pain is managed by giving drugs and therapies.

How long does EHF last?

The incubation period for the EBOV infection has been found to be around 12 days. However, it may last as long as 25 days. The disease is transmittable until the blood secretions contain the virus.

Ebola Hemorrhagic Fever Prevention

Prevention of EHF is not an easy task as the origin of the virus is not known. However, there still exist some primary measures which may seem to be effective in the avoidance of the condition.

First of all, the medical facilities providing treatment to EHF patients need to be active in curtailing its spread, after the report of one such case. In the presence of proper diagnostic tools, the task becomes easier.

A medical care facility must also be able to employ isolation of the patients in order to stop contagion. Staffs of the healthcare facilities should be given proper protective clothing and gear which can safeguard them from contacting this disease. Even family members should avoid direct skin contact as it spreads on contact.

Sterilization of equipments and complete protective settings can ensure the limitation of the infection. If direct contact with patients is limited, chances of infection reduce.

The Center for Disease Control and Prevention (CDC) along with World Health Organization (WHO) has developed the guidelines which the hospitals should follow. To prevent many such outbreaks in future, extensive research is demanded to probe the spread of the Ebola virus along with its reservoir.

Ebola Hemorrhagic Fever Risk factors

Some of these factors may increase the chances of getting infected with Ebola viruses:

  • Professionals involved with animal research, especially monkeys that are flown down from African sites. Ones imported from Philippines might pose a risk for them too.
  • While handling the dead bodies of those infected with EVD during funeral may heighten the chances to some extent.
  • Traveling to African locales which had reported of Ebola outbreaks should be checked.
  • In the absence of protection, medical professionals and caregivers are at risk including the family members.

Ebola Hemorrhagic Fever Life expectancy

The life span of the host of the virus is considerably reduced. Patients may die in just a few days or weeks. Around 75% to 90% mortality rate can be noted in patients suffering from EHF.

Ebola Hemorrhagic Fever Prognosis

As per medical records, the prognosis of this disease is poor. High mortality is associated with the disease. If a patient lives, he/she may be afflicted with long term problems like alopecia, orchitis, muscle pain or joints pain. In some patients, occurrence of ocular ailments like iridocyclitis, photophobia, choroiditis, blindness and tears overflow can be noted. Death usually occurs due to MODS (Multiple Organ Dysfunction Syndrome) as a result of focal tissue necrosis, fluid redistribution and hypotension.

Ebola Hemorrhagic Fever Facts

Check out some important facts associated to the condition:

Image of Ebola Hemorrhagic Fever

Picture 2 – Ebola Hemorrhagic Fever Image

  • Ebola viruses have been considered as potent bioterrorism agents in conjunction with Marburg viruses.
  • Soviet Union manufactured bioweapon from Marburg virus as it showed more stability than Ebola.
  • Ebolaviruses require Biosafety Level 4-equivalent containment, as they are World Health Organization Risk Group 4 Pathogens.
  • According to reports from the BBC, around 5,000 gorillas have died due to Ebola outbreak.

References:

http://en.wikipedia.org/wiki/Ebola_virus_disease#Signs_and_symptoms

http://www.webmd.com/a-to-z-guides/ebola-hemorrhagic

http://www.who.int/mediacentre/factsheets/fs103/en/

http://www.webmd.com/a-to-z-guides/ebola-hemorrhagic?page=3

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