Ebola Haemorrhagic Fever
Commonly abbreviated as Ebola HF, the infectious disease known as Ebola Haemorrhagic Fever is a serious illness that is frequently fatal. Ebola HF is not only life threatening for humans, but for primates such as chimps, gorillas, and monkeys as well. Ebola Haemorrhagic Fever was first diagnosed in 1976 and has since had scattered outbreaks.
Ebola HF is caused by an infection from the Ebola virus from the RNA family of viruses called Filovirdae. There are four subtypes of the Ebola virus, three of which can cause disease in humans. The three viruses that impact humans are: Ebola-Ivory Coast, Ebola-Zaire, and the Ebola Sudan. The fourth subtype of the Ebola virus, the Ebola-Reston, causes disease in nonhuman primates rather than in humans. The Ebola virus takes its name from a river in the Democratic Republic of the Congo, where the virus was initially identified.
The natural reservoir of the Ebola virus has yet to be determined. Scientists theorize that the Ebola virus is zoonotic and is typically hosted by an animal originating from Africa. There is a report of isolation of the Ebola-Reston in cynomolgous monkeys residing in America and Italy, but the monkeys had been imported from the Philippines. The Ebola virus is not native to any other continent than Africa.
There have been reports of Ebola HF in the Republic of the Congo, the Democratic Republic of the Congo, the Ivory Coast, Gabon, Uganda, and Sudan. In Liberia, there was a case of a person with indication of Ebola infection, but the person showed no symptoms of disease. In England, an individual working in a laboratory contracted Ebola HF from accidental contact with an infected needle. There has never been a case of Ebola HF in humans in America, though the Ebola-Reston has caused disease in monkeys used for research in American facilities. There were reports of laboratory workers becoming infected with Ebola-Reston, but the virus did not cause disease.
Outbreaks of Ebola HF tends to occur at irregular intervals in a medical care environment. Some scientists suggest that sporadic isolated instances may go unnoticed. The Ebola virus causes acute infection without a carrier state. We do not know exactly how the Ebola virus initially inhabits a human at the onset of an outbreak because its natural reservoir is unidentified. The general consensus is that contact with an infected animal occurs.
Transmission from the initial case patient at the start of an outbreak can occur through various means. Direct contact with the contaminated secretions or the blood is a common method. This is how the Ebola virus is commonly spread between friends and family members as healthy individuals nurse sick individuals. The Ebola virus can also spread from contaminated needles or various objects that have infected blood or secretions on them.
When an outbreak occurs in a medical facility, the transmission is referred to as nosocomial. Nosocomial transmission is common to outbreaks of Ebola HF because in Africa, many medical facilities lack protective gear for the staff such as gloves and masks. When infected individuals are treated without protective gear, it is more likely that the health care provider will contract the virus. Facilities may also lack disposable syringes or practice improper sterilization and hygiene. Reused needles can quickly spread infection.
When an outbreak of Ebola-Reston occurred at a laboratory in the state of Virginia, it was suspected that transmission occurred through the air from primate to primate. Ebola viruses do have the capacity to spread through the air, but there have been no recorded instances of Ebola HF spreading from human to human through the air.
The symptoms of Ebola HF manifest after an incubation period of approximately five weeks. Symptoms strike suddenly and can include muscle aches, fever, joint aches, weakness, headache, and sore throat. Stomach pain, vomiting, and diarrhea often follow such symptoms with external bleeding, rash, hiccups, and red eyes as less common symptoms.
It has yet to be determined why some patients make a full recovery from Ebola HF while others do not. Data does show that most patients who die from Ebola HF fail to produce an adequate response through their immune system.
Diagnosis of Ebola HF can be difficult because its early symptoms are not specific to the Ebola virus. Diagnosis becomes easier when patients display the wide range of symptoms common to the disease and necessitates isolation of the patient and notifying the CDC as well as health departments relevant to the patient’s location.
Laboratory tests are required to diagnose Ebola HF. When it has only been two or three days since the manifestation of symptoms, the following tests are used: ELISA testing, IgM ELISA, virus isolation, and PCR. ELISA testing is antigen capture enzyme linked immunosorbent assay testing while PCR testing is polymerase chain reaction testing. For later stages of Ebola HF, tests for IgM and IgG antibodies can be done. Retrospective diagnosis on individuals who have suffered fatalities can be done through virus isolation, PCR, or immunohistochemistry testing.
Treatment of Ebola HF is mainly supportive therapy so that the patient has plenty of fluids and electrolytes, maintained oxygen, good blood pressure, and fighting any complications such as infections. There is no standard formula for treatment.
Prevention of Ebola HF is challenging because the natural reservoir of the virus is unknown. Socioeconomic factors contribute to outbreaks occurring at epidemic levels in medical care facilities. Therefore, it is especially important that medical staff can identify a case of Ebola HF should an instance occur. The facility should be equipped with the appropriate diagnostic equipment and a means to isolate a case and contain the outbreak. Medical staff should always use protective gear and practice excellent hygiene, sanitation, and sterilization. The blood and secretions of patients, living or deceased should be avoided at all times.