Ebola Virus Disease (EVD)
Ebola virus disease (EVD) is a deadly disease with occasional outbreaks that occur mostly on the African continent. It is also known as Ebola hemorrhagic fever (EHF). EVD most commonly affects people and nonhuman primates (such as monkeys, gorillas, bats and chimpanzees).
Case fatality rates have varied from 25 to 90 percent in past outbreaks. The average case fatality rate is around 50 percent.
Ebola is a virus that causes problems with how your blood clots. It is known as a hemorrhagic fever virus, because the clotting problems lead to internal bleeding, as blood leaks from small blood vessels in your body. The virus also causes inflammation and tissue damage.
The Ebola virus first appeared during two 1976 outbreaks in Africa. Ebola gets its name from the Ebola River, which is near one of the villages in the Democratic Republic of Congo where the disease first appeared.
The time between exposure and when symptoms occur (incubation period) is 2 to 21 days. On average, symptoms develop in 8 to 10 days.
Late symptoms include:
• Bleeding from the mouth and rectum
• Bleeding from eyes, ears, and nose
• Organ failure
The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, six species have been identified –
• Ebola virus (species Zaire ebolavirus)
• Sudan virus (species Sudan ebolavirus)
• Taï Forest virus (species Taï Forest ebolavirus)
• Bundibugyo virus (species Bundibugyo ebolavirus)
• Reston virus (species Reston ebolavirus)
• Bombali virus (species Bombali ebolavirus)
Ebola virus disease (EVD) in humans is caused by above four viruses. Fifth one Reston virus does not cause disease in humans but in primates. Bombali virus was first identified in bats in 2018, and experts do not know yet if it causes disease in either animals or people.
Ebola does not spread as easily as more common illnesses such as colds, the flu, or measles. There is NO evidence that the virus that causes Ebola is spread through the air or water. A person who has Ebola CANNOT spread the disease until symptoms appear.
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with:
• Bedclothes and bedding
• Needles and syringes
• Medical equipment
• Blood or body fluids of a person who is sick with or has died from Ebola
• Objects that have been contaminated with body fluids (like blood, feces, vomit) from a person sick with Ebola or the body of a person who died from Ebola
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This occurs through close contact with patients when infection control precautions are not strictly practiced.
Pregnant women who get acute Ebola and recover from the disease may still carry the virus in breastmilk, or in pregnancy related fluids and tissues. This poses a risk of transmission to the baby they carry, and to others.
Ebola does NOT spread through –
• Insects (mosquitoes)
Ebola virus lead to death for a high number of people who are affected. As the illnesses progress, the viruses can cause:
It can be difficult to clinically distinguish Ebola virus disease (EVD) other infectious diseases such as malaria, typhoid fever and meningitis. Many symptoms of pregnancy and Ebola disease are also quite similar.
Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.
Confirmation that symptoms are caused by Ebola virus infection are made using the following diagnostic methods:
• antibody-capture enzyme-linked immunosorbent assay (ELISA)
• antigen-capture detection tests
• serum neutralization test
• reverse transcriptase polymerase chain reaction (RT-PCR) assay
• electron microscopy
• virus isolation by cell culture
Current WHO recommended tests include:
• Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
• Rapid antigen detection tests for use in remote settings where NATs are not readily available
There’s no cure for Ebola, though researchers are working on it. There are two drug treatments which have been approved for treating Ebola.
• Inmazeb is a mixture of three monoclonal antibodies (atoltivimab, maftivimab, and odesivimab-ebgn).
• Ansuvimab-zykl (Ebanga) is a monoclonal antibody given as an injection. It helps block the virus from the cell receptor, preventing its entry into the cell.
Doctors manage the symptoms of Ebola with:
• Fluids and electrolytes
• Blood pressure medication
• Blood transfusions
• Treatment for other infections
A vaccine Ervebo is available to prevent Ebola virus disease(EVD) in people who live in the most at-risk countries. If you plan to travel to one of the countries where Ebola is present, the CDC recommends taking the following steps to prevent illness:
• Practice careful hygiene. Wash your hands with soap and water or an alcohol-based hand sanitizer. Avoid contact with blood and body fluids.
• Avoid contact with people who have a fever, are vomiting, or appear ill.
• Do not handle items that may have come in contact with an infected person’s blood or body fluids. This includes clothes, bedding, needles, and medical equipment.
• Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
• Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.
• Avoid hospitals in West Africa where Ebola patients are being treated.
• After you return, pay attention to your health for 21 days. Seek medical care right away if you develop symptoms of Ebola, such as a fever. Tell the provider that you have been to a country where Ebola is present.
Health care workers who may be exposed to people with Ebola should follow these steps:
• Wear PPE, including protective clothing, including masks, gloves, gowns, and eye protection.
• Practice proper infection control and sterilization measures.
• Isolate patients with Ebola from other patients.
• Avoid direct contact with the bodies of people who have died from Ebola.
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