CONDITIONS

What Is Ebola

The Centers for Disease Control and Prevention (CDC) defines Ebola as a hemorrhagic fever, which is caused by an infection with one or more of the four strains of the Ebola virus known to be infectious to humans.

Ebola is an infectious and generally fatal disease marked by fever and severe internal bleeding. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission via infected bodily fluids like saliva, blood, semen, sweat, tears urine and more.

Ebola first came onto the medical radar in the 1976, and was named after a river in the Democratic Republic of Congo (formerly Zaire), near where the disease was first observed. Ebola first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo.

Outbreaks of Ebola have occurred sporadically throughout Africa since its discovery. However, the recent spike in global travel has caused an increase in media coverage of the disease. The current outbreak in West Africa, (first cases reported in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined.

Certain groups have had higher rates of infection. Health-care workers have frequently been infected while treating patients with suspected or confirmed Ebola. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.

It is important to note that people remain infectious as long as their blood contains the virus.

What Causes Ebola

Ebola is caused by an infection with one of four strains of the Ebola virus known to be infectious to humans. These strains are:

  • Ebola virus (Zaire ebolavirus)
  • Sudan virus (Sudan ebolavirus)
  • Taï Forest virus (Taï Forest ebolavirus)
  • Bundibugyo virus (Bundibugyo ebolavirus)

Though most of the media coverage of Ebola focuses on human cases, the disease is also found in non-human primates, and is thought to be an animal-borne illness (transmitted through animals, in the case of Ebola: bats). Ebola is a highly contagious disease, though the CDC reports that it is only transmittable through direct contact with infected bodily fluids. This means that the disease is not airborne, and therefore poses slightly less risk as an epidemic disease.

According to the CDC, bodily fluids through which Ebola may spread include:

  • Blood
  • Urine
  • Saliva
  • Feces
  • Vomit
  • Breast Milk
  • Semen

The disease may also be transmitted through contact with objects that have come into contact with infected bodily fluids (including medical tools such as needles and syringes), infected bats and/or nonhuman primates, and direct contact with bodily fluids from a recovered Ebola patient. The CDC also notes that Ebola is only contagious after symptoms have started to occur. This means that if you come into contact with a person who later develops Ebola, it is likely that you will not contract the disease.

 

Risk Factors For Ebola

Is it likely that I will contract Ebola? The latest and most deadly Ebola outbreak has caused global concern over possible outbreaks, especially with increased urbanization and long-distance travel. However, most governments have placed strict sanctions on travelers coming from Ebola-outbreak regions.

In the US, the CDC has issued travel warnings for passengers flying to Guinea and Sierra Leone, instructing travelers to avoid nonessential travel. A similar, less severe travel alert exists for passengers flying to Liberia, who are instructed to use enhanced precautions. Some state governments have chosen to quarantine patients flying in from Ebola-affected regions for several days or weeks to prevent possible outbreaks. In 2014, there were only 4 confirmed cases of Ebola in the US. Watch for signs of Ebola and follow these Ebola prevention tips to help lessen the chance of an outbreak in your area.

Diagnosing Ebola

Diagnosing Ebola can be difficult due to the symptoms it shares with other hemorrhagic fevers. In addition to the presence of Ebola symptoms and recent travel to or from an Ebola-affected region, doctors can use  several tests to confirm an Ebola diagnosis. The World Health Organization (WHO) lists the following as confirmation tests for an Ebola diagnosis:

  • Antibody-capture enzyme-linked immunosorbent assay (ELISA), serum neutralization tests and antigen-capture detection tests, which all test for the presence of Ebola-specific antigens (immune proteins).
  • Reverse transcriptase polymerase chain reaction (RT-PCR) assay, which tests for the presence of Ebola RNA (organism-specific genetic material). This method can be more effective than antigen-detection tests in diagnosing the disease in its acute (early) stage, because patients often die from Ebola before their bodies are able to produce the appropriate antigens.
  • Electron microscopy and virus isolation by cell culture to visualize the Ebola virus in blood samples.

Symptoms of Ebola

Ebola shares many symptoms with other hemorrhagic fevers and tropical diseases. Therefore, it is necessary to take into account an individual’s travel history. Patients exhibiting Ebola-like symptoms may be suspected of having the disease if they have travelled to or from a geographic area in which they may have been exposed to Ebola within 21 days of symptom onset.

According to the Center for Disease Control and Prevention, the following may be signs and symptoms of an Ebola viral infection:

  • Fever
  • Severe headache
  • Muscle pain
  • Weakness
  • Muscle Pain
  • Fatigue
  • Diarrhea
  • Vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhage (bleeding or bruising)

**On average, Ebola symptoms appear 8 to 10 days after exposure to the virus. However, symptoms may appear as early as 2 days following exposure or late as 21 days.

Prognosis

The World Health Organization (WHO) reports an average mortality rate of 50% among Ebola patients. This is taking into account past outbreaks of the disease which have occurred with varying strains of the disease, the individual mortality rates of which range from 25%-90%. The high mortality rate of Ebola is in part due to the lack of any licensed Ebola vaccines. Researchers are currently studying the possible effectiveness of several vaccines and treatment methods for Ebola.

Screening

The Centers for Disease Control and Prevention (CDC) recommends that travelers be screened when exiting Ebola affected countries and when entering the United States.

The exit screening guidelines for travelers leaving West Africa (especially Guinea, Liberia, and Sierra Leone) are as follows:

  • It is NOT OK to travel if a traveler:
    • Has been in an area in which there is a high risk of Ebola exposure
    • Has been in an area in which there is a low risk of Ebola exposure AND exhibits symptoms or signs of Ebola
  • It IS OK to travel if a traveler:
    • Has been in an area in which there is a low risk of Ebola exposure AND has not exhibited symptoms or signs of Ebola

The entry screening guidelines for travelers entering the United States after being in countries with Ebola outbreaks (especially Guinea, Liberia, and Sierra Leone) are as follows:

  • Travelers should fly into one of the following airports:
    • New York (JFK)
    • Newark
    • Washington-Dulles
    • Chicago O’Hare
    • Atlanta
  • Travelers will be subject to immediate medical evaluation if they exhibit signs or symptoms of Ebola.
  • Travelers will be subject to 21 days of symptom monitoring by the health department.
  • Travelers will be cleared to enter the country if they have been in areas with low Ebola exposure risk AND do not show signs or symptoms of Ebola.

Prevention

The Centers for Disease Control and Prevention offers the following tips to help to protect yourself and those around you from contracting Ebola:

  • Do not touch the blood, urine, feces, saliva, vomit, sweat, or semen of people who are sick
  • Wash your hands often with soap and water
  • Do not handle items that may have come in contact with a sick person’s blood or body fluids, like clothes, bedding, needles, or medical equipment
  • Do not touch the body of someone who has died of Ebola
  • Follow the latest travel and traveler screening guidelines available on the CDC’s website (www.CDC.gov)

Medication And Treatment

There are currently no approved treatments for Ebola patients. There are several medications, immune therapies, and vaccines that are being investigated by health officials. A few of these therapies have been used successfully on patients infected with the Ebola virus, though it is difficult to determine what amount of the success is due to the therapy and what amount of success is due to other factors. Treatment of Ebola patients therefore is typically focused on supporting the body, which is termed supportive therapy, while it fights the infection.

Care that an Ebola patient receives will most likely include:

  • Intravenous fluids (IV), to prevent dehydration
  • Electrolyte therapy, to restore lost body salts and minerals
  • Maintenance of oxygen and blood pressure levels
  • Treatment of secondary infections that develop as a result of the weakened immune system

When To Contact A Doctor

Seek immediate medical attention if you have recently travelled (within 21 days) to or from an Ebola-affected geographic region and you experience any of the following:

  • Fever
  • Severe headache
  • Muscle pain
  • Weakness
  • Muscle Pain
  • Fatigue
  • Diarrhea
  • Vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhage (bleeding or bruising)

 

Find a Doctor

To find a general practitioner or infectious disease specialist in your area, visit www.healthgrades.com

 

Resources

For more information on Ebola, visit:

 

Questions For Your Doctor

If you suspect you may have come in contact with the Ebola virus, go immediately to your local hospital, and ask to speak with an infectious disease specialist.

Questions For A Doctor

  • Does my travel record make me at risk for developing Ebola?
  • Is my planned destination in an Ebola risk area?
  • What can I do to prevent an Ebola infection?
  • What signs and symptoms should I look out for?
  • Is it possible that my symptoms are the result of an Ebola infection?
  • Should I monitor myself for an Ebola infection? If yes, for how long?