Medicine for Africa - Medical Information Service

BOLA    EVER

Definition:

Ebola fever is caused by the Ebola virus, a virus of the family of Filoviridae viruses which also included the often fatal Marburg virus.  The Filoviridae viruses are RNA viruses of the five-member group of viruses causing the so-called Viral Hemorrhagic Fevers (VHFs).  Currently, four subtypes of Ebola are known, three of which can cause hemorrhagic fever – EBO-C, EBO-S, EBO-Z. The fourth subtype, EBO-R, can infect humans as well, but so far has not been documented to cause the development of disease.

The source of the Ebola virus is currently not known – to-date, three major outbreaks have occurred in Central Africa – the first in the Democratic Republic of Congo (the former Zaire), where the virus was first discovered in 1976, and named for the river where it was found.  The other two outbreaks occurred in (western) Sudan in 1976 and 1979, respectively.  Smaller outbreaks occurred in rural Gabon in 1994 and 1996, respectively, while two isolated cases of Ebola fever were reported in Côte d’Ivoire (Ivory Coast) in 1994 and 1995.  The most recent known outbreak occurred in 2007 in rural Uganda, where 124 people had contracted the disease with 35 fatalities. 

The hemorrhagic fever caused by the Ebola virus is one of the deadliest of the VHF group.  The virus causes damage to the small blood vessels (capillaries), resulting in increased vascular permeability and internal bleeding into organs and connective tissues.

The virus can be transmitted by close person-to-person contact with an infected individual, via direct contact with infected blood and blood-borne products, body fluids, infected organs, or semen. Thus, family members and medical personnel are at a high risk for contracting the virus when caring for an ill person. As the virus can also be spread via body fluids and semen, it can also be transmitted via any kind of sexual intercourse, especially, if conducted without appropriate preventive measures such as using a (male or female) latex condom.  The Ebola virus can still be transmitted sexually for some time after a patient has recuperated from the disease. 

Transmission can also occur by way of reusing hypodermic needles.  This situation may happen with intravenous (IV) drug abusers, or even in some health care facilities in developing countries, due to insufficient supply of clean or single-use needles.

Symptoms:

Infection with the Ebola virus causes a rapid and extensive replication of the virus in all tissues.  This viral replication is usually accompanied by widespread and severe focal necrosis, especially in the liver, resulting in so-called Councilman bodies (collection of dead cells), similar to those seen in Yellow fever.

Symptoms usually become apparent within two to 21 days after the initial infection and include:

• Sudden (high) fever;
• Weakness and muscle pain;
• Headache and sore throat, followed by
• Vomiting and diarrhea;
• Skin rash;
• Beginning failure of liver and kidney functions, and finally
• Internal and external bleeding.

Mortality rate ranges from 50% to 90% of infected patients.

Diagnosis:

The Ebola virus can be diagnosed from blood samples by way of serologic tests, such as the so-called indirect fluorescent antibody test (IFAT), the ELISA (Enzyme-Linked ImmunoSorbent Assay), radioimmunoassay, the radioimmunoprecipitation assay or the Western blot assay. All these tests have in common that they require a highly specialized, well equipped laboratory and specifically trained laboratory technicians, in order to be performed.

Another confirmation of infection with Ebola virus can be achieved by conducting a blood culture. However, since handling any Ebola virus containing blood sample is considered an extreme biohazard due to its high infectious potential, setting up a blood culture has to be performed with utmost care.

Treatment:

As of 2008, there is no known treatment for, or cure of Ebola fever! 

The only kind of treatment that can be offered is supportive care, such as IV fluid replacement, electrolytes, proper nutrition and comforting care, all of which may be of benefit to the patient.  However, such care has to be administered with strict attention to isolation procedures, such as a special isolation station or room. 

Prevention:

The only prevention consists of eliminating the risk of coming into contact with the virus. 

For health care personnel it is adamant to be extremely careful when handling an infected person who has to be hospitalized in an isolated station.

Travelers or tourists should avoid areas where Ebola outbreaks can occur, especially in rural areas. 

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DISCLAIMER: The above article is only intended to provide general information regarding this topic. It is not intended and does NOT replace the need to consult a medical or other professional person, if you have or believe to have this disease/disorder. While the article was researched, written and reviewed by medical professionals, and Medicine for Africa, its staff and publisher made every effort to assure accuracy and correctness, it does not claim to be complete, correct or to reflect the very latest stand of medical/scientific knowledge in the disease’s/syndrome’s pathology, diagnostic and/or therapeutic development. Medicine for Africa, its founder, management, staff, writers, reviewers or publishers may NOT be made responsible or legally bound to any information provided above, and cannot be held liable to any conclusions or decisions the reader may draw after reading this article. The reader is explicitly advised to consult a licensed physician and to present his/her specific situation before making any health related decisions.