Ebola Virus Disease (EVD)

Ebola Virus Disease (EVD)

Article
Diseases & Conditions
Infectious Diseases
Contributed byKrish Tangella MD, MBAMay 21, 2020

What are the other Names for this Condition? (Also known as/Synonyms)

  • Ebola Hemorrhagic Fever (EHF)
  • EVD (Ebola Virus Disease)
  • Viral Hemorrhagic Fever

What is Ebola Virus Disease? (Definition/Background Information)

  • Ebola Virus Disease (EVD), also known as Ebola Hemorrhagic Fever, is a severe and deadly disease found in humans and primates. All cases of the hemorrhagic fever have been reported from west and central Africa (in countries, like Sierra Leone, Liberia, Sudan, Congo, and Uganda)
  • The disease is caused by the Ebola virus, which is a part of the Filoviridae family of RNA viruses. Currently, there are 4 identified subtypes of Ebola virus that cause disease in humans:
    • Ebola-Zaire
    • Ebola-Sudan
    • Ebola-Ivory Coast
    • Ebola-Bundibugyo
  • The disease can be transmitted in a variety of ways - contact with infected bodily fluids, contaminated medical equipment, and infected animals and animal material, are the most common forms of transmission
  • Symptoms of the disease appear between 5-10 days after transmission has occurred. Early symptoms are usually mild (that include fever, headaches, sore throat, weakness); over time though, these become increasingly severe, potentially resulting in death
  • Symptomatic treatment is administered for this viral infection; however, the prognosis is generally poor (70% fatality)

Who gets Ebola Virus Disease? (Age and Sex Distribution)

  • Almost all reported cases of Ebola Virus Disease are from (in and around) west and central Africa
  • The disease occurs in both males and females of all age groups

What are the Risk Factors for Ebola Virus Disease? (Predisposing Factors)

The risk factors of Ebola Virus Disease include:

  • Almost all cases of Ebola have been reported from central/west Africa. Thus, living or traveling to certain regions of Africa is considered a risk factor
  • Conducting research on primates (such as monkeys, chimpanzees, and gorillas) may also put one at risk for contracting EVD, as many primates (and even fruit bats) carry the virus
  • Providing medical care or preparing burial grounds for individuals with the disease, may also increase the likelihood of transmission

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ebola Virus Disease? (Etiology)

  • Ebola Virus Disease (previously termed as Ebola Hemorrhagic Fever) is caused by the Ebola virus. The Ebola virus is an RNA virus, which means that it has ribonucleic acid (RNA) as its genetic material
  • The virus can come into contact with humans through animal-human contact, or human-human contact
  • It can be transmitted from animals to humans through blood (slaughtering, eating infected animals) or animal waste products
  • Human to human transmission occurs through bodily fluids contact. Usually, individuals become infected in medical settings, when they are tending to patients/family members, or preparing the burial of infected individuals (almost all EVD cases are from the lesser developed regions of central Africa)

What are the Signs and Symptoms of Ebola Virus Disease?

Signs and symptoms of Ebola Virus Disease vary depending on the length of infection. Within the first few days, signs and symptoms include:

  • Fever, fatigue
  • Muscle aches, headaches
  • Stomach pain
  • Sore throat
  • Rashes
  • Red, itchy eyes
  • Vomiting

Within one week of infection, the signs and symptoms become more severe and can include:

  • Chest pain
  • Swollen eyes, blindness
  • Bleeding from eyes, ears, nose, mouth, rectum
  • Swollen genitalia
  • Impaired liver, kidney function
  • Depression

After the signs and symptoms become severe and various complications develop, death inevitably occurs.

How is Ebola Virus Disease Diagnosed?

Ebola Virus Disease cannot be diagnosed, until the onset of symptoms occurs. Once the symptoms appear, the following tests may be performed:

  • Physical exam with medical history evaluation
  • Virus isolation in cell culture
  • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
  • Antigen detection testing
  • Serum neutralization testing
  • Polymerase chain reaction (PCR) testing

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ebola Virus Disease?

As Ebola Virus Disease symptoms worsen, life-threatening complications may occur, such as:

  • Multiple organ failure
  • Severe bleeding
  • Seizures
  • Coma

Individuals, who survive EVD, experience a slow recovery with complications that include:

  • Hair loss
  • Sensory changes
  • Weakness, fatigue
  • Headaches
  • Hepatitis (possibly)

How is Ebola Virus Disease Treated?

Currently, there are no treatment options for individuals with Ebola Virus Disease.

  • Often times, supportive therapy is provided to patients, to help them cope with the disease and its symptoms
  • Electrolyte balance, oxygen and blood pressure checks, and infection treatment, are provided through supportive therapy
  • Bleeding disorders are usually treated through transfusions
  • Medications are provided to treat shock or depression that may develop

How can Ebola Virus Disease be Prevented?

Preventive measures for Ebola Virus Disease include:

  • Avoiding contact with individuals affected by EVD (or Ebola Hemorrhagic Fever) is the most effective way, to avoid contracting the viral infection
  • Be careful while handling primates (and other animals), especially during research, veterinary care, etc.

Other preventative measures include:

  • Frequent hand washing
  • Limited contact with individuals with EVD, or those who died from Ebola infection
  • Following all infection-control procedures, in healthcare  and other settings; use protective clothing, masks, and gloves
  • Ensure proper disposal of contaminated products, needles, etc.
  • Avoid or limit travel to Ebola endemic regions, especially if there are reports of an outbreak

What is the Prognosis of Ebola Virus Disease? (Outcomes/Resolutions)

  • Almost 70% of individuals with Ebola Virus Disease die from the disease
  • With no treatment options, the outcome of infected individuals is generally dismal, although some cases of recovery have been reported

Additional and Relevant Useful Information for Ebola Virus Disease:

Ebola Virus Disease is named after the Ebola river, near a village in Democratic Republic of Congo (in central Africa), where the disease outbreak was noticed in 1976.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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