Deadly Ebola outbreak
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Ebola Hemorrhagic Fever

Symptoms_of_ebola

Symptoms of Ebola  typically include

  • Fever (greater than 38.6°C or 101.5°F)
  • Severe headache
  • Muscle pain
  • Weakness
  • Diarrhea (may be bloody)
  • Nausea and vomiting.
  • Abdominal (stomach) pain
  • Lack of appetite
Over time, symptoms become increasingly severe and may include:
  • Red eyes.
  • Raised rash.
  • Chest pain and cough.
  • Severe weight loss.
  • Bleeding, usually from the eyes, and bruising (people near death may bleed from other orifices, such as ears, nose and rectum)

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

WHO: Ebola key facts

Centers for Disease Control and Prevention, Special Pathogens Branch

ebola-1024x698

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission:

  • with infection resulting from direct contact (through broken skin or mucous membranes)
  • with the blood, secretions, organs or other bodily fluids of infected people
  • indirect contact with environments contaminated with such fluids
  • objects (such as needles) that have been contaminated with infected body fluids
  • infected animals

Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.

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Transmission from Bodily Fluids and Fomites

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

No specific treatment is available. New drug therapies are being evaluated.

Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can increase the chances of survival.

  • Providing intravenous fluids and balancing electrolytes (body salts)
  • Maintaining oxygen status and blood pressure
  • Treating other infections if they occur

Timely treatment of Ebola HF is important but challenging because the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms, such as headache and fever, are nonspecific to ebolaviruses, cases of Ebola HF may be initially misdiagnosed.

However, if a person has the early symptoms of Ebola HF and there is reason to believe that Ebola HF should be considered, the patient should be isolated and public health professionals notified. Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.

Experimental treatments have been tested and proven effective in animal models but have not yet been used in humans.

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Questions and Answers on Experimental Treatments and Vaccines for Ebola

Ebola: Experimental drugs and vaccines

Centers for Disease Control and Prevention, Special Pathogens Branch

Controlling Reston ebolavirus in domestic animals
No animal vaccine against RESTV is available. Routine cleaning and disinfection of pig or monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.
As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of Ebola infection in people.
In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

In Africa, during EVD outbreaks, educational public health messages for risk reduction should focus on several factors:

  • Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat.
  • Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids.
  • Close physical contact with Ebola patients should be avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home.
  • Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
  • Communities affected by Ebola should inform the population about the nature of the disease and about outbreak containment measures, including burial of the dead. People who have died from Ebola should be promptly and safely buried.

When cases of the disease do appear, risk of transmission is increased within healthcare settings. Therefore, healthcare workers must be able to recognize a case of Ebola and be ready to use practical viral hemorrhagic fever isolation precautions or barrier nursing techniques. They should also have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.

Barrier nursing techniques include:

  • wearing of protective clothing (such as masks, gloves, gowns, and goggles)
  • using infection-control measures (such as complete equipment sterilization and routine use of disinfectant)
  • isolating patients with Ebola from contact with unprotected persons.
  • The aim of all of these techniques is to avoid contact with the blood or secretions of an infected patient. If a patient with Ebola dies, direct contact with the body of the deceased patient should be avoided.

CDC, in conjunction with the World Health Organization, has developed a set of guidelines to help prevent and control the spread of Ebola. Entitled  Infection Control for Viral Haemorrhagic Fevers in the African Health Care Setting,
the manual describes how to

  • recognize cases of viral hemorrhagic fever (such as Ebola)
  • prevent further transmission in healthcare setting by using locally available materials and minimal financial resources.

If you must travel to an area with known Ebola cases, make sure to do the following:

  • Practice careful hygiene. Avoid contact with blood and body fluids.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • 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 where Ebola patients are being treated. The U.S. embassy or consulate is often able to provide advice on facilities.
  • After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms of Ebola.

Infection Control for Viral Haemorrhagic Fevers in the African Health Care Setting

WHO recommended infection control measures

Educating yourself about the Ebola virus is one way to help stop the virus from spreading.

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