April 23, 2014
Article by Global Pre-Meds
Hospital doctor shadowing & global health experience programs.
The Ebola virus disease (EVD) is a viral haemorrhagic fever and one of the most contagious diseases known to man. It is a rare and deadly virus characterised by bleeding inside and outside of the body. Outbreaks typically occur sporadically in remote villages in Western and Central Africa, but have spread to some cities as well.
A relatively new disease in human history, Ebola first appeared in 1976 as two simultaneous attacks in Nzara in Sudan and Yambuku in Democratic Republic of Congo (DRC). It takes its name from the Ebola River in the DRC where one of the first known outbreaks occurred. The Ebola virus is severe and has a fatality rate of up to 90%. Over 1000 cases have been reported since 1976.
Humans can contract the disease as they come into contact with blood or bodily fluid of infected animals such as bats, monkeys and pigs, or humans. Fruit bats are believed to be the natural hosts of Ebola, carrying and spreading the disease to other animals and humans without suffering adverse affects themselves.
Ebola is a virus of the family Filoviridae, genus Ebolavirus. There are five identified subspecies of the virus with four affecting humans. Although there is no conclusive evidence, researchers believe that the first human infected with Ebola initially came into contact with an infected animal.
The Ebola virus is highly virulent and is easily spread through the contact with blood or bodily fluids either through direct contact with patients or indirectly through contaminated equipment. It is common for health care workers as well as family and friends of patients to become infected if protective personal equipment such as gloves, masks and sterilised equipment is not strictly used.
Signs and symptoms for Ebola appear 2-21 days after exposure. The initial stages of Ebola are similar to a severe flu, dengue or malaria. Typical symptoms include: fever, joint pain, weakness, muscle pain, vomiting, diarrhoea, nausea and headaches. Some patients may also experience a rash, respiratory distress, chest pain, hiccups, red eyes and bleeding inside and outside of the body. Around 10% of patients are able to recover from the virus for reasons not yet completely understood.
The initial onset of Ebola has symptoms similar to other diseases including cholera, malaria, dengue, typhoid fever, meningitis, hepatitis and other haemorrhagic fevers. This requires testing to be done to rule out other possible options. In addition laboratory testing may be done for a definitive diagnosis. As the virus is extremely contagious testing must be conducted with extensive biological containment measures in place.
Treatment for Ebola is only to provide intensive supportive care aimed at reducing the symptoms for the comfort of the patient. No standard vaccine or treatment has been licenced for people or animals.
No vaccine is available to date for the Ebola virus, nor is there effective treatment for those infected. In the absence of both, prevention relies on awareness and individual protective measures to reduce infection and death as well as animal control measures.
Public education campaigns focus on the following:
Reducing the risk of animal to human transmission by limiting exposure to bats, pigs and monkeys and the consumption of their raw meat.
Reducing human-to-human contact by strictly adhering to personal protective equipment (PPE) measures.
Inter-community communication about their personal experiences and education about correct procedures including burial of the dead.
In the case of containing the disease in domesticated animals (in particular pig farms because of the presence of bats) public education focuses on the proper handling of sick animals using PPE, correct slaughtering measures and raising public awareness about thoroughly cooking meat and milk before consumption.