Ebola virus disease
Background
- Viral hemorrhagic fever
- Unknown reservoir (?bats)
2014 Outbreak Details[1]
- No confirmed cases diagnosed via US transmission as of 9/10/14
- Outbreak includes
- Cities of:
- Port Harcourt, Nigeria
- Lagos, Nigeria
- Dakar, Senegal
- Countries of:
- Guinea
- Liberia
- Sierra Leone
- Cities of:
Communicable Transmission
- Via blood and body fluids (urine, saliva, semen, feces, vomit) in contact with mucous membranes or via instruments such as needles
Clinical Features
- Severe, often fatal (40-65%) hemorrhagic fever
- Incubation period: 2-21 days (most commonly 8-10)
- Common symptoms:
- Influenza-like Illness: fever, headaches, myalgias, malaise, diarrhea, vomiting, abdominal pain, anorexia
- Hemorrhagic symptoms: unexplained bleeding/bruising
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Workup
Persons under Investigation (PUI)
- Obtain a travel history for all persons presenting with fever
- Consider Ebola in any person who presents within 21 days of traveling to an epidemic area
- During evaluation isolate with standard, contact, and droplet precautions
- Immediately to the PUIs to local health authorities or CDD
- Los Angeles repots to Acute Communicable Disease Control Program (ACDC) at 213-240-7941 (nights/weekends: 213-974-1234)
- Special diagnostic testing requires consultation
Diagnostics
A few days after infectious symptoms begin, ELISA IgM, PCR or virus isolation are possible. Later in the disease or during recovery, IgM or IgG can be tested.
Management
- Isolation precautions: standard, contact and droplet[2]
- Isolate in a single room with the door closed
- Limit entry and maintain a log of people who enter the room
- Use standard, contact, and droplet precautions
- Test and treat for other possible causes of Fever in Travelers while evaluating for Ebola
- CDC has guidance for safe specimen handling
- Supportive care
- Currently no non-experimental medications directed at the Ebola virus, although newer medications are under evaluation
Disposition
Admit, isolation, possible ICU for serologic results and clinical observation/supportive care.
See Also
External Links
Sources
cdc.gov/ebola cdc.gov- viral hemorrhagic fevers