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Medical Bulletin

Ebola
the Deadly African Virus


Ebola Virus Disease (EVD) or Ebola Hemorrhagic Fever (EHF)) or simply Ebola is a serious disease
caused by Ebola virus, which is often fatal if untreated. Ebola virus disease (EVD) first appeared in
1976 in 2 simultaneous outbreaks, one in Sudan, and the other in Democratic Republic of Congo.
The latter occurred in a village near the Ebola River, from where this disease gets its name.
World Health Organization (WHO) has declared Ebola outbreak, a Public Health Emergency of
International concern. The recent outbreak of the Ebola virus (first case notified in March 2014)
mainly affects three countries in West Africa: Guinea, Liberia and Sierra Leone. Around 8,300
cases and more than 4,000 deaths have been reported across these countries.




Ebola Outbreaks Prior to 2014


Transmission/Spread
Ebola Virus is transmitted into the human population through close contact with the blood and
body secretions (saliva, stool and urine) of infected animals such as fruit bat, chimpanzees,
gorillas, monkeys, forest antelope and porcupines, who get sick or die from Ebola.



Ebola spreads through human-to-human via direct contact with the blood and other body
secretions (vomit, sweat, semen, stool and urine) of an infected person.
Most people are infected by taking care of other infected people, either by directly touching the
victim's body or by cleaning up body fluids (stools, urine or vomit). Laboratory samples from
patients are an extreme biohazard risk.
Healthcare workers have frequently been infected while treating such patients. This has occurred
through close contact with patients when infection control precautions are not strictly followed.
Burial ceremonies in which mourners have direct contact with the body of the deceased person
can also play a role in the transmission of Ebola.
Men who have recovered from the disease can still transmit the virus, through their semen for up
to 7 weeks after recovery from illness.
What Are the Symptoms of Ebola
The incubation period (time interval from infection with the virus to onset of symptoms) of Ebola
virus is 2 to 21 days. Humans are not infectious until they develop symptoms.

Signs and Symptoms include:
High Fever
Headache
Joint and Muscle aches
Sore Throat
Weakness
Stomach Pain
Loss of Appetite
Skin Rash
Impaired Renal functions
Impaired Liver functions

As the disease gets worse, it causes internal bleeding, as well as bleeding from eyes, ears, and
nose. Some people may vomit or cough up blood and have bloody diarrhea.





Diagnosis
It can be difficult to distinguish Ebola Virus Disease from other infectious diseases such as
Malaria, Typhoid fever and Meningitis. Laboratory findings include low White Blood cells and
Platelet counts and elevated Liver enzymes.

Confirmatory Tests Include:
Antibody-capture Enzyme-Linked Immunosorbent Assay (ELISA)
Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) Assay
Electron Microscopy
Virus isolation by cell culture.
Treatment and Vaccine
No standard treatment is available. Supportive treatment includes rehydration with oral or
intravenous fluids and treatment of specific symptoms, improves survival. However, a range of
potential treatments, including transfusion of blood products, immune therapies and drug
therapies are currently being evaluated.
Prevention and Control
At present there is no FDA approved vaccine available for Ebola. The best way is to avoid
traveling to areas where Ebola virus is found.
If you are travelling to an area affected by an Ebola outbreak, ensure the following:
Practice careful hygiene; for example, wash your hands with soap and water or an alcohol
based hand sanitizer. Avoid direct contact with blood and body fluids.
Do not handle items that may have come in contact with an infected persons blood or
body fluids (such as clothes, bedding, needles, and medical equipments).
Avoid hospitals in West Africa where Ebola patients are being treated.
After you return, monitor your health for 21 days and seek medical care immediately if
you develop symptoms of Ebola.



Healthcare workers who may be exposed to people with Ebola should follow these steps:

Wear appropriate PPEs.
Practice proper infection control and sterilization measures.
Isolate patients with Ebola from other patients.
Avoid direct contact with the bodies of people who have died from Ebola.
Notify health officials if you have had direct contact with the blood or body fluids, such as
faeces, saliva, urine, vomit, and semen of a person who is sick with Ebola. The virus can
enter the body through ruptured skin or mucous membrane, for example, eyes, nose, or
mouth.