Ebola virus disease: Difference between revisions
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==Background== | ==Background== | ||
*Viral hemorrhagic fever | |||
*reservoir is not known (?bats) | |||
===2014 Outbreak Details<ref>California Health Alert Network. Alert Id: 35317. 9/10/2014</ref> === | |||
*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 | |||
===Communicable Transmission=== | |||
*Transmission can occur via direct contact with blood and body fluids (urine, saliva, semen, feces, vomit) in contact with mucous membranes or via instruments such as needles | |||
==Clinical Features== | ==Clinical Features== | ||
*Severe, often fatal (40-65%) hemorrhagic fever | |||
*Incubation period: 2-21 days (most commonly days 8-10) | |||
*Common symptoms: | |||
**Influenza-like Illness: [[fever]], [[headaches]], myalgias, malaise, [[diarrhea]], [[vomiting]], [[abdominal pain]], anorexia | |||
**Hemorrhagic symptoms: unexplained bleeding/bruising | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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# LCMV- Lymphocytic Choriomeningitis Virus- not usually fatal | # LCMV- Lymphocytic Choriomeningitis Virus- not usually fatal | ||
# Hanta Virus Pulmonary Syndrome- Endemic to United States | # Hanta Virus Pulmonary Syndrome- Endemic to United States | ||
# Marburg Hemorrhagic Fever- Last known 2008(Uganda) | # Marburg Hemorrhagic Fever- Last known 2008 (Uganda) | ||
==Workup== | ==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 | |||
**Persons who have been in an outbreak area during the prior 21 days should be isolated with standard, contact, and droplet precautions during evaluation | |||
*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. | 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== | ==Management== | ||
*Isolated with standard, contact and droplet precautions<ref>California Health Alert Network. Alert Id: 35317. 9/10/2014</ref> | |||
**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== | ==Disposition== | ||
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==See Also== | ==See Also== | ||
*[[Fever in Travelers]] | |||
*[[Viral Hemorrhagic Fevers]] | |||
==External Links== | ==External Links== | ||
Revision as of 16:31, 12 September 2014
Background
- Viral hemorrhagic fever
- reservoir is not known (?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
- Transmission can occur via direct contact with 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 days 8-10)
- Common symptoms:
- Influenza-like Illness: fever, headaches, myalgias, malaise, diarrhea, vomiting, abdominal pain, anorexia
- Hemorrhagic symptoms: unexplained bleeding/bruising
Differential Diagnosis
- Ebola Hemorrhagic Fever
- Lassa Fever- transmitted via rats
- LCMV- Lymphocytic Choriomeningitis Virus- not usually fatal
- Hanta Virus Pulmonary Syndrome- Endemic to United States
- Marburg Hemorrhagic Fever- Last known 2008 (Uganda)
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
- Persons who have been in an outbreak area during the prior 21 days should be isolated with standard, contact, and droplet precautions during evaluation
- 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
- Isolated with standard, contact and droplet precautions[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