Ebola virus disease

Revision as of 19:23, 14 October 2014 by Vincent Chan (talk | contribs)

Background

  • An RNA based virus from the Filovirus Family with 5 species mainly originating from Africa.
  • Outbreaks in Gabon, Africa occured in 1996 and in July, 2014[1]
  • Viral hemorrhagic fever
  • Unknown reservoir with most likely being bats

2014 Outbreak Details[2]

  • 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

  • Via blood and body fluids (urine, saliva, semen, feces, vomit) in contact with mucous membranes or via instruments such as needles[3]

Clinical Features

  • Severe, often fatal (40-65%) hemorrhagic fever
  • Incubation period: 2-21 days (most commonly 8-10)
  • Common symptoms:

Differential Diagnosis

Fever in traveler

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

  1. Ebola Virus Disease, West Africa http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4233-ebola-virus-disease-west-africa-25-july-2014.html.
  2. 2.0 2.1 California Health Alert Network. Alert Id: 35317. 9/10/2014
  3. Peters CJ. Chapter 197. Ebola and Marburg Viruses. Harrison’s Principles of Internal Medicine, 18e. 2012