What are Ebola virus disease symptoms, signs and treatment?

Unfortunately, early symptoms of Ebola virus disease are nonspecific and include...

• fever,
• headache,
• weakness, Continue...

 

• vomiting,
• diarrhea,
• stomach discomfort,
• decreased appetite,
• joint and muscle discomfort.

As the disease progresses, patients may develop other symptoms and signs such as:

• a rash,
• eye redness,
• hiccups,
• sore throat,
• cough,
• chest pain,
• bleeding both inside and outside the body (for example, mucosal surfaces, eyes),
• difficulty breathing and swallowing.

Ebola virus disease symptoms and signs may appear from about two to 21 days after exposure (average incubation period is eight to 10 days). It is unclear why some patients can survive and others die from this disease, but patients who die usually have a poor immune response to the virus. Patients who survive have symptoms that can be severe for a week or two; recovery is often slow (weeks to months) and some survivors have chronic problems such as fatigue and eye problems.

How do physicians diagnose Ebola hemorrhagic fever?

Ebola hemorrhagic fever is diagnosed preliminarily by clinical suspicion due to association with other individuals with Ebola and with the early symptoms described above. Within a few days after symptoms develop, tests such as ELISA, PCR, and virus isolation can provide definitive diagnosis. 

Later in the disease or if the patient recovers, IgM and IgG antibodies against the infecting Ebola strain can be detected; similarly, studies using immunohistochemistry testing, PCR, and virus isolation in deceased patients is also done usually for epidemiological purposes.

What is the treatment for Ebola hemorrhagic fever?

According to the CDC and others, standard treatment for Ebola hemorrhagic fever is still limited to supportive therapy. Supportive therapy is balancing the patient's fluid and electrolytes, maintaining their oxygen status and blood pressure, and treating such patients for any complicating infections. Any patients suspected of having Ebola hemorrhagic fever should be isolated, and caregivers should wear protective garments. Currently, there is no vaccine or specific treatment for Ebola hemorrhagic fever according to the CDC. However, the CDC recommends the following:

• Providing intravenous fluids (IV) and balancing electrolytes (body salts)
• Maintaining oxygen status and blood pressure
• Treating other infections if they occur

Patients diagnosed with Ebola in the U.S. are sent to special hospitals (Contact the CDC immediately for information for experimental vaccines, treatment protocols, and patient care and/or transfer to an appropriate facility). Experimental medical treatments of Ebola infections include immune serum, antiviral drugs, and supportive care in an intensive-care hospital facility approved by the CDC to treat Ebola infections.

What are complications of Ebola hemorrhagic fever?

Ebola hemorrhagic fever often has many complications; organ failures, severe bleeding, jaundice, delirium, shock, seizures, coma, and death (about 50%-100% of infected patients). Those patients fortunate enough to survive Ebola hemorrhagic fever still may have complications that may take many months to resolve. Survivors may experience weakness, fatigue, headaches, hair loss, hepatitis, sensory changes, and inflammation of organs (for example, the testicles and the eyes). Some may have Ebola linger in their semen for months and others may have the virus latently infect their eye(s).

Male patients may have detectable Ebola viruses in their semen for as long as six months after they survive the infection. Researchers consider the chance of getting infected with Ebola from semen is very low; however they recommend utilizing condoms for six months.

It is apparent that we don't know everything about Ebola infections. A physician who was thought to be cured of Ebola, Dr. Ian Crozier, in fall 2014 developed burning light sensitivity in his eyes. He returned to Emory University where he was treated and after several tests he was found to have Ebola infection in his eyes. However, only the fluid removed by needle from his eyes showed viable virus; his tears and the outer membrane of his eyes had no detectable virus. Consequently, doctors considered the patient not to be able to spread the virus. One of the complications was that his blue eye color turned green. Fortunately, for Dr. Crosier, treatment with steroids and antiviral agents allowed his eyes to return to normal. This unusual circumstance has suggested that follow-up eye exams are likely to be important in patients who survive Ebola infections.