Ebola hemorrhagic fever

• Alternative Names

  Ebola virus infection; Viral hemorrhagic fever

• Causes, incidence, and risk factors

  Ebola hemorrhagic fever (Ebola fever) is caused by a virus belonging to the family called Filoviridae. Scientists have identified four types of the Ebola virus. Three have been reported to cause disease in humans: Ebola-Zaire virus, Ebola-Sudan virus, and Ebola-Ivory Coast virus. The human disease has so far been limited to parts of Africa.

  A very small number of people in the United States who were infected with the fourth type of the virus, known as Ebola Reston, did not develop any signs of disease.

  The disease can be passed to humans from infected animals and animal materials. Ebola can also be spread between humans by close contact with infected bodily fluids or through infected needles in the hospital.

• Symptoms

  During the incubation period, which can last about 1 week, symptoms include:

  • Arthritis
  • Backache (low-back pain)
  • Chills
  • Diarrhea
  • Fatigue
  • Fever
  • Headache
  • Malaise
  • Nausea
  • Sore throat
  • Vomiting

  Late symptoms include:

  • Bleeding from eyes, ears, and nose
  • Bleeding from the mouth and rectum (gastrointestinal bleeding)
  • Depression
  • Eye inflammation (conjunctivitis)
  • Genital swelling (labia and scrotum)
  • Increased feeling of pain in skin
  • Rash over the entire body that often contains blood (hemorrhagic)
  • Roof of mouth looks red
  • Seizures, coma, delirium

  As many as 90% of patients die from the disease. Patients usually die from shock rather than from blood loss.

• Signs and tests

  There may be signs and symptoms of:

  • Coma
  • Disseminated intravascular coagulation
  • Shock

  Tests used to diagnose Ebola fever include:

  • CBC
  • Electrolytes
  • Tests of how well the blood will clot (coagulation studies)
  • Tests to show whether someone has been exposed to the Ebola virus
• Treatment

  There is no known cure. Existing medicines that fight viruses (antivirals) do not work well against Ebola virus.

  The patient is usually hospitalized and will most likely need intensive care. Supportive measures for shock include medications and fluids given through a vein.

  Bleeding problems may require transfusions of platelets or fresh blood.

• Expectations (prognosis)

  As many as 90% of patients die from the disease. Patients usually die from shock rather than blood loss.

• Complications

  Survivors may have unusual problems, such as hair loss and sensory changes.

• Calling your health care provider

  Call your health care provider if you have traveled to Africa (or if you know you have been exposed to Ebola fever) and you develop symptoms of the disorder. Early diagnosis and treatment may improve the chances of survival.

• Prevention

  Avoid areas in which there are epidemics. Wear a gown, gloves, and mask around sick patients. These precautions will greatly decrease the risk of transmission.

• References

  Bell M. Viral hemorrhagic fevers. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 404.

  Peters CJ. Marburg and ebola virus hemorrhagic fevers. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 161.

Review Date: 8/28/2009

Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.