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Ebola hemorrhagic fever: disease that causes severe bleeding

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Ebola is an acute, presumably zoonotic disease from the group of viral hemorrhagic fevers that occurs with a pronounced hemorrhagic syndrome. It has a high mortality rate and is one of the most dangerous viral infections.

The first cases of Ebola virus disease were reported in 1976, when two outbreaks of a previously unknown disease occurred in Nzare (Sudan) and Yambuku (Democratic Republic of the Congo). In the latter case, the village was located near the Ebola River – this is how the disease got its name.

Causes of Ebola fever Ebola

virus is an RNA virus of the genus Filovirus of the familyfiloviridae . Its possible natural hosts are considered to be bats living in Africa. Primates can become a source of infection for humans, although they are not a natural reservoir of the virus, but rather an accidental host, like humans. Forest antelope, duikers, porcupines and pigs can also be sources of infection.

  • Contact route – involves direct contact with infected tissues or fluids (blood, urine, saliva, feces, semen). In epidemiological foci, the virus can infect people who care for the sick or prepare the bodies of the dead for burial.
    Transmission by contact is possible only if anti-epidemiological measures are not observed, that is, through direct skin contact with an infected biomaterial.

    It should be noted that the virus is able to penetrate intact skin, but the presence of small cracks and wounds on the skin significantly increases the likelihood of infection.

  • Sexual way – the transmission of the virus is possible through unprotected sexual contact with a sick or carrier of the infection. In people who managed to survive after infection, the virus was found in semen and vaginal secretions for a long time (sometimes for several months) after recovery.
  • The alimentary route is through the mucous membrane of the gastrointestinal tract. Eating infected foods can cause infection if the food was contaminated with virus particles during preparation or was contaminated initially, in the case of monkey or wild boar meat infected with the Ebola virus.
  • Airborne droplets – during coughing and sneezing, particles of saliva and sputum containing the virus can cause infection. In this case, the penetration of the virus through the mucous membrane of the nasopharynx is possible.

The spread of the Ebola virus is carried out thanks to three successive links – the primary carrier (presumably bats of the family of fruit bats and leaf-nosed) – primates – humans. Moreover, any link in this chain can become a source of infection for humans. Primary infection involves direct human contact with bats. Secondary infection occurs when a person comes into contact with an infected primate or a sick person.

Classification of the disease

There are five subtypes of the Ebola virus:

  1. Bundibuggio (BDBV).
  2. Zaire (EBOV).
  3. Reston (RESTV).
  4. Sudan (SUDV).
  5. Thai Forest (TAFV).

 

 

Symptoms of Ebola

The length of the incubation period for the disease depends on a number of factors.

The incubation period is the time during which the virus multiplies and accumulates in the body in sufficient quantities to develop the disease. This period is also characterized by the activation of immune cells and the development of an immune response. The incubation period for Ebola depends on a number of factors (primary or secondary infection, immune system status, viral load, route of infection). With primary infection, a person falls ill after an average of 5-8 days, with a secondary infection, it takes a little longer.

The period of clinical manifestationscharacterized by the occurrence of specific or nonspecific symptoms. In most cases, the disease begins with diarrhea, vomiting, general malaise. Later, more severe symptoms join: bleeding (intestinal, gastric, uterine, bleeding of mucous membranes, hemorrhages at injection sites and skin lesions, hemorrhages in the conjunctiva), pain behind the sternum and in the lumbar region, etc. The hemorrhagic syndrome progresses rapidly. On the 5-7th day, some patients (50%) develop a measles-like rash, after which the skin begins to peel off.

Around the second week after the onset of the disease, when the virus infects most of the organs, multiple organ failure develops, the symptoms of which depend on the affected organs. Most often, there is difficulty and rapid breathing, a decrease in blood pressure, yellowness of the skin and mucous membranes, and the absence of urine output.

The period of resolution of the disease with a favorable outcome occurs 2-3 weeks after infection. However, unfortunately, in most cases the patient dies. The cause of death is massive bleeding with the development of shock, intoxication with decay products due to kidney and liver failure, impaired cardiac activity and lung function.

People who have survived the disease shed the virus into the environment for another 2-3 weeks after recovery.

Within 2-3 months after recovery, there may be muscle pain, asymmetric joint pain, headache, dizziness, menstrual irregularities, hearing loss, tinnitus, hair loss, weight loss.

According to the recommendations of the World Health Organization and the Center for Disease Control (USA), people who have these symptoms and who have been in West Africa in the previous 3 weeks should be considered as possible cases of Ebola. All measures of anti-infective protection are applied to them until this assumption is refuted.

Ebola Diagnosis

Due to the absence of specific signs of infection due to the high rate of development of the disease, as well as due to high risks, the diagnosis of Ebola fever is difficult and is based on the following criteria:

  • medical history, collection of epidemiological anamnesis;
  • general examination and clinical examination;
  • isolation and study of the virus (PCR diagnostics);
  • serological tests (ELISA, RSK, indirect hemagglutination reaction);
  • histological examination of tissues.

 

Which doctors to contact

Ebola is diagnosed and treated by an infectious disease specialist.

Treatment of Ebola fever

Treatment of patients with Ebola fever is carried out in special boxes-isolations only permanently.

To date, there are no specific drugs that could cure Ebola, so the basis is supportive therapy aimed at eliminating structural and functional disorders in the body and designed to alleviate the patient’s condition.

With the help of special solutions and preparations, the volume of circulating blood is replenished.

To prevent thrombosis, anticoagulants (drugs that prevent blood clotting) are administered.

The use of anti-inflammatory drugs is aimed at reducing inflammation and lowering body temperature.

Complications

Ebola hemorrhagic fever is complicated by toxic shock, hemorrhagic and hypovolemic shock.

Ebola

prevention Specific prevention of the disease is vaccination: injectable single-dose Ebola virus vaccine (rVSV∆G-ZEBOV-GP, live). It is necessary for those who have planned a trip to the epidemic zones of Africa.

Nonspecific prevention of Ebola hemorrhagic fever consists in isolating patients in special departments or isolation wards with autonomous life support. For the transportation of patients, special transport insulators are used. Medical personnel work in individual protective equipment.

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