Introduction
Ebola virus infection, which is also referred to as Ebola Virus Disease (EVD) or Ebola Haemorrhagic Fever (EHF), is an infection affecting humans and other animals. The disease is caused by Ebola virus.
History of Ebola virus
Ebola Haemorrhagic Fever (EHF) was first noted in 1976 at Yambuku, a village near the Ebola River in the Democratic Republic of the Congo, from which the disease derives its name.
A similar outbreak was also recorded at Nzara, a town in South Sudan. As per the statistics and records of the World Health Organization, 24 outbreaks of Ebola have occurred since 1976, accounting for a total of 2,387 cases and 1,590 deaths.
However, the largest Ebola outbreak recorded to date was the Ebola epidemic in West Africa that started in December 2013 and subsided in January 2016, which eventually caused 28,646 cases and 11,323 deaths.
Causes of Ebola virus disease
Ebola hemorrhagic fever in humans is caused by the viruses of the genus Ebola virus. The Zaire Ebolavirus is the most dangerous and has caused the highest outbreaks of the disease.
The natural reservoir for Ebola is controversial, but most virologists believe that bats are the most likely candidate.
Risk factors for Ebola virus disease
During an Ebola outbreak, individuals who exhibit the highest susceptibility for infection include the following risk groups such as health care workers and family members in close proximity to infected patients.
The virus is very contagious such that even mourners attending burial rituals of dead Ebola patients may acquire the infection.
Signs and symptoms of Ebola virus disease
As per WHO guidelines, the signs and symptoms of EHF consist of two phases.
- ‘The Dry Phase’ is characterised by sudden onset of fever, malaise, myalgia, headache and sore throat.
- ‘The Wet Phase’ is characterised by rash, diminished kidney and liver function, and bleeding.
- The rash of the Ebola virus is a characteristic maculopapular rash manifesting between the fourth and sixth day of infection. Typically, the rash starts on the upper arms, flexor forearms and upper legs in a centripetal pattern.
Treatment for Ebola virus infections
The treatment is essentially supportive and has been known to improve outcomes. The supportive measures comprise oral rehydration therapy (consuming sweetened and salty water).
In some patients - experiencing vomiting and diarrhoea, intravenous fluids are administered. A novel therapeutic agent such as Inmazeb was approved for medical use in the United States from October 2020 to treat Ebola infections caused by Zaire Ebolavirus.
The World Health Organization (WHO) cautions against the use of aspirin or ibuprofen for the management of fever and myalgia which increases the risks of bleeding associated with these drugs.
The use of blood products, packed red blood cells, platelets or fresh frozen plasma may be indicated based on the severity of bleeding diathesis. The indication for heparin to prevent disseminated intravascular coagulation is guarded.
Prevention of Ebola Virus
The virus spreads via body fluids, secretions and blood from infected humans or through particles that have been contaminated with infected body fluids. Bats are the carriers or reservoirs for the virus resulting in the spread of the virus.
Prevention measures include frequent hand washing when in contact with a diseased individual. The spread of the disease can also be limited from infected animals to humans by the use of personal protective equipment.
Control of outbreaks is a major challenge that encompasses an efficiently coordinated medical service and community participation. The various steps comprise rapid case detection, contact tracing of patients, rapid access to laboratory services, care for infected people and proper disposal of the dead through burial or cremation.
Vaccines for Ebola
An Ebola vaccine, rVSV-ZEBOV, has been approved by the FDA in the United States since December 2019. This vaccine has been evaluated to be protective from tenth day after administration. Field trials of this vaccine were undertaken in Guinea between 2014 and 2016.
Conclusion
Ebola virus is a threat to human health. Preventing the disease's transmission is the greatest way to reduce instances and outbreaks. Implementing awareness programmes is necessary to raise people's awareness of the need to eradicate Ebola infection.
