Tuesday, July 29, 2014
Prevention Of Ebola Virus Hemorrhagic Fever
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.
Ebola hemorrhagic fever often has many complications; organ failures, severe
bleeding, jaundice, delirium, shock, seizures, coma, and death (about 50% to 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).
The prognosis of Ebola hemorrhagic fever is often poor; the death rate of
this disease ranges from about 50% to 100%, and those who survive may
experience the complications listed above.
What are complications of Ebola hemorrhagic fever?
What is the prognosis of Ebola hemorrhagic fever?
What are Ebola hemorrhagic fever symptoms and signs?
Unfortunately, early symptoms of Ebola hemorrhagic fever are nonspecific and
include the following: fever, headache, weakness, vomiting, diarrhea, stomach
discomfort, decreased appetite, and joint and muscle discomfort. As the disease
progresses, patients may develop other symptoms such as a rash, eye redness,
hiccups, sore throat, cough, chest pain, bleeding both inside and outside the
body (for example, mucosal surfaces, eyes), and difficulty breathing and
swallowing. Symptoms may appear from about two to 21 days after exposure (average 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.
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.
How do physicians diagnose Ebola hemorrhagic fever?
What causes Ebola hemorrhagic fever?
The cause of Ebola hemorrhagic fever is Ebola virus infection that
results in
coagulation abnormalities, including gastrointestinal bleeding,
development of a
rash, cytokine release, damage to the liver, and massive viremia (large
number of
viruses in the blood) that leads to damaged vascular cells that form
blood
vessels. As the massive viremia continues, coagulation factors are
compromised
and the microvascular endothelial cells are damaged or destroyed,
resulting in
diffuse bleeding internally and externally (bleeding from the mucosal
surfaces
like nasal passages and/or mouth and gums and even from the eyes [termed
conjunctival bleeding]). This uncontrolled bleeding leads to blood and
fluid loss
and can cause hypotensive shock that causes death in many Ebola-infected
patients.
The risk factors for Ebola hemorrhagic fever are travel to areas where Ebola
infections (see current CDC travel advisories for African countries) have been
reported. In addition, association with animals (mainly primates in the area
where Ebola infections have been reported) is potentially a risk factor
according to the CDC. Another potential source of the virus is eating "bush
meat." Bush meat is the meat of wild animals, including hoofed animals, primates,
and rodents. Currently, evidence for any airborne transmission of this virus is
lacking. During Ebola hemorrhagic fever outbreaks, health-care workers and family
members and friends associated with an infected person are at the highest risk of
getting the disease. Researchers who study Ebola hemorrhagic fever viruses are
also at risk of developing the disease if a laboratory accident occurs.
What are risk factors for Ebola hemorrhagic fever?
What is Ebola hemorrhagic fever?
Ebola hemorrhagic fever is a viral disease caused by Ebola virus that results
in nonspecific symptoms early in the disease and often causes internal and
external hemorrhage (bleeding) as the disease progresses. Ebola hemorrhagic
fever is considered one of the most lethal viral infections; the mortality rate
(death rate) is very high during outbreaks (reports of outbreaks range from
about 50% to 100% of humans infected, depending on the Ebola strain).
Ebola hemorrhagic fever was first noted in Zaire (currently, the Democratic
Republic of the Congo or DRC) in 1976. The original outbreak was in a village
near the Ebola River after which the disease was named. During that time, the
virus was identified in person-to-person contact transmission. Of the 318
patients diagnosed with Ebola, 88% died. Since that time, there have been
multiple outbreaks of Ebola virus, and five strains have been identified; four
of the strains are responsible for the high death rates. The four Ebola strains
are termed as follows: Zaire, Sudan, Tai Forest, and Bundibugyo virus, with Zaire
being the most lethal strain. A fifth strain termed Reston has been found in
the Philippines. The strain infects primates, pigs, and humans and causes few if
any symptoms and no deaths in humans. Most outbreaks of the more lethal strains
of Ebola have occurred in Africa and mainly in small- or medium-sized towns. Once
recognized, African officials have isolated the area until the outbreak ceased.
However, in this new outbreak that began in Africa in March 2014, some of the
infected patients have reached larger city centers and have been hospitalized.
Unfortunately, many people may have been exposed to the virus in the city, thus
causing more infections (and deaths). This outbreak in Africa has now spread to
Guinea's capital and has been detected in the neighboring countries of Liberia and
Sierra Leone. About 122 infected people have been diagnosed and 78 have died as
of Apr. 1, 2014. The infecting Ebola virus detected this outbreak is the
Zaire strain, the most pathogenic strain of Ebola. Health agencies are terming
this outbreak as an "unprecedented epidemic."
What is the history of Ebola hemorrhagic fever?
Ebola hemorrhagic fever (Ebola virus disease) facts
- Ebola hemorrhagic fever is a disease caused by four different strains of Ebola virus; these viruses infect humans and nonhuman primates.
- It is also referred to as Ebola virus disease.
- Ebola hemorrhagic fever has a short history since it was discovered in 1976. There have been a few outbreaks, including the current (April 2014) "unprecedented epidemic" in Africa.
- Ebola viruses are mainly found in primates in Africa and possibly the Philippines; there are only occasional outbreaks of infection in humans.
- Ebola hemorrhagic fever occurs mainly in Africa in the Republic of the Congo, Gabon, Sudan, Ivory Coast, and Uganda, but it may occur in other African countries.
- Ebola virus can be spread by direct contact with blood and secretions, by contact with blood and secretions that remain on clothing, and by needles and/or syringes used to treat Ebola-infected patients.
- Risk factors for Ebola hemorrhagic fever are travel to areas with endemic Ebola hemorrhagic fever and/or any close association with an infected person.
- Symptoms of Ebola hemorrhagic fever include an incubation period of two to 21 days, starting with abrupt fever, headache, joint and muscle aches, sore throat, and weakness; progression of symptoms include diarrhea, vomiting, stomach pain, hiccups, and rash with more devastating symptoms of internal and external bleeding in many patients.
- Early clinical diagnosis is difficult as the symptoms are nonspecific; however, if the patient is suspected to have Ebola, the patient needs to be isolated and local and state health departments need to be immediately contacted.
- Definitive diagnostic tests for Ebola hemorrhagic fever are ELISA and/or PCR tests; viral cultivation and biopsy samples may also be used.
- There is no standard treatment for Ebola hemorrhagic fever; only supportive therapy is available.
- There are many complications from Ebola hemorrhagic fever; the prognosis for patients ranges from fair to poor since many patients died from the disease (death rate equals about 25%-100%).
- Prevention of Ebola hemorrhagic fever is difficult; early testing and isolation of the patient, plus barrier protection for caregivers (mask, gown, goggles, and gloves), is very important to prevent others from getting infected.
- Researchers are trying to understand the Ebola virus and pinpoint its ecological reservoirs to better understand how outbreaks occur. Researchers are actively trying to establish an effective vaccine against Ebola viruses by using several experimental methods, but there is no vaccine available currently.
Sex, kissing, shared needles can give you Ebola
Feature Pix
Though the patient has passed away, there are fears that many people he had come in contact with as he journeyed from Liberia to Nigeria may have been infected; while the medical workers that attended to him during his brief stay in the hospital also need to be examined!
The reasons are not far-fetched: Ebola virus is virulent — it is extremely dangerous and deadly, and usually spreads very quickly. The WHO estimates that the death rate is a whopping 90 per cent.
Indeed, the united States-based Centres for Disease Control warns that death through the virus can take place anytime between two to 21 days of infection, usually due to multiple organ failure, loss of blood or shock.
Mode of contact
Experts say Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. And once it enters an individual, s/he becomes a high risk to everyone s/he comes into contact with. And that’s why you can’t afford to be careless with the way you relate with people, especially when it comes to intimate relationships such as kissing, necking and sexual intercourse.
The Lagos State Commissioner of Health, Dr. Jide Idris, warns that infection occurs from direct contact — through broken skin or mucous membranes — with the blood, or other bodily fluids or secretions such as poops, urine, saliva and semen of infected people. The WHO corroborates this claim.
Sex and the virus
How can Ebola in the semen infect you, whether it is outside or inside of the body? Experts proffer an answer. The WHO states that people are infectious as long as their blood and secretions contain the virus. All you need do to get infected is to have any form of contact with the infected semen and you are done!
A gynaecologist, Dr. Damilola Akinduro, adds that in normal sexual process, sperm ejaculated into a woman’s vagina can live in her cervical mucus or upper genital tract for three to five days, making fertilisation possible.
He also says sperm ejaculated outside the body might survive in semen — the fluid released during ejaculation — up to a few hours. So, even if you try to play safe by having a man ejaculate outside of your body in the name of coitus interruptus or through anal and oral sex, you may still be infected within the few hours that the sperm and the virus are still alive. Scary, isn’t it?
And as terrible as the situation is, WHO discloses that even men who have recovered from the (Ebola) illness can still spread the virus to their partner through their semen for up to seven weeks after recovery.
“For this reason, it is important for men to avoid sexual intercourse for at least seven weeks after recovery or to wear condoms if having sexual intercourse during seven weeks after recovery,” WHO counsels.
Wet dreams
Akinduro says that since most people may be ignorant of their Ebola status, parents should advise their male adolescents who may have wet dreams to wash their beddings and other clothing materials that may have been soiled in the process.
Indeed, experts at the European Centre for Disease Prevention and Control assure that Ebola virus is easily killed by soap, bleach, sunlight or drying.
“Machine washing clothes that have been contaminated with fluids will destroy Ebola,” they say; adding that “Ebola virus survives only a short time on surfaces that are in the sun or have dried.”
Akinduro also urges careful handling and safe disposal of used condoms, so that people don’t come into contact with them.
Signs and symptoms
As for knowing whether or not you have the virus, the WHO says if you have sudden onset of fever, intense weakness, muscle pain, headache and sore throat, don’t delay. Rather, visit the hospital and have a medical test. “It may make a difference between dying and staying alive,” Akinduro suggests.
The WHO also suggests that the aforementioned typical signs and symptoms are usually followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. You don’t want to go through this painful experience; so, see the doctor without delay.
Drug addicts at risk
Experts note that needle-sharing among people who inject drugs is a very common phenomenon; and blood transfer is common as a result.
It is common knowledge that drug addicts who share needles risk a lot of infectious diseases ranging from HIV to Hepatitis B & C; but physicians are now warning that drug addicts are also at risk of contacting Ebola virus if they share unsterilised needles with infected person.
Akinduro adds that sharp objects such as blades may also not be shared. He even says since no one knows his Ebola status, it is advisable to never share sharp objects, even among family members.
“It doesn’t cost much to own a razor blade and use it personally, if only to prevent possible infection should someone close to you be infected with Ebola and you aren’t aware,” he says.
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Stages Of Ebola Virus Disease
