Monday, August 4, 2014

Ebola Virus – What You Need to Know

 Blog contributed by
Dr. Joseph Cincotta,
primary care physician
The African Ebola Virus outbreak has been one story that has been a prominent part of recent health-related news.  Although not a new problem for the African continent the most recent outbreak has gotten much more attention as concern has grown about the spread of this virus from rural and more isolated communities to more urban settings, and the concern of its spread to even further places across the globe.

The Ebola virus was first recognized in 1976 in Zaire and since that time there have been a number of outbreaks across different African regions.  The infection currently has a very high mortality rate – 57 to 88%, and there is no vaccination to prevent the infection.  In addition, there is currently no specific anti-viral medication treatment program available to combat the infection once it occurs.  Treatment today is focused on what we call ‘supportive measures’ in an effort to give the patient’s own immune system time to overcome the infection.  Unfortunately, these ‘supportive measures’ are not always successful and patients still succumb to the infection.

The virus is spread by direct person-to-person contact.  This may involve direct contact with an infected patient or direct contact with infected body fluids from that patient.  If exposed, it generally takes about 5 to 7 days to develop symptoms but there are cases where it has taken longer than 2 weeks for symptoms to develop.  This raises the concern of the spread of this virus from one geographic area to another, as patients who are infected but who have no symptoms may travel out of a known area of infection and spread the virus.  As populations become more mobile and less isolated the possibility of spread of the infection is higher and requires more attention to efforts to contain the spread of the virus.

Symptoms of the disease usually start with a rather abrupt onset of fever, chills and tiredness.  These are followed by headache and muscle ache, nausea, vomiting, diarrhea, and abdominal pain.  As you will notice, these are very common symptoms for many other infections, and there is nothing specific to indicate an Ebola infection during the early phase.  Thus, the medical team needs to have a high degree of suspicion particularly when working in areas known to be at risk for this infection.  And, for health care workers not in those regions, getting a travel history from patients as part of the routine history when a patient has these symptoms is very important.

Over a period of several days the symptoms often worsen and may involve bleeding from different sites, problems with bruising, and very low blood pressure.

Work is going on to develop a vaccine as well as find medications to treat the infection.  However, efforts to date have been unsuccessful.  For now we need to rely on supportive measures such as IV fluids and nutrition and treating the complications of the disease when they occur.  These measures allow the body time to develop its own antibodies to fight off the infection.

Efforts at prevention involve avoiding travel to areas of known infection , doing your best to avoid sick individuals, and paying attention to good hygiene practices of regular hand-washing.


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