Ebola hemorrhagic fever

Ebola hemorrhagic fever is a severe and often deadly illness that can occur in humans and primates (monkeys, gorillas).

Ebola hemorrhagic fever has made worldwide news because of its destructive potential.

Ebola virus infection; Viral hemorrhagic fever

Ebola hemorrhagic fever (Ebola fever) is caused by a virus belonging to the family called Filoviridae. Scientists have identified five types of 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.

The Reston type of Ebola virus has recently been found in the Philippines.

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 body fluids or through infected needles in the hospital.

During the incubation period, which can last about 1 week after infection, 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 swelling (conjunctivitis)
• Genital swelling (labia and scrotum)
• Increased feeling of pain in the skin
• Rash over the entire body that often contains blood (hemorrhagic)
• Roof of mouth looks red

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 clots (coagulation studies)
• Tests to show whether someone has been exposed to the Ebola virus

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.

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

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

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.

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.

Bausch DG. Viral hemorrhagic fevers. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier. 2011: chap 389.

Peters CJ. Marburg and ebola virus hemorrhagic fevers. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2009: chap 164.

Review Date: 08/24/2011

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.