Main points

• Ebola virus disease (EVD) in humans, formerly known as Ebola hemorrhagic fever, is a rare but severe and often fatal disease.
• The virus is transmitted to humans through wild animals and spreads through humans to humans.
• The average death rate caused by EVD is about 50%. The death rate caused by the spread of this disease in the past has varied from 25% to 90%.
• Community participation is important for successful disease control.
• Effective control of disease outbreaks relies on the implementation of a set of interventions, especially case management, infection prevention and control practices, surveillance and contact tracing, appropriate laboratory services, safe and effective protection, and community mobilization.
• Vaccines to protect against Ebola are being developed and have been used to help control Ebola outbreaks in Guinea and the Democratic Republic of Congo (DRC).
• Early supportive care, including rehydration and symptomatic therapy, prolongs survival.. There is no approved treatment to inactivate the virus, but a wide range of hematologic, immunologic, and drug therapies are available.
• Pregnant and lactating women with Ebola should receive basic supportive care... In addition, vaccine prophylaxis and empiric treatment should be offered under similar conditions to non-pregnant people.

What is the Ebola virus?

Ebola virus causes a serious and acute illness that often leads to death if left untreated.. EVD first appeared in 1976 with simultaneous outbreaks in New Zealand (South Sudan) and Yambuko (Democratic Republic of the Congo)..

2014-2016 was the largest outbreak in Africa since the outbreak in the West.. 1976... The outbreak began in Guinea and then spread across the land border of Sierra Leone and Liberia... The current outbreak in eastern Democratic Republic of Congo in 2018-2019 is complicated by negative impacts on public health activities.

The Filoviridae virus family includes three genera: Quavirus, Marburg virus, and Ebola virus.... Six species have been identified in the Ebola virus genus: Zaire, Bundibugyo, Sudan, Tai Jungle, Reston, and Bombali.... This virus has caused a recent epidemic in the Democratic Republic of Congo and West Africa.

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How is the Ebola virus transmitted?

Fruit bats (Pteropodidae) are thought to be the natural host of Ebola virus...Ebola is transmitted to human populations through close contact with the blood, secretions, organs, or other fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, pronghorns, or diseased or dead forest hedgehogs found in rainforests.

Ebola is then spread through direct contact (through skin wounds or mucous membranes) and through human-to-human transmission in the following ways:

• Blood or body fluids of a person who has died from Ebola
• Objects contaminated with body fluids (such as blood, feces, vomit) of a person who died or died from Ebola

Healthcare workers are often infected when treating patients with suspected EVD. This happens when infection control precautions are not taken seriously when in close contact with patients.

Burial ceremonies, which involve direct contact with the corpse, can also play a role in the transmission of Ebola.

As long as people's blood contains the virus, they are also carriers.

Pregnant women who have contracted acute Ebola and recover from the disease may still transmit the virus through breast milk or fluids and tissues associated with pregnancy. Women who become pregnant after recovering from Ebola are not at risk of transmitting the virus.

See more: infectious disease doctor

Breastfeeding women who wish to continue breastfeeding after recovering from Ebola should be monitored for doing so, and their milk should be tested for Ebola before breastfeeding begins.

Ebola virus symptoms

The incubation period, which is the time between exposure to the virus and the onset of symptoms, is 2 to 21 days....A person infected with Ebola cannot transmit the disease until symptoms appear.

Symptoms of EVD may be sudden and include:

• Fever
• fatigue
• Muscle pain
• Headache
• Sore throat

which continues with these signs:

• vomiting
• diarrhea
• Skin rash
• Symptoms of kidney and liver dysfunction

In some cases, internal and external bleeding (for example, bleeding gums, or blood in the stool).

Laboratory findings include a decrease in the number of white blood cells and platelets and an increase in liver enzymes.

How is the Ebola virus diagnosed?

It is difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever, and meningitis.... Many of the symptoms of pregnancy and Ebola are also quite similar.. Considering the risks of pregnancy, pregnant women should be fully tested if they suspect Ebola.

Determining whether symptoms are caused by Ebola virus infection or not is possible with the help of the following diagnostic methods:

• Enzyme-linked immunosorbent assay (ELISA)
• antigen tracking tests
• Serum neutralization test
• reverse transcription polymerase chain reaction (RT-PCR) measurement
• Electron microscope
• Isolation of virus through cell culture

Special care should be taken in the selection of diagnostic tests that take into account the technical characteristics, incidence and prevalence of the disease, and the social and medical implications of the test results. It is strongly recommended that diagnostic tests that have undergone independent and international evaluation be considered for use.

Current measurements recommended by the World Health Organization (WHO) are:

• Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
• Rapid antigen detection tests for use in remote areas where NAT is not readily available....These tests are recommended as part of surveillance activities for screening purposes, but reactive tests should be confirmed with NAT.

Preferred examples for detection are:

• Whole blood of living patients with symptoms collected in ethylenediaminetetraacetic acid (EDTA).
• Saliva sample stored in common transportation environment, collected from deceased patients or in situations where blood collection is not possible.

Specimens collected from patients present a high environmental risk....Laboratory evaluations on non-inactivated samples should be performed under maximum biological containment conditions.. All biological samples during transportation at the national and international level should be done using the triple packing system.

How is the Ebola virus treated?

Supportive care - replacing lost water or fluids using oral or intravenous fluids - and treating specific symptoms are effective in increasing survival.. There is still no proven treatment for EVD.. Democratic Republic of the Congo, in the 2018-2019 Ebola outbreak in the Democratic Republic of the Congo.

Pregnant and breastfeeding women with Ebola, like everyone else, should receive basic supportive care... In the same way, laboratory treatment should be done under the same conditions as non-pregnant people.

See more: Internist

Ebola virus vaccine

In a large trial conducted in Guinea in 2015, a lab-made Ebola vaccine provided significant protection against EVD. The vaccine, known as rVSV-ZEBOV, was studied in a trial of 11,841 people. Of the 5,837 people who received the Ebola vaccine, none of them received the Ebola vaccine. Ebola or more after vaccination.

The rVSV-ZEBOV vaccine was used in the recent 2018-2019 Ebola epidemic in the Democratic Republic of Congo... Pregnant and lactating women should have access to the vaccine under similar circumstances.

Ebola virus prevention and control

Effective control of an epidemic relies on the implementation of a series of measures, including case management, surveillance and contact tracing, appropriate laboratory services, safe burial, and community mobilization.. Community participation is key to successful control of an outbreak... Increasing awareness of Ebola risk factors and protective measures (including reducing transmission of messages to individuals can be an effective strategy to reduce human vaccination).. It should focus on several factors:

• Reducing the risk of wildlife transmission to humans through contact with fruit bats, monkeys, chimpanzees, longhorns and forest hedgehogs and consuming their raw meat....Handling animals should be done with gloves and other protective clothing....animal products (blood and meat) must be whole before consumption
..
• Reducing the risk of human-to-human transmission through direct or close contact with people with symptoms Ebola, especially with Their body fluids. Gloves and appropriate personal protective equipment should be used when caring for patients.. Regular washing of hands after examining patients in the hospital and also after taking care of patients at home is mandatory.
• Measures to contain the epidemic, including safe and respectful burial of corpses, identification of people in contact with a person infected with Ebola and monitoring their health for 21 days, the importance of separating healthy people from sick people in order to prevent further spread and the importance of good hygiene and maintaining a clean environment.
• reducing the risk of sexual transmission; According to WHO recommendations, based on further analysis of ongoing research and evidence from the WHO Advisory Group on the Response to Ebola Virus Disease, men who have recovered from EVD should practice safer sex and hygiene for 12 months after the onset of symptoms or two negative semen tests for Ebola virus. Therefore, contact with water and body fluids with Ebola virus is recommended.. are negative and are recovering.
• reducing the risk of transmission from fluids and tissues related to pregnancy; Pregnant women who have survived Ebola need social support to access regular antenatal screening (ANC), address any pregnancy complications and address the need for sexual and reproductive care and safe delivery.. This should be done in collaboration with Ebola and women's health care professionals.. Pregnant women should always be respected in sexual and reproductive health decisions..

Infection control in medical centers

Healthcare workers should always follow standard precautions regardless of possible diagnosis...these include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to avoid splashing or contact with contaminated material), safe injection methods, and safe burial methods.

Health center workers who are responsible for caring for patients infected with or suspected of being infected with the Ebola virus should use more infection control measures to prevent contact with the patient's blood and body fluids and contaminated surfaces or materials such as clothing and bedding.... In case of close contact (at a distance of 1 meter) with patients with EVD, the workers of health and health centers should use long faces or clean masks.. sleeves and gloves (sterile gloves in some cases).

Laboratory workers are also at risk... Samples taken from humans and animals to investigate Ebola infection must be prepared by trained personnel and in equipped laboratories.

Caring for people who have recovered from Ebola

A number of medical complications, including mental health problems, have been reported in some people after recovery from Ebola. The Ebola virus may still be present in some body fluids, such as semen, fluids associated with pregnancy, and breast milk.

Ebola survivors need social support to cope with medical and psychological challenges, as well as to minimize the risk of continued transmission of the Ebola virus. To meet such needs, a dedicated program has been set up to care for people who have recovered from Ebola.

It has been found that in some people who have recovered from the disease, the Ebola virus persists in places where they do not have an immune system....These places include the testicles, the inner part of the eye, and the central nervous system....In women who were infected during pregnancy, the virus can still be found in the placenta, amniotic fluid, and the fetus...In women who were infected with the virus while breastfeeding, the virus may be present in breast milk.

Although systemic disease recurrence due to increased viral replication at a specific site in a person who has recovered from EVD is a rare event, it has been proven.... The reasons for this phenomenon are still not well understood.

Viral persistence studies show that in a small percentage of recoveries, reverse transcription polymerase chain reaction (RT-PCR) testing of some body fluids may be positive for Ebola virus for more than 9 months.

More surveillance information and research is needed on the risks of sexual transmission, and in particular the prevalence of live and transmissible virus in semen over time.... At present, based on the available evidence, WHO recommends that:

• All people who have recovered from Ebola and their sexual partners should receive counseling to ensure safer sex until they test negative twice.. Recovery should use a condom.
• Male survivors of Ebola should be tested for semen 3 months after the onset of illness, and then for those who test positive, they should be tested every month thereafter until their sperm tests negative for the virus by RT-PCR twice with a one-week interval between tests.
• Ebola defects and their sexual partners should:
• Avoid any sexual intercourse, or
• Practice safe sex through correct and consistent condom use until the semen test is negative twice.
• With a negative test, those who have recovered can continue their normal sexual activities without fear of transmission of the Ebola virus.
• Based on further analysis of ongoing research and consideration of the WHO Advisory Group on the Response to Ebola Virus Disease, WHO recommends that male survivors of Ebola virus disease practice safe sexual and hygienic practices for 12 months from the onset of symptoms or until two negative semen tests.
• Those who have recovered should observe personal hygiene and hand hygiene by immediately and thoroughly washing their hands with soap and water after any physical contact with semen, including after masturbation, until the semen test for the presence of Ebola has been negative twice.