Ebola, formerly known as Ebola hemorrhagic fever, is a potentially fatal ebolavirus infection, such as the case that has been detected in Goma (Democratic Republic of the Congo); a city of more than a million inhabitants. Ebolavirus belongs to the filovirus family. It is spread through body fluids. The affected person must be isolated immediately and their treatment requires protective measures for everyone who is in contact with the patient.
Causes of Ebola
Unknown origin
The origin of Ebola is unknown but the host appears to be the fruit bat. Several African countries have been sources of outbreaks. It is spread by direct contact with the body fluids (sweat, blood, semen, urine, feces, saliva…) of the patient. It has been estimated that each infected person can transmit the virus to two other people. Infection occurs when the virus enters through the skin or mucous membranes. Depending on the type of strain, and the affected area, whether it is rural or urban, the number of affected people and the mortality rate also depend.
Registered strains of ebolavirus:
– Ebola-Zaire strain. First strain classified in 1976. It has a high mortality rate. The largest outbreak was in West Africa in 2014. The World Health Organization (WHO) declared an international health emergency.
– Ebola-Sudan strain. Second strain classified in 1976.
– Ebola-Reston strain. It was detected in 1989 and did not affect humans but a group of macaques imported to Reston (Virginia, United States).
– Ebola-Tai-Forest strain. Detected in 1994 in chimpanzees from the Tai forests in the Ivory Coast.
– Ebola-Bundibugyo strain. Detected in 2007 in Uganda, in the Bundibugyo region, an area bordering the Democratic Republic of the Congo.
The main risk factors for contracting the disease are:
– Be healthcare personnel.
– Be a family member or person in direct contact with the patient.
– Have direct contact with the patient’s clothing, bedding, used protective equipment and waste medical supplies used to treat the patient.
– Direct contact with the corpse of a person who died due to the virus.
Ebola symptoms
They start with a severe headache
Symptoms usually begin between two days and three weeks after contracting the virus:
– Severe headache.
– Eye irritation.
– High fever.
– Sore throat.
– Muscle pain.
– Chills.
– Weakness.
– Fatigue.
– Nausea and vomiting.
– Diarrhea.
– Skin rashes.
– Liver and kidney failure.
– Bleeding from the mouth and rectum and/or from the nose, eyes and ears.
Ebola diagnosis
fluid sample
The diagnosis is confirmed by a reverse transcriptase polymerase chain reaction-PCR test. Detects the virus and antigens in a fluid sample.
Ebola treatment and medication
Hydration and fluids
Ebola does not have a specific treatment. The patient must be isolated and cared for by qualified personnel and with the necessary protective equipment against biological risks. It involves alleviating the patient’s symptoms and suffering by rehydrating them orally or intravenously and administering antipyretics, analgesics, antiemetics and tranquilizers. It is important to control blood pressure, apply oxygen if there are breathing difficulties, and control the risk of other infections with broad-spectrum antibiotics. Blood transfusions, plasma replacement therapy, and dialysis may also be needed.
Nutritional and vitamin supplements are also usually administered. When the patient recovers, he is immune to the strain of the virus that he had contracted, but it is recommended not to have sexual relations or to use correctly applied barrier contraceptives for up to nine months to a year after overcoming the disease, especially in the case of men since the virus can survive that time in semen. Condoms must be handled in safe conditions. Semen must show two negative tests for ebolavirus for a case to be declared free of it.
After overcoming the disease, in the long term, it can lead to joint and visual problems.
Ebola prevention
Protective measures and rVSV-ZEBOV vaccine
Prevention measures focus on adequate hygiene and disinfection; avoid people who show signs of illness in areas where the disease has been declared or in the event of an epidemic; do not handle corpses of those who died from ebolavirus; and use highly protective equipment in case of contact with the virus, applying the measures recommended by health authorities for its placement and also for its removal.
Additionally, the experimental rVSV-ZEBOV vaccine was shown to be effective in 2015 in uninfected people who were in contact with the virus.
It is recommended to maintain hygienic and safe sexual relations with the use of correctly applied barrier contraceptives and discard them applying safety protocols.
This article was published in La Vanguardia on July 17, 2023
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