Ebola Virus Disease

EVD Description

• Hemorrhagic fever with case fatality rate up to 90% • Endemic areas: Central and West Africa • Wildlife reservoir: bats implicated • No cases in humans ever reported in U.S.

Transmission

• Direct contact with bodily fluids from infected person or contaminated objects (e.g. needles) • Incubation period: usually 8-10 days (range 2-21 days) • High-risk individuals – Health care workers – Family members or others in close contact with EVD patients • Can spread quickly in health care settings

Signs and Symptoms

• Early signs non-specific: fever, malaise, weakness, muscle pain, headache, sore throat, vomiting, diarrhea • Late signs: bleeding, multi-organ dysfunction leading to shock and death

Diagnosis

• Complicated by non-specific early symptoms • BSL-3 lab required (BSL-4 for virus isolation)

Timeline of infection

Within a few days after onset Later in disease course or after recovery Retrospectively in deceased patients      

Diagnostic tests available

 Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing IgM ELISA Polymerase chain reaction (PCR) Virus isolation  Serology: IgM and IgG Immunohistochemistry testing PCR Virus isolation

Response

• Treatment – Supportive only – Prompt treatment important • Prevention – Standard, contact, droplet precautions – Contact tracing, monitoring for 21 day incubation period – Immediate isolation of ill contacts – Disinfection of contaminated surfaces, objects by standard methods – No vaccine available

Public Health Messaging

• Identify population at-risk: those with recent history of travel to endemic areas • Health care providers – Should have low threshold of suspicion among travelers returning from endemic areas – Barrier precautions successfully prevent spread • Travelers – Should be aware of risk of EVD in endemic areas – Avoid exposure to risk factors (caves or mines inhabited by bats, healthcare settings where EVD is present, close contact with EVD patients)