Viral hemorrhagic fever

Alternative names
Ebola virus infection; Ebola hemorrhagic fever

Definition
Ebola hemorrhagic fever is a severe illness likely transmitted to humans from infected animals and animal materials. It causes shock and severe bleeding abnormalities.

Causes, incidence, and risk factors

Ebola hemorrhagic fever (Ebola fever) is a viral disease that is limited to parts of Africa. It has been newsworthy worldwide because of its destructive potential.

The exact mode of transmission is not understood. The incubation period appears to be up to 1 week, at which time the patient develops fatigue, malaise, headache, backache, vomiting, and diarrhea.

Within a week, a raised (papular) rash appears over the entire body. The rash is often hemorrhagic (contains blood). Hemorrhaging generally occurs from the gastrointestinal tract, causing the patient to bleed from both the mouth and rectum. Mortality is high, reaching 90%. Patients usually die from shock rather than blood loss.

Symptoms

Early:

     
  • malaise  
  • fatigue  
  • headache  
  • sore throat  
  • backache (low)  
  • nausea  
  • vomiting  
  • diarrhea  
  • arthritis

Late:

     
  • conjunctivitis (eye inflammation)  
  • generalized rash, hemorrhagic  
  • roof of mouth looks red  
  • genital swelling (labia and scrotum)  
  • depression  
  • increased sense of pain in skin  
  • gastrointestinal bleeding (from mouth and rectum)  
  • bleeding from eyes, ears, and nose  
  • seizures, coma, delirium

Signs and tests

There may be signs and symptoms of:

     
  • disseminated intravascular coagulation  
  • shock  
  • coma

Tests used in the diagnosis of Ebola fever include:

     
  • coagulation studies (tests of how well the blood will clot)  
  • serologic studies to demonstrate exposure to the Ebola virus  
  • CBC may demonstrate a low white blood cell count (leukopenia) and low platelet count (thrombocytopenia)  
  • electrolytes

Treatment

There is no known cure for the disorder at this time.

The patient will be hospitalized and will likely need intensive care. Supportive measures for shock will be used (including medications and intravenous fluids).

There will be an attempt to correct bleeding abnormalities, often including transfusions of platelets and/or fresh blood.

Expectations (prognosis)

There is a high fatality rate for this disorder (80% to 90%).

Complications

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

Calling your health care provider

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 help improve the chances of survival.

Prevention

Avoid areas of epidemics. Absolute gown, glove, and mask precautions are necessary around sick patients. These precautions will greatly decrease the risk of transmission.

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.