Diagnosis of Ebola fever

Ebola viral fever is a dreaded fever with high mortality  rate, Early diagnosis of the disease is important for initiation of treatment. Following are the laboratory features. 

Laboratory findings

1. Decreased blood count initially.

2. Increase in neutrophil count later.

3.Fall in Platelet counts (sometimes much below) 50,000/µL.

4. Laboratory evidence of DIC is present but its clinical significance not known.

5. Increased  liver enzymes  alanine and aspartate aminotransferases.

7. Elevation of serum bilirubin.

8. The serum amylase level may be increased  indicating pancreatitis.

9. Deterioration of renal function can occur especially with low blood pressure .

Diagram of Ebola virus

Diagnosis

Most of the acutely sick patients will have high levels of viral load in the blood.

Methods of detection of virus include

1. ELISA is a sensitive diagnostic test.

2. Virus isolation and reverse-transcription PCR is useful.

3. Recovering patients develop antibody to ebola virus ( IgM and IgG antibodies ) that are detected by ELISA test.

4. The indirect fluorescent antibody test with paired sera is an effective test.

5. Quarantine or geographic spread is detected by Real-time PCR.

6. Skin biopsies is useful for postmortem diagnosis.

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Treatment and prevention of Ebola fever.

Ebola fever is a dangerous viral fever associated with high death rate. Ebola is a viral disease caused by Ebola virus. Ebola affect multiple organs in the body, and may be associated with bleeding manifestation and low blood pressure which increase the death rate.

Prevention of Ebola fever

Prevention of Ebola fever is very important because no specific treatment is available for this disease.

Currently there is 

1. No vaccine 

2. No antiviral drug

3. Barrier nursing precautions in taken in African hospitals can significantly reduce the spread of Ebola virus from one person to other and can prevent epidemic.

4. An adenovirus - vectored Ebola glycoprotein gene is undergoing phase 1 trials in humans.

5. An experimental vaccine - vesicular stomatitis virus - based vaccine has protected macaques when it is given both before and after infection with the Zaire Ebola virus

Treatment of Ebola fever

For Ebola Virus Infections no virus specific treatment is available.

Usually what is given is supportive treatment, but sometime especially when the viral load is very high supportive treatment may not work well.

Animal studies shows improved survival in those treated with

1. Inhibitor of factor VIIa/tissue factor 

2. Activated protein C;. 

3. siRNA (small interfering RNA) interfere with viral multiplication is effective for prevention of disease after exposure to patient (post exposure prophylaxis)

Patients with low blood pressure vigorous treatment of shock is done with 

1. IV fluids.

2. Drugs to increase the blood pressure.

3. Those patients with significant blood loss require blood transfusion.

If the low blood pressure is not treated adequately the normal function of heart and lungs will be affected.

Ebola fever is treated with acetaminophen

Ensure adequate hydration is given to patients.

Useful Link : Clinical manifestations of Ebola fever.

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Clinical manifestations of Ebola fever.

Ebola fever is caused by  Ebola virus.The disease is associated with high death rate.High death rate is due to multiple organ involvement. Epidemics usually starts with single case who acquire the disease from unknown reservoir in the nature. Infection spread through close contact with the patient or their body fluid this can be acquired from home or hospital.

Initial manifestations include

1. Sudden onset of headache.

2. Musle pain.  

3. Fever .

4. Severe tiredness.

5. Vomiting and tendency to vomit.

6. Rash.

Continued fever is associated with 

1. Diarrhea (can be severe).

2. Chest pain (accompanied by cough).

3. Depressed mentation.

4. Bleeding manifestations in the skin or oral cavity,need not be present in all severe cases .It is seen in less than 50% of cases.

5. Low blood pressure.

Following are the additional findings 

1. Edema of the face, neck, and/or scrotum.

2. Enlargement of liver. 

3. Flushing.

4. Conjunctival injection.

5. Pharyngitis.

After 10 to 12 days after the onset of fever there may be improvement and patient recover from the disease. Some people may get the fever after sometime.

Some rare complications are 

1. Late liver involvement.

2. Infection of eye(Uveitis)

3. Infection of testes (Orchitis).

Useful links : Treatment and prevention of Ebola fever.

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