Diagnostics | Ebola

Diagnostics

In order to prove an infection with the Ebola virus beyond doubt, it is not sufficient to assess the clinical condition of the patient, as the presentation may be very similar to infections with other hemorrhagic viruses. To confirm the diagnosis, body secretion of the sick patient is needed, for example saliva, urine or blood. This must be examined in a high-security level 4 laboratory under the highest safety precautions.

There a PCR (Polymerase Chain Reaction) is carried out, which allows the virus RNA in the patient’s body secretion to be identified. At the same time, the tests also examine for other similarly progressing diseases, such as malaria, Marburg fever, dengue fever or Lassa fever. An alternative diagnostic method to PCR is the cultivation of the virus on special culture media. The virus grows there in a characteristic thread-like form which can be detected under an electron microscope.

Therapy

So far, there is no causal therapy available for the treatment of Ebola fever. Treatment is therefore limited to alleviating the symptoms and mitigating the course of the disease. Patients must receive intensive medical care.

The fever is lowered and patients receive electrolyte and glucose solutions to compensate for fluid and electrolyte loss. Antiviral drugs have not yet shown any effect. Essential in the treatment of patients is their isolation and shielding from other patients and the treating staff.

The patient room is only entered in special protective clothing. Unprotected contact with body fluids and excrements of the patient carries a high risk of infection and must be avoided under all circumstances. Accordingly, patients treated in Germany are placed in special isolation units equipped for the treatment of highly infectious patients.

Intensive research is being conducted on a causal therapy against Ebola fever. On a trial basis, a not yet approved antibody against the Ebola virus has already been used in diseased persons, which led to an improvement in some patients, but no change in the disease state in others. In general, the mortality rate among Ebola patients is very high.

Unfortunately, the high mortality rate is also due to poor medical care and hygiene in the epidemic areas. If the body forms antibodies against the Ebola virus during the disease, the disease can be survived. However, the prerequisite for survival without consequential damage is that the bleeding is controlled and blood transfusions and fluid infusions are given.

Without this intensive treatment, circulatory and organ failure very often occurs. If, however, it can be prevented that during the disease organs take greater damage, a complete cure can be achieved. However, if organs are damaged due to circulatory failure, long-term consequences can occur, for example kidneys that have been insufficiently supplied with blood can be restricted in their function or fail completely.

This complication requires dialysis or a donor organ after the infection. Intensive research has been underway for several years to develop a vaccine against Ebola fever. Since September 2014, a vaccine developed in the U.S. has been tested on healthy test subjects for the first time.

In this vaccine a chimpanzee virus was fused with a particle from an Ebola virus. The organism of the test persons is supposed to form antibodies against this Ebola virus particle. A further vaccine from Canada is now also in the test phase in humans after successful testing on monkeys.

Particularly due to the large outbreak of Ebola fever in 2015, research on a vaccine has been pushed forward enormously due to the high demand. Experimental vaccines have already been made available to the WHO on a trial basis.