Symptoms
After an incubation period of up to a maximum of three weeks (21 days), the disease begins with nonspecific flu-like symptoms such as fever, chills, feeling sick, digestive disorders and muscle pain. The typical and sometimes uncontrolled bleeding in the skin, mucous membrane and inside the body occurs due to a blood clotting disorder and does not necessarily have to occur. The disease has a high mortality rate of 50% on average and has so far been observed mainly in Africa. However, there is a risk of spread. Family members as well as medical personnel are often affected because these groups come into close contact with patients, which is necessary for infection.
Causes
The cause of the disease is infection with Ebola virus, an enveloped, filamentous RNA virus of the filovirus family (Filoviridae). Five Ebola species are known: Zaire, Bundibugyo, Sudan, Reston, and Taï Forest. Ebola is a zoonotic disease, with the animal reservoir likely being fruit bats (, , ). Other primates such as monkeys, gorillas, and chimpanzees can also become infected and infect humans. Ebola first appeared in the Democratic Republic of Congo in 1976, as well as in the Republic of Sudan in Nzara. The name is derived from the Ebola River in the Congo.
Transmission
The virus is usually transmitted from person to person through blood and other bodily fluids (urine, vomit, sweat, stool, semen, breast milk) during direct contact. It enters the host through small tears in the skin or through the mucous membrane. Infection via contaminated objects and syringes is also possible. Dangerous airborne transmission has rarely been detected in practice (as is the case with influenza, for example). Insects, water, and food also play no role in infection (exception: bushmeat from Africa).
Diagnosis
Diagnosis is made by medical treatment based on clinical symptoms, patient history, epidemiologic situation, and laboratory methods. Initially, diagnosis is difficult because of nonspecific symptoms.
Treatment
Patients are strictly isolated (barrier nursing), and extensive hygienic measures are essential, such as protective masks, goggles, protective suits, and disinfection:
- Fluid and electrolyte supply, oxygen.
- Maintain blood pressure
- Prevent secondary infections: antibiotics
- Antimalarials, if the diagnosis is not established
New, causally effective drugs are in the development stage and are approved in some countries. These include:
- Ansuvimab (Ebanga)
- Remdesivir
Prevention
- One vaccine was licensed in the EU and the US in 2019 (Ervebo, rVSVΔG-ZEBOV-GP).
- Avoid direct contact, physical contact with ill persons and deceased persons.
- Avoid affected areas
- Strict hygiene, hygiene masks, application of disinfectants (surfaces eg Javel water).
- Thorough washing of hands with soap and water.