Ebola

Ebola: description

Ebola (Ebola fever) is a serious, reportable virus infection that counts among the so-called hemorrhagic fevers. These are infectious diseases that are associated with fever and increased bleeding tendency (including internal bleeding). Risk area is mainly Equatorial Africa, where medical care is often insufficient. To date, there are no uniform standards for the treatment of Ebola. Also a vaccine does not exist so far.

The first infection with the Ebola virus was described in the 1970s in Sudan and the Congo. Since then there have been epidemics again and again. Most recently, a major epidemic broke out in Guinea in February 2014. The disease has been curbed in the past mostly by strict isolation of sufferers, thereby preventing major Ebola epidemics. In addition, the high mortality limits the spread. Death often occurs after just a few days.

A virus very similar to the Ebola virus is the Marburg virus, also a hemorrhagic fever. Both viruses belong to the family of filoviruses. They cause similar diseases that are not clearly distinguishable.

Due to the great danger of Ebola, the pathogen is discussed as a possible warfare agent. But there are so far no indications. An attempt by the Japanese Aum sect to use Ebola viruses for terrorist attacks in Japan failed.

Ebola: symptoms

It takes about two to 21 days between the infection and the outbreak of Ebola. Symptoms include headache and body aches, high fever, conjunctivitis, nausea and rash. In addition, kidney and liver function may be disturbed. In the blood test, decreased numbers of white blood cells and platelets. The fever can subside in the meantime. In this case, however, the disease often takes on a more severe course later.

Just a few days after the onset of the disease, severe internal and external haemorrhages, especially those from the mucous membranes, can occur. In addition to the eye and the gastrointestinal tract of other organs can be affected.

This disease is not specific to Ebola. Fever, bleeding and organ damage also occur in other serious infections. This makes it difficult for doctors to make an accurate diagnosis in the beginning.

In the course of Ebola, various organs often fail. An inflammation of the brain may additionally occur and further worsen the prognosis. The serious illnesses are similar to a septic shock and can be fatal. Cause of death is often heart failure.

Ebola: causes and risk factors

The disease is caused by the Ebola virus, of which five strains are known. Three of these virus strains have caused major outbreaks in humans.

Contagion from animal to human

Through close contact with infected animals, the Ebola virus is transmitted to humans. It is assumed that fruit bats form the natural reservoir of the pathogen; but this is not guaranteed. Also of other infected animals, especially monkeys and pigs, is a danger of infection. For this reason, sick animals should be quarantined as soon as possible. The carcasses of dead animals must be carefully disposed of. Raw meat of these animals should not be consumed.

Unlike many other tropical infections, transmission of the Ebola virus through mosquito bites is not yet known.

Contagion from person to person

The infection from person to person usually takes place only through close contact. In rare cases, the Ebola virus can also be transmitted by cough (droplet infection). Diseased persons are contagious as long as there is a fever. Infections during the incubation period (the phase between the infection with the pathogen and the onset of first symptoms) have not been reported so far.

Especially relatives and caregivers of Ebola patients are at high risk of getting infected too. In an outbreak in Uganda in 2000, 60 percent of nursing staff were infected with the virus. Therefore, Ebola patients need to be strictly isolated. All physical contact and sharing of items such as cutlery should be avoided. People who are in very close physical contact with the patient may also be isolated. Body temperature should definitely be checked regularly with each contact person. The greatest risk of infection is statistically seen before the isolation and before the outbreak of Ebola.

Special care should also be taken when dealing with the deceased and at funerals. The same is true after a surviving Ebola infection: even 61 days after the disease died down, the virus could still be detected in seminal fluid.

Risk of infection when traveling in Ebola areas

According to experts, there is usually no increased risk of infection for travelers to areas where Ebola occurs (especially tropical rainforests of Central Africa). Only those who had close contact with infected persons are highly endangered. Nevertheless, all tourists should inform themselves before departure about the current health situation in the region.

Ebola is notifiable

Ebola early warning systems are essential to prevent or contain major outbreaks. In Germany, even the suspicion of an Ebola infection must be reported by the attending physician to the Robert Koch Institute.

Ebola: examinations and diagnosis

Especially in the early disease phase, the distinction between Ebola and other diseases such as yellow fever, Lassa fever, dengue fever or even malaria difficult. If suspected, patients must be isolated early. Samples are taken which are examined for the Ebola virus. The pathogen can be detected above all in the blood, but also in the skin. Antibodies to the virus usually form only later in the disease.

Only specialized laboratories of the highest level of safety are allowed to work with the Ebola virus and to examine samples from patients suspected of having Ebola. Such special laboratories are among others in Munich, Hamburg and Berlin.

If Ebola is suspected, the blood values ​​are also closely monitored. In addition, there will be close monitoring of whether bleeding or organ function is impaired.

Ebola: treatment

So far, no effective treatment for Ebola has been found, which is why the mortality rate is still very high. Likewise, there are no standardized treatment recommendations. Therapy with an antiviral drug can be considered, but so far has hardly been successful in contrast to similar viral diseases.

Important for an Ebola infection is the intensive care of the patients. Sufficient fluid intake with electrolytes is essential for successful treatment. In the case of (imminent) organ failure, an organ replacement procedure must be started quickly, such as dialysis for kidney failure. However, in countries where Ebola occurs (Central Africa), such medical interventions are often unavailable.

In part, Ebola patients are given antibiotics to fight episodes that can affect the diseased body more easily. Even sedatives may be important to help the patient to reduce their anxiety. In addition, it is essential to control blood clotting.

The main goal of the care of the patients is the prevention and treatment of complications.

Ebola: Disease course and prognosis

The infection usually starts like a severe flu and then goes into the phase of hemorrhagic fever – so there are various bleeding on. In the further course, organ damage can be added, which significantly worsen the prognosis. It is particularly fatal if important organs such as the kidneys fail.

The generally poor prognosis of the disease is also due to the low-developed health systems in the areas of spread of the Ebola virus. Symptoms and organ failures often require expensive and modern therapy procedures, which are usually not available in such countries.

For these reasons leads Ebola in 50 to 80 percent of cases to death. Often the infected die just a few days after onset of the disease. Survivors of Ebola infection often struggle with long-term consequences such as psychosis and liver inflammation.