Ebola natural history: Difference between revisions
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** Hemorrhage signs are usually associated with [[abdominal pain]] and [[diarrhea]]. | ** Hemorrhage signs are usually associated with [[abdominal pain]] and [[diarrhea]]. | ||
** Anorexia, nausea, sore throat and postration are symptoms usually associated with non-hemorrhagic [[ebola virus disease]]. | ** Anorexia, nausea, sore throat and postration are symptoms usually associated with non-hemorrhagic [[ebola virus disease]]. | ||
* | * In some patients, on approximately the fifth day of the [[ebola virus disease]], a rash on the trunk precedes the appearance of hemorrhagic sings. | ||
* Patients who develop more severe hemorrhagic manifestations such as [[ | * Patients who develop more severe hemorrhagic manifestations such as [[hematemesis]], [[melena]], [[epistaxis]], [[ear bleeding]] and [[hematuria]] have a poorer prognosis and often die within a week.<ref name="pmid2749110">{{cite journal| author=Sureau PH| title=Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire. | journal=Rev Infect Dis | year= 1989 | volume= 11 Suppl 4 | issue= | pages= S790-3 | pmid=2749110 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2749110 }} </ref> | ||
* [[Tachypnea]] has been shown to be the most important indicator of fatal outcome | * [[Tachypnea]] has been shown to be the most important indicator of fatal outcome. It often appears a few hours before [[death]]. Other correlates of fatal outcome are [[hypotension]], [[tachycardia]] and [[anuria]]. | ||
* Without treatment, the [[patient]] | * Without treatment, the [[patient]] may develop [[symptoms]] of [[shock]], which may eventually lead to [[death]].<ref name="pmid21084112">{{cite journal| author=Feldmann H, Geisbert TW| title=Ebola haemorrhagic fever. | journal=Lancet | year= 2011 | volume= 377 | issue= 9768 | pages= 849-62 | pmid=21084112 | doi=10.1016/S0140-6736(10)60667-8 | pmc=PMC3406178 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21084112 }} </ref> | ||
* | * Survival for 11 days is generally associated with recovery. | ||
* The convalescence period | * The convalescence period is associated with [[asthenia]] and [[arthralgia]].<ref name="pmid2749110">{{cite journal| author=Sureau PH| title=Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire. | journal=Rev Infect Dis | year= 1989 | volume= 11 Suppl 4 | issue= | pages= S790-3 | pmid=2749110 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2749110 }} </ref> | ||
==Complications== | ==Complications== |
Revision as of 16:23, 15 July 2014
Ebola Microchapters |
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Ebola natural history On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.; Guillermo Rodriguez Nava, M.D. [2]
Overview
In the absence of supportive care, the Ebola virus rapidly progresses to death in up to 90% of cases. An Ebola infection can be complicated by multiorgan failure and shock. The prognosis of Ebola virus disease is poor, and depends of the supportive care given and the Ebola virus strain. The Zaire Ebola virus has mortality rate as high as 90%.[1]
Natural History
- Ebola virus disease has an incubation period from 2 to 21 days.
- The symptoms of ebola virus disease usually develop early after the incubation period in fatal cases, and patients who die, generally die in the first two weeks.
- Initial symptoms include high fever, chills, headache, malaise and myalgia.
- The ebola virus disease can course with or without hemorrhage.
- Hemorrhage signs are usually associated with abdominal pain and diarrhea.
- Anorexia, nausea, sore throat and postration are symptoms usually associated with non-hemorrhagic ebola virus disease.
- In some patients, on approximately the fifth day of the ebola virus disease, a rash on the trunk precedes the appearance of hemorrhagic sings.
- Patients who develop more severe hemorrhagic manifestations such as hematemesis, melena, epistaxis, ear bleeding and hematuria have a poorer prognosis and often die within a week.[2]
- Tachypnea has been shown to be the most important indicator of fatal outcome. It often appears a few hours before death. Other correlates of fatal outcome are hypotension, tachycardia and anuria.
- Without treatment, the patient may develop symptoms of shock, which may eventually lead to death.[3]
- Survival for 11 days is generally associated with recovery.
- The convalescence period is associated with asthenia and arthralgia.[2]
Complications
Survivors may have unusual problems, such as hair loss and sensory changes. There are also some late complications that may occur due to Ebola: They are:
- Hearing loss
- Unilateral orchitis
- Headache
- Fatigue
- Myalgias
- Tinnitis
- Amenorrhea
- Bulimia
- Suppurative parotitis
Prognosis
The prognosis for a patient infected with the ebola virus is typically not good. The mortality rate from ebola can be 50% for patients infected with the Sudan ebolavirus or as high as 90% for the patients infected with the Zaire ebolavirus. Many times patients will die from shock rather than blood loss. It should be noted that patients who are able to survive with ebola for two weeks are usually able to recover slowly.
References
- ↑ "CDC Ebola Hemorrhagic Fever Information Packet" (PDF). April 2010.
- ↑ 2.0 2.1 Sureau PH (1989). "Firsthand clinical observations of hemorrhagic manifestations in Ebola hemorrhagic fever in Zaire". Rev Infect Dis. 11 Suppl 4: S790–3. PMID 2749110.
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.