Ebola natural history
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Ebola Microchapters |
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Diagnosis |
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Treatment |
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Ebola natural history On the Web |
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American Roentgen Ray Society Images of Ebola natural history |
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.
- Without treatment, the patient may develop symptoms of shock, which may eventually lead to death.[2]
- Many times patients will die from shock rather than blood loss.
- The convalescence period is associated with asthenia and arthralgia.[3]
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
- Ebola infection is associated with poor survival with mortality rates ranging from 50% for patients infected with the Sudan ebolavirus to as high as 90% for the patients infected with the Zaire ebola virus. It should be noted that patients who are able to survive with ebola for two weeks are usually able to recover slowly, despite the potential sequelae of the disease, which include:[2]
- Recurrent hepatitis
- Myelitis
- Psychosis
- Uveitis
- Tachypnea is the strongest correlate of fatal outcome. It often appears a few hours before death. Other correlates of fatal outcome are hypotension, tachycardia and anuria.
- Severe hemorrhagic complications such as hematemesis, melena, epistaxis, ear bleeding and hematuria are associated with a poorer prognosis and are often associated with death within a week.[3]
- Survival for 11 days is generally associated with recovery.
References
- ↑ "CDC Ebola Hemorrhagic Fever Information Packet" (PDF). April 2010.
- ↑ 2.0 2.1 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.
- ↑ 3.0 3.1 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.