Ebola symptoms

Ebola symptoms, transmission and diagnosis

Not least because of the dramatic course of the disease, Ebola is considered one of the most dangerous epidemics in the world, even though outbreaks are rather rare and so far the epidemics have been limited to a few African countries. The Ebola virus infections are particularly feared, because until today no efficient treatment is known and because the viruses lead to the death of the patients in up to 90 per cent of the cases. Added to this is the dramatic clinical picture with bleeding from the mucous membranes and bleeding into the upper layers of the skin. The affected people bleed practically from all body orifices.

contents

• Ebola symptoms, transmission and diagnosis
• The Ebola virus
• Symptoms of Ebola virus infection
• transmission
• diagnosis
• treatment
• outbreaks

The Ebola virus

The trigger of the Ebola fever are viruses from the family of the so-called Filoviridae. Five different strains of the Ebola virus (Bundibugyo, Zaire, Reston, Sudan and Taï forest ebolavirus) are known, and according to the Robert Koch Institute (RKI) "out of the five known species of the Ebola virus three species outbreaks triggered in humans (Zaire, Sudan, Bundibugyo) ". In addition to humans, primates such as gorillas or chimpanzees are so-called Fehlwirte also potential victims of the infections.

For a long time there was uncertainty about the natural reservoir of viruses. According to the World Health Organization (WHO), "fruit bats, in particular the genera Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are currently considered potential natural hosts for the Ebola virus." This could also explain the geographical distribution of the sub-Saharan Africa. Human infections were first detected in 1976 in two simultaneous outbreaks in Sudan and the Democratic Republic of the Congo (formerly Zaire). The virus was named after the river Ebola, which was in close proximity to the significantly affected village in the Democratic Republic of the Congo. According to the RKI, the viruses are capable of "multiplying in almost all cells of the host," whereby "due to the rapid virus synthesis, a virus crystal (crystalloid) is secreted that leaks out from the nucleus and individual viruses mimic Lysis of the cell. "

Symptoms of Ebola virus infection

After an incubation period of two to 21 days, according to the WHO, the first symptoms of the infection can be observed. The Ebola fever usually begins with flu-like symptoms such as body aches, headache, sore throat and fever. In the further course the fever reaches body temperatures of more than 38.5 degrees Celsius and those affected suffer from massive diarrhea, nausea and vomiting. Add to this the typical bleeding of a so-called hemorrhagic fever. "Internal bleeding, bleeding into the tissue (bruises), bloody stools and urine" as well as "skin and mucosal bleeding" are mentioned here by the RKI as possible consequences of the infection. Other Ebola symptoms, according to the RKI, are "liver and kidney dysfunction with edema, shock and circulatory collapse, cramping and paralysis."

With the spread of infection in the organism, the capillary blood vessels are increasingly destroyed, with "especially bleeding in the gastrointestinal tract, spleen and lung" leading to the death of patients, reports the RKI. However, the head of virology at the Bernhard Nocht Institute (BNI), Professor Stephan Günther, sees this a little differently and explains: "Most patients are likely to die from organ failure, not from bleeding." Regardless of which acute cause causes the death of the patient Infected conditionally, it is agreed in professional circles that up to 90 percent of the infections can be fatal in the aggressive strains.

transmission

The virus can be transmitted via the blood, other body fluids or tissues of infected people and animals, according to the WHO in Africa, for example, "infections are documented by the handling of infected chimpanzees, gorillas, fruit bats, monkeys, antelopes and porcupines Infection risk is generally considered high in direct contact with infected people. This also applies after death, when mourners come into contact with the body of the deceased at funerals, reports the WHO. In addition, "men who have recovered from the disease could transmit the virus for up to seven weeks after recovery through their sperm." Also, an infection via contaminated food or the contaminated environments of sick people is possible. Since the latter rely on intensive care during the illness and the hygienic precautions on the spot are often insufficient, a transfer to fellow human beings is by no means uncommon.

diagnosis

A confirmed Ebola diagnosis can be done by means of various tests in the laboratory. Here, the WHO calls the so-called ELISA (Enzyme Linked Immunosorbent Assay), the antigen detection tests, the serum neutralization test, the reverse transcriptase polymerase chain reaction (RT-PCR), the electron microscopy and virus isolation by cell culture. Since the samples of the patients pose an extreme biological risk, the tests have to be carried out under maximum biological safety conditions according to the WHO. "Laboratory diagnostics must take place in a special laboratory of protection level 4, whereby in Germany" for the microbiological diagnosis of filoviruses with the Philipps University of Marburg and the Bernhard Nocht Institute in Hamburg, two facilities are available ", explains the RKI.

In the run-up to the laboratory diagnostic search for the Ebola virus, the RKI believes that diseases caused by other pathogens that can trigger a viral haemorrhagic fever, such as the lassa virus, hantaviruses, the Crimean Congo virus or the dengue virus should be excluded. Non-viral diseases such as malaria, typhus abdominalis or rickettsioses should also be ruled out in the course of differential diagnosis.

treatment

To date, there are no effective treatments or medicines for Ebola virus infection. The patients require intensive medical care and should be "isolated in a suitable treatment center for highly contagious diseases (special isolation ward)", reports the RKI. Therapeutic care focuses on alleviating the symptoms. For example, infusions and cardiovascular stabilizing drugs are used, explains BNI expert Professor Stephan Günther. In addition, there is the possibility in Europe of stabilizing the condition of patients by means of "artificial respiration, dialysis, blood substitutes, that is, everything that modern intensive care medicine has to offer". In case of doubt, however, intensive care medicine can not save the lives of patients.

outbreaks

After the first outbreak was registered in 1976 in what was then Zaire (today the Democratic Republic of the Congo), further epidemics followed in Central African countries such as Gabon, Uganda and Sudan. However, the largest epidemic to date was in February 2014 in West Africa, where the Ebola infections from Guinea also spread to the neighboring states of Sierra Leone and Liberia. By mid-July 2014, more than 600 people are already being affected by the Ebola virus and around 1,000 people have become infected. An end of the wave of infection was only one and a half years later in sight. The plethora of victims and the difficult conditions on the ground made the containment of the disease a hugely challenging task for aid agencies and national health authorities. In addition, the population often had reservations about the helpers, and since Ebola had never before appeared in West Africa, there was a lack of knowledge about the routes of infection and the need for hygiene measures. The situation was alleviated only a little by the fact that the pathogen strain did not lead to the death of patients in 90 percent of cases, but only around 60 percent of infections. In total, around 28,000 people have been infected by the epidemic in Guinea, Liberia and Sierra Leone and around 11,300 have died as a result of the infection. (Fp)