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An Ebola epidemic in Central Africa has been declared a “public health emergency of international concern” by the World Health Organization (WHO). As of May 22, over 800 Ebola cases have been reported in the Democratic Republic of the Congo, including more than 180 deaths; these counts include both suspected and laboratory-confirmed cases of the disease. There are also two confirmed cases and one death in Uganda, specifically among people who had recently traveled to the DRC…….Continue reading….
By: Nicoletta Lanese
Source: Live Science
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Critics:
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a zoonotic viral hemorrhagic fever in humans and other primates, caused by four of the six known ebolaviruses. Symptoms typically start anywhere between two days and three weeks after infection. The first symptoms are usually fever, sore throat, muscle pain, and headaches. These are usually followed by vomiting, diarrhoea, rash, hepatic and renal dysfunction, at which point some people begin to bleed both internally and externally.
Outbreaks of the disease have had a mortality rate of between 25 and 90%, averaging out at approximately 50%. The viral species involved and timing of treatment play a critical role in its prognosis. Death is often due to shock from fluid loss, and typically occurs between 6 and 16 days after the first symptoms appear. The viruses have caused intermittent outbreaks in sub-Saharan Africa since 1976 when the disease was first reported, with the largest one being the 2013–16 Western African epidemic.
They spread through direct contact with body fluids, such as blood from infected humans or other animals, or from contact with items that have recently been contaminated with infected body fluids. There have been no documented cases, either in nature or under laboratory conditions, of spread through the air between humans or other primates. After recovering from Ebola, semen or breast milk may continue to carry the virus for anywhere from several weeks to several months.
Fruit bats are believed to be the natural host of the viruses; they are able to spread the viruses without being affected by it. The symptoms of Ebola may resemble those of several other diseases, including malaria, cholera, typhoid fever, meningitis and other viral hemorrhagic fevers. Diagnosis is confirmed by testing blood samples for the presence of viral RNA, viral antibodies or the virus itself.
Control of outbreaks requires coordinated medical services and community engagement, including rapid detection, contact tracing of those exposed, quick access to laboratory services, care for those infected, and proper disposal of the dead through cremation or burial. Prevention measures involve wearing proper protective clothing and washing hands when close to patients and while handling potentially infected bushmeat, as well as thoroughly cooking bushmeat.
Two treatments (atoltivimab/maftivimab/odesivimab and ansuvimab) are associated with improved outcomes. Supportive care and treatment of symptoms increases the survival rate considerably compared to late start. These include oral rehydration therapy (drinking slightly sweetened and salty water) or giving intravenous fluids, and treating symptoms. An Ebola vaccine was approved by the US FDA in December 2019.
In October 2020, atoltivimab/maftivimab/odesivimab (Inmazeb) was approved for medical use in the United States to treat the disease caused by Zaire ebolavirus. The length of time between exposure to the virus and the development of symptoms (incubation period) is between 2 and 21 days, and usually between 4 and 10 days. However, recent estimates based on mathematical models predict that around 5% of cases may take longer than 21 days to develop.
Symptoms usually begin with a sudden influenza-like stage characterised by fatigue, fever, weakness, decreased appetite, muscular pain, joint pain, headache, and sore throat. The fever is usually higher than 38.3 °C (101 °F).This is often followed by nausea, vomiting, diarrhoea, abdominal pain, and sometimes hiccups. The combination of severe vomiting and diarrhoea often leads to severe dehydration.
Next, shortness of breath and chest pain may occur, along with swelling, headaches, and confusion. In about half of the cases, the skin may develop a maculopapular rash, a flat red area covered with small bumps, five to seven days after symptoms begin. Recovery may begin between seven and 14 days after first symptoms. Death, if it occurs, follows typically six to sixteen days from first symptoms and is often due to shock from fluid loss.
In general, bleeding often indicates a worse outcome, and blood loss may result in death. People are often in a coma near the end of life. Those who survive often have ongoing muscular and joint pain, liver inflammation, and decreased hearing, and may have continued tiredness, continued weakness, decreased appetite, and difficulty returning to pre-illness weight. Problems with vision may develop.
It is recommended that survivors wear condoms for at least twelve months after initial infection or until the semen of a male survivor tests negative for Ebolavirus on two separate occasions. Survivors develop antibodies against Ebola that last at least 10 years, but it is unclear whether they are immune to additional infections.
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