Ebola fever - symptoms and signs, pathogenesis, diagnosis, treatment and prevention. How do you get infected with Ebola? Persistent virus in survivors of Ebola virus disease

• Ebola virus disease (EVD), formerly known as hemorrhagic fever Ebola is severe, often fatal disease of people.
• The virus is transmitted to humans from wild animals and spreads among people from person to person.
• The average case fatality rate for EVD is about 50%. In previous outbreaks, case fatality rates ranged from 25% to 90%.
• The first outbreaks of EVD occurred in remote villages of Central Africa in tropical rainforests, but outbreaks in West Africa in 2014-2016. covered large cities and rural areas.
• Active community participation is essential for successful outbreak control. Effective outbreak control relies on a combination of measures, such as case management, infection prevention and control measures, surveillance and contact tracing, effective laboratory services, safe disposal and social mobilization.
• Early supportive therapy with rehydration and symptomatic treatment contributes to increased survival of patients. There is no licensed treatment with a proven ability to neutralize the virus, but a number of treatments are currently being developed. therapeutic agents based on blood, as well as immunological and medicinal methods of therapy.

reference Information

Ebola virus causes acute serious disease, which is often fatal if left untreated. Ebola virus disease (EVD) first emerged in 1976 with two simultaneous outbreaks in Nzara (now South Sudan) and Yambuku, Democratic Republic of the Congo. The second outbreak occurred in a village near the Ebola River, from which the disease takes its name.

Outbreak in West Africa 2014-2016 is the largest and most complex Ebola outbreak since the virus was discovered in 1976. More people got sick and died in this outbreak than in all other outbreaks combined. It is also spreading between countries, starting in Guinea and spreading across land borders into Sierra Leone and Liberia.

The Filoviridae family of viruses includes 3 genera: Lloviu, Marburg and Ebola. There are 5 types of Ebola: Zaire, Bundibugyo, Sudan, Reston and Thai Forest. The first three of these—the Bundibugyo, Zaire, and Sudan Ebola viruses—are associated with large outbreaks in Africa. The virus that caused in 2014 - 2016. outbreak in West Africa, belongs to the Zaire species.

Transmission of infection

Fruit bats of the family Pteropodidae are believed to be the natural hosts of the Ebola virus. Ebola enters the human population through close contact with the blood, secretions, organs, or other body fluids of infected animals, such as chimpanzees, gorillas, fruit bats, monkeys, bush antelope, and porcupines found dead or sick in rainforests.

Ebola then spreads through person-to-person transmission through close contact (through broken skin or mucous membranes) with the blood, secretions, organs, or other body fluids of infected people, as well as with surfaces and materials (eg, bedding, clothing) contaminated such liquids.

Health care workers often become infected while caring for patients with suspected or confirmed EVD. This occurs as a result of close contact with patients without strict adherence to infection control standards.

Funeral rites that involve direct contact with the body of the deceased can also transmit the Ebola virus.

People remain infectious as long as their virus remains in their body.

Sexual transmission of infection

Additional surveillance data and further research are needed regarding the risks associated with sexual transmission, and in particular regarding the presence of viable and transmissible virus in seminal fluid over the long term. Based on the available evidence, WHO makes the following interim recommendations:

• All Ebola survivors and their sexual partners should receive counseling on safe sex practices before receiving twice negative result seminal fluid test. Survivors should be provided with condoms.
• Male Ebola survivors should be offered semen testing three months after illness onset and then, if the test is positive, every month until the semen is tested twice negative for the virus by RT-PCR, with a week interval between tests.
• Ebola survivors and their sexual partners should
• After receiving a negative test result, Ebola survivors can safely resume normal activities. sex life without fear of transmitting the virus.
• Based on analysis of additional evidence from ongoing research and discussions by the WHO Advisory Group on the Response to Ebola Virus Disease, WHO recommends that men who have had Ebola virus disease practice safe sex and practice good hygiene for 12 months after the onset of symptoms or until their semen tests two negative for Ebola virus.
• Until a semen test test negative twice for Ebola virus, survivors of the disease should practice good hand and personal hygiene by washing promptly and thoroughly with soap and water after any physical contact with semen, including after masturbation. During this period, you should be careful when handling used condoms and disposing of them safely to avoid contact with seminal fluid.
• All survivors, their partners and families should be treated with compassion and respect for their dignity.

• Interim recommendations regarding sexual transmission of Ebola virus disease

Symptoms of Ebola virus disease

The incubation period, that is, the time interval from the moment of infection with the virus to the appearance of symptoms, ranges from 2 to 21 days. People are not contagious until symptoms appear. The first symptoms are the sudden onset of fever, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, kidney and liver dysfunction, and, in some cases, both internal and external bleeding (eg, bleeding from the gums, blood in the stool). Laboratory tests reveal low levels of white blood cells and platelets along with elevated liver enzymes.

Persistent virus in survivors of Ebola virus disease

The Ebola virus is known to persist in immune-privileged parts of the body of some people who have had Ebola virus disease. These body parts include the testes, the inside of the eyes and the central nervous system. In women infected during pregnancy, the virus persists in the placenta, amniotic fluid and embryo. In women infected while breastfeeding, the virus may persist in breast milk.

Viral resistance studies suggest that a small percentage of recovered individuals may test positive for Ebola virus by reverse transcriptase polymerase chain reaction (RT-PCR) of some body fluids for more than 9 months.

Recurrence of symptoms in a person who has had EVD due to increased replication of the virus in a specific part of the body has been documented, although rare. The reasons for this phenomenon have not been fully elucidated.

Diagnostics

It can be difficult to distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. The following tests are done to confirm that symptoms are caused by the Ebola virus:

• enzyme-linked antibody capture immunosorbent assay (ELISA);
• antigen detection tests;
• serum neutralization reaction;
• polymerase chain reaction with reverse transcriptase (RT-PCR);
• electron microscopy;
• virus isolation in cell cultures.

the following:

Automated and semi-automated nucleic acid amplification tests (NAT) for routine diagnostics.

Rapid antigen detection tests for use in remote areas without access to NAT. These tests are recommended for screening purposes as part of surveillance, but reactive tests must be confirmed by NAT.

Preferred samples for diagnostics:

Whole blood collected by EDTC from living symptomatic patients.

An oral fluid sample stored in a universal transport medium and collected from deceased patients or when blood collection is not possible.

Samples taken from patients pose an extremely high biohazard; Laboratory testing of non-inactivated samples should be performed under maximum biological containment conditions. During national and international transport, all biological specimens must be placed in triple packaging systems.

Treatments and vaccines

Maintenance therapy with oral or intravenous administration fluids and treatment of specific symptoms improves survival. There is no proven treatment for EVD yet. However, a number of potential treatments are currently being evaluated, including blood products, immune and drug therapies.

An experimental Ebola virus vaccine has demonstrated strong preventative effects against the deadly virus in a large-scale trial conducted in Guinea. The vaccine, called rVSV-ZEBOV, was studied in 2015 in a trial that included 11,841 people. Among the 5,837 people who received the vaccine, there were no cases of Ebola reported 10 days or more after vaccination. At the same time, 23 cases of the disease were reported among people who did not receive the vaccine 10 or more days after vaccination.

The trial was led by WHO, in collaboration with Guinea's Ministry of Health, Médecins Sans Frontières and the Norwegian Institute of Public Health, in collaboration with other international partners. A ring vaccination protocol was chosen for the trial, with some rings vaccinating soon after a case is identified and others three weeks later.

Prevention and control

Good outbreak control relies on a combination of interventions, namely case management, surveillance and contact tracing, good laboratory services, safe burials and social mobilization. Important Involving local communities is key to successfully controlling outbreaks. Effective way to reduce transmission of the disease among people is to increase awareness of the risk factors for contracting EVD and personal protective measures (including vaccination). Risk reduction communications should emphasize the following factors:

• Reducing the risk of transmission from wild animals to humans as a result of contact with infected fruit bats or monkeys/primates and consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Before consumption, their products (blood and meat) must be thoroughly cooked.
• Reducing the risk of person-to-person transmission as a result of direct or close contact with people who have symptoms of EVD, especially with their body fluids. Gloves and appropriate personal protective equipment should be worn when caring for patients at home. After visiting sick people in hospitals and caring for sick people at home, you should wash your hands regularly.
• To reduce risk possible transfer sexually transmitted infections- Because this risk cannot be eliminated, men and women who have recovered from Ebola should abstain from all types of sex (including anal and oral sex), for at least three months after the onset of symptoms. If abstinence from sex is not possible, it is recommended to use male or female condoms. It is recommended to avoid contact with bodily fluids and wash your hands with soap. WHO does not recommend isolating male or female convalescent patients with negative blood test results for Ebola virus.
• Outbreak containment measures including the rapid and safe burial of the deceased, identification of persons who may have had contact with someone infected with Ebola, monitoring the health status of people who had contact with sick people for 21 days, the importance of separating healthy and sick people to prevent further transmission, the importance proper hygiene and cleanliness.

Infection control in healthcare settings

Health care workers should always follow standard precautions when caring for patients, regardless of the suspected diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to protect yourself from splashes or other contact with infectious materials), safe injection practices, and safe burial of the dead.

Health care workers caring for patients with suspected or confirmed Ebola virus infection should take additional infection control measures to prevent exposure to the patient's blood and body fluids, as well as contaminated surfaces or materials such as clothing and bed dress. When in close contact (closer than one meter) with a person with EVD, health care workers should protect their face (using a face shield or medical mask and goggles) and wear a clean, nonsterile, long-sleeved gown and gloves (sterile for some procedures).

Laboratory workers are also at risk. Specimens taken from humans and animals for the diagnosis of Ebola infection should be handled by trained personnel in properly equipped laboratories.

WHO activities

WHO aims to prevent Ebola outbreaks by providing surveillance for Ebola virus disease and supporting countries at risk to develop preparedness plans. The Ebola and Marburg fever epidemic: preparedness, prevention, control and assessment provides general guidance for managing outbreaks of Ebola and Marburg virus disease.

If an outbreak is identified, WHO responds by providing support for surveillance, community engagement, case management, laboratory services, contact tracing, infection control, logistics support and training, and assistance with safe burial practices.

Table: Timeline of Ebola virus disease outbreaks

*This number includes suspected, probable and laboratory confirmed cases.

Ebola virus

Symptoms

Ebola fever is characterized by sudden rise fever, severe general weakness, muscle pain, headaches, and sore throat. This is often accompanied by vomiting, diarrhea, rash, kidney and liver dysfunction, and in some cases, both internal and external bleeding. Laboratory tests reveal low levels of white blood cells and platelets along with elevated liver enzymes.

Transmission of infection

The Ebola virus is transmitted through direct contact with the blood, secretions, organs, or other body fluids of an infected person.

Funeral rites, in which people attending a funeral have direct contact with the body of the deceased, may play a significant role in the transmission of the Ebola virus.

In Côte d'Ivoire, the Republic of Congo and Gabon, cases of human infection with Ebola virus have been documented from the handling of infected chimpanzees, gorillas and bush antelope, both dead and alive. There have also been reports of transmission of the Reston strain of Ebola through handling of cynomolgus monkeys.

Health care workers are often infected with Ebola virus while handling patients through close contact in the absence of appropriate infection control measures and appropriate barrier care practices.

Research into developing a vaccine was funded primarily by the Department of Defense and the United States, which feared that the virus could be used to create biological weapons. Thanks to this funding, several vaccine prototypes were developed and successfully tested on animals. Two companies, Sarepta and Tekmira, have already begun testing vaccine prototypes in humans.

In 2012, Gene Ohlinger ( Gene Olinger), a virologist at the US Army Institute of Infectious Diseases ( USAMRIID), reported that, at the current level of funding, a vaccine could be obtained in 5-7 years. However, in August 2012, the US Department of Defense announced that it was suspending further funding for vaccine development due to "financial difficulties." A final decision on whether to renew or completely stop funding these studies should be made in September 2012.

Scientists developing the vaccine told the BBC that if the US Department of Defense refuses further funding for research, an Ebola vaccine may never be created.

Etiology

According to its morphological properties, the virus coincides with the Marburg virus ( Marburgvirus), but differs antigenically. Both of these viruses belong to the filovirus family (Filoviridae). The Ebola virus is divided into five subtypes: Sudanese, Zairean, Ivory Coast, Reston and Bundibugyo. Only 4 subtypes affect humans. The Reston subtype is characterized by an asymptomatic course. The natural reservoirs of the virus are believed to be in the equatorial African forests.

Subtypes

Zaire ebolavirus

This subtype was first recorded in Zaire, which is why it got its name. It has the highest mortality rate, reaching 90%. The average mortality rate hovers around 83%. During the 1976 outbreak, the mortality rate was 88%, in 1994 - 59%, in 1995 - 81%, in 1996 - 73%, in 2001-2002 - 80%, in 2003 - 90%. The first outbreak was recorded on August 26, 1976 in the small town of Yambuku. The first case was a 44-year-old school teacher. Symptoms of the disease resembled those of malaria. The spread of the virus is believed to have initially been facilitated by the repeated use of injection needles without sterilization.

Sudanese ebolavirus

This is the second subtype of the Ebola virus, recorded approximately at the same time as the Zaire virus. The first outbreak is believed to have originated among factory workers in the small town of Nzara, Sudan. The carrier of this virus was never identified, despite the fact that immediately after the outbreak, scientists tested for the presence of the virus in various animals and insects living in the vicinity of this town. The most recent outbreak was recorded in May 2004. On average, case fatality rates were 54% in 1976, 68% in 1979, and 53% in 2000 and 2001.

Reston ebolavirus

This virus is classified as a type of Ebola virus, but there is some speculation that it may be a new virus of Asian origin. The virus was discovered during an outbreak of simian hemorrhagic fever virus (SHFV) in 1989. It was established that the source of the virus were green macaques, which were brought to Germany to one of the research laboratories. After this, outbreaks were recorded in the Philippines, Italy and the USA (Texas). Despite the fact that this subtype belongs to the Ebola species, it is not pathogenic for humans. However, it poses a danger to monkeys.

Ivory Coast ebolavirus

The virus was first discovered in chimpanzees in the forest of Ivory Coast, Africa. On November 1, 1994, the corpses of two chimpanzees were discovered. An autopsy showed the presence of blood in the cavities of some organs. The study of chimpanzee tissue yielded the same results as the study of tissue from people who fell ill with Ebola during 1976 in Zaire and Sudan. Later, in the same 1994, other chimpanzee corpses were found in which the same subtype of the Ebola virus was discovered. One of the scientists who performed autopsies on dead monkeys fell ill with Ebola. Symptoms of the disease appeared a week after the autopsy of the chimpanzee. Immediately after this, the sick woman was taken to Switzerland for treatment, which, six weeks after infection, resulted in a complete recovery.

Bundibugyo ebolavirus

On November 24, 2007, the Ugandan Ministry of Health declared an Ebola outbreak in Bundibugyo. After isolating the virus and analyzing it in the United States, the World Health Organization confirmed the presence of a new type of Ebola virus. On February 20, 2008, the Ugandan Ministry of Health officially declared the end of the epidemic in Bundibugyo. A total of 149 cases of infection with this new type of Ebola were recorded, 37 of which were fatal.

• The Ebola virus is mentioned in the game Crysis 2
• The Ebola virus is mentioned in the film Prometheus when David tells the main character about the death of her father (the reason is the Ebola virus)
• In the TV series “Body Investigation” (season 2, episode 19), the Ebola virus is mentioned. (or rather its variety)
• In the series “The Walking Dead (TV series)” (season 1 episode 6) the Ebola virus is mentioned.
• In the series "Breaking Bad" (Season 3, Episode 10), the Ebola virus is mentioned.
• In the film L: Change the World, the Ebola virus is referred to as biological weapons and the cause of death of all the inhabitants of the Thai village.

see also

Notes

Links

Description

• Ebola Virus Haemorrhagic Fever - Proceedings of the international congress on the Ebola virus and other hemorrhagic diseases, Antwerp, Belgium, December 6-8, 1977
• Questions and answers about Ebola virus disease - Center for Disease Control (CDC)
• Research aimed at obtaining a vaccine against the Ebola virus

Epidemiology

• History of Ebola Virus Outbreaks, US Center for Disease Control
• Control of viral infection in Africa, US CDC 1998

Life cycle

• Biomarker Database - information on Ebola

Virulence

• U.S. Army Medical Research Institute of Infectious Diseases: Gene-Specific Ebola Therapies Protect Nonhuman Primates from Lethal Disease
• Lethal experimental infection of rhesus monkeys with Ebola-Zaire (Mayinga) virus by the oral and conjunctival route of exposure PubMed, February 1996, Jaax et al.
• Lethal experimental infections of rhesus monkeys by aerosolized Ebola and marburg virus PubMed, August 1995
• Marburg and Ebola viruses as aerosol threats PubMed, 2004, USAMRIID
• Other viral bioweapons: Ebola and Marburg hemorrhag fever PubMed, 2004
• Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory PubMed, December 1993
• What is the probability of a dangerous strain of Ebola mutating and becoming airborne? Brett Russel, retrieved 2006-07-10.

Wikimedia Foundation. 2010.

Ebola fever also called Ebola hemorrhagic fever or Ebola virus disease. The last name, the disease caused by the Ebola virus, is correct and generally accepted in world practice today. Based on the first letters of the words in the name of the pathology (the disease caused by the Ebola virus), an abbreviation was created - EVD, which is currently widely used. In the future, the terms “Ebola fever” and “EVD” will mean the same pathology.

Ebola fever is a viral infection that causes various organs and systems under the influence of disseminated intravascular coagulation syndrome (DIC syndrome). The essence of the infection is the development of intravital necrosis of various tissues, that is, the person is still alive, but the affected organs have already died. In fact, the body ends up with a whole rotting and decomposing organ, which releases an incredible amount of toxic substances that provoke severe intoxication. In addition, the second feature of the infection, for which it is called hemorrhagic, is the development of disseminated intravascular coagulation due to the destruction of all blood cells, including platelets responsible for blood clotting. Due to the complete lack of blood clotting, numerous bleedings develop from any, even the smallest wounds. Blood literally oozes out of the human body. However, bleeding can be not only external, but also internal. Death usually occurs from internal bleeding or multiple organ failure.

Ebola fever is very severe, a person is sick for at least 2 - 3 weeks. The mortality rate for Ebola fever is incredibly high and varies depending on the type of virus that causes this case infections, from 50 to 90%. This means that out of 10 people who become ill, 5 to 9 people die. Ebola affects humans and primates, which include monkeys, gorillas and chimpanzees.

The name of the infection was given by the name of the Ebola River, in the basin of which the deadly virus was first discovered and identified. dangerous disease. In villages located in the tropical jungles of Africa, along the banks of the Ebola River, an epidemic of a previously unknown infection broke out in 1976, which was so terrible that only one person out of 10 people who fell ill survived. It was during that epidemic that British virologists went to the jungles of Africa and were able to isolate and then identify the virus that became the causative agent of the terrible infection from the tissues of the dead. It turned out to be a new, hitherto unknown virus, named “Ebola” in honor of the name of the river, the banks of which were its “homeland”.

Main characteristics of Ebola fever

• Ebola fever is a severe and often fatal infection;


• The mortality rate for Ebola epidemics ranges from 50 to 90%;


• Spontaneous outbreaks of fever occur mainly in settlements in central and western Africa located in close proximity to tropical rainforests;


• The Ebola virus is transmitted to the human population from animals and then spreads from sick to healthy people;


• The host of the virus is believed to be the Pteropodidae family of fruit bats;


• An Ebola patient needs intensive therapy, which consists in the constant administration of electrolyte solutions and the use of symptomatic agents;


• There is no specific treatment for Ebola;


• There is currently no vaccine for Ebola.

The history of the Ebola virus

So, the first case of Marburg fever was recorded in German city Marburg in 1967, where an employee of a monkey nursery fell ill and died 2 weeks later. As it was later established, he became infected from monkeys exported from Uganda. Then the Ebola epidemic broke out in 55 villages in Zaire and 27 villages in Sudan. Both epidemics began simultaneously and were caused by different subtypes of the Ebola virus, so transmission of infection from one region to another is excluded. Both epidemics devastated the population of the villages, but the epidemic did not spread beyond a clearly limited geographical region, ending as suddenly as it began.

Then in 1980, Frenchman Monet fell ill with Ebola after visiting a cave in Mount Elgon, which is located in Kenya. Monet arrived and went to hospital in Nairobi with symptoms similar to a regular attack of malaria, so the doctors were not alarmed. However, as the disease progressed, it became obvious that this was not malaria, but none of the medical staff at the hospital could understand anything, since they had never encountered such an infection before. Monet's attending physician, Shem Musoke, did not know what danger he was in when the Frenchman literally covered him with his blood from head to toe during an attack. Within a month, Dr. Monet also died from the same terrible symptoms as the French explorer. Then hospital staff in Nairobi collected tissue and blood samples from the deceased doctor and sent them to the US Center for Viral Disease Control, where the deadly virus was isolated. This is how samples of the Ebola virus were first obtained.

Since then, outbreaks of Ebola have been recorded in various African countries. However, they began suddenly, covered a strictly defined territory without spreading beyond its borders, and, having claimed the lives of several dozen or hundreds of people, also suddenly stopped. The latest outbreak of Ebola, which began in the spring of 2014, became the largest in the history of the existence of this infection, and has already claimed the lives of eight hundred people. superfluous person. Moreover, the virus is ready to break out in “ Big world“, and then a terrible pandemic may begin, the outcome of which can only be compared with the plague in medieval Europe.

Ebola fever – photo

This photograph shows the characteristic appearance of subcutaneous hemorrhages that literally cover the entire body of an Ebola patient.

Ebola virus

• Bundibugyo (BDBV);


• Zairian (EBOV);


• Reston (RESTV);


• Sudanese (SUDV);


• Thai Forest (TAFV).

Viruses of the Bundibugyo, Zaire and Sudan subtypes provoked large outbreaks of Ebola fever in various African countries. The Reston and Thai Forest subtypes of the Ebola virus have been identified in the Philippines and China; they are capable of being transmitted to people, but do not cause severe infection with a possible fatal outcome. The Reston and Thai Forest Ebola virus is dangerous for monkeys, who become infected, become seriously ill and die. In humans, these types of Ebola virus can only cause mild infection. However, in most cases, people who are accidentally infected with the Reston or Thai Forest Ebola virus experience gradual and asymptomatic elimination from the body.

Sudanese, Zaire and Bundibugyo Ebola viruses cause a hemorrhagic fever-type infection in humans. All types of Ebola virus have been studied relatively poorly. Ebola virions have a very simple structure. Structurally, it is distantly related to the measles and rabies viruses. However, despite its simplicity, the Ebola virus in the process of evolution has absorbed all the best achievements. Naturally, the best from the point of view of the virus, but from the human point of view, these are the worst qualities and forecasts.

A viral particle of any subtype has a filamentous or cylindrical shape, the genetic material is represented by a single strand of RNA (ribonucleic acid). In the center of the viral particle there is a strand, which is the basis for attachment and twisting of the RNA helix. On the outside, the virus is covered with a lipoprotein membrane, on which there are spike-like projections located at an equal distance from each other. Spikes cover the entire outer surface of the virus particle. The structure of the Ebola virion includes only 7 protein molecules.

Of the seven protein molecules present in the structure of the virus, the purpose of only three has been clarified. And the remaining 4 protein molecules of the Ebola virus remain a complete mystery to scientists, since it is impossible to imagine their purpose, their functions, their mechanism of action, etc. However, one thing is certain - the main target of the protein molecules of the Ebola virus is the cells of the immune system. Ebola virus strikes immune system almost instantly, like the explosion of a directed projectile, which significantly distinguishes it from HIV, which requires at least 10 years for the same purpose.

Therefore, the Ebola virus, according to scientists, is an unknown killer that is capable of destroying 9/10 of the population of planet Earth in a short time. Compared to it, the AIDS virus is a harmless warning, Nature's amusement.

The Ebola virus is heat resistant. In blood and plasma, the virus becomes inactive when heated to 60 ° C and maintained at this temperature for half an hour. When exposed to direct sunlight, the virus lives on average 1 – 2 minutes. The virus can easily withstand low temperatures; according to experimental data, it survives a year’s stay at -70°C very well. It is inactivated by ethyl alcohol, chloroform and sodium deoxychlorate when exposed to these chemicals for at least 1 hour.

Ebola fever - spread, transmission routes

After entering a person, the Ebola virus spreads from the infected to the healthy. Moreover, the routes of transmission of the virus from a sick person to a healthy person are very diverse.:

• Contact with secretions, body fluids, blood or organs of an infected person. Infection occurs through minor damage present on the skin and mucous membranes;


• Contact with any media (linen, water, food, needles, medical instruments etc.) contaminated with secretions, blood, body fluids or organ parts (for example, pieces of skin) of a person infected with the Ebola virus;


• Direct contact with the body of someone who has died from Ebola (for example, kissing, washing, and other funeral rituals);


• Having sex with an Ebola patient without a condom. The virus can be transmitted from one person to another through semen for up to seven weeks after recovery from fever;


• Inhalation of sputum particles produced by an infected person.

Thus, the modes of transmission of the Ebola virus are highly variable. A person can become infected through contact with any secretions of an infected person, as well as when using general subjects everyday life However, most often, infection occurs through direct contact with materials infected with biological secretions. The most dangerous from the point of view of infection is contact with the blood of an Ebola patient.

Health care workers become infected with the Ebola virus through contact with EVD patients if infection control rules and regulations are not followed.

A person is a source of infection for others as long as his blood and biological secretions (sweat, saliva, urine, semen, feces, etc.) contain the virus. Typically, after clinical recovery, a person remains infectious to others for another seven weeks, during which he must remain in quarantine in a medical facility.

Ebola fever - what is the incubation period

Diagnosis of Ebola fever

• Enzyme-binding immunosorbent antibody capture assay (ELISA);


• Tests to detect virus antigens;


• Serum neutralization reaction;


• Reverse transcriptase polymerase chain reaction (RT-PCR);


• Electron microscopy;


• Virus isolation in cell cultures.

Pathogenesis of Ebola fever

However, usually the virus has an affinity for a specific type of cell, for example, hepatocytes (hepatitis viruses), pneumocytes (pneumonia viruses), etc. Once in the body, such a virus finds cells for which it has an affinity and causes an infectious-inflammatory disease of the corresponding organ. The Ebola virus has an affinity for almost all cells of the human body, with the exception of bones and skeletal muscles, and therefore causes disease in all organs and systems simultaneously.

The Ebola virus has a perfect mechanism for entering cells. After all, for subsequent reproduction, it needs to penetrate inside the cell without damaging or destroying it, and for this it will have to “deceive” the receptors present on its surface. The Ebola virus has this ability.

In a study by American scientist Mark Goldsmith, it was found that the Ebola virus exhibits on its surface a molecule similar in structure to folic acid (vitamin B9). And almost every cell in the human body has a receptor that captures folic acid, since it is necessary for the normal functioning of vital processes. Thus, the Ebola virus disguises itself as a folic acid molecule, and the body cell itself captures it with the appropriate receptor. Then, due to its own transmembrane transport mechanisms, the Ebola virus, under the guise of folic acid, is brought inside the cell, where it attacks its genome and begins to actively multiply. In principle, this penetration method can be conditionally called a “Trojan horse”.

After penetrating the cell, the Ebola virus integrates into the genome and forces it to work for itself, that is, to produce only viral structures. Thus, the virus multiplies and literally invades the cell. After some time, the body cell dies, its membrane disintegrates, and many viral particles enter the lymph, blood and intercellular matrix to attack and destroy new cells, causing their death and severe dysfunction of the corresponding organ. Ebola viruses most often attack liver cells, walls blood vessels and respiratory organs, so the infection begins with fever, bleeding disorders, sore throat, etc.

It is assumed that the virus penetrates especially easily into the body cells of those people who are poorly nourished and therefore lack folic acid. Such people have a large number of free folic acid receptors on the surface of their cells, which readily “pick up” the virus masquerading as a vitamin. It is in them that the Ebola virus simultaneously penetrates various tissues, causing systemic destruction of many internal organs.

However, large doses of folic acid are not able to have a pronounced preventive or therapeutic effect against the Ebola virus. Instead, scientists have developed special antibodies that occupy free folic acid receptors on cells and block the entry of the viral particle. A drug based on these antibodies has shown its effectiveness, but so far only in laboratory conditions. It is on the basis of these antibodies that a cure for Ebola fever is being developed.

Symptoms and course of the disease

So, the Ebola virus enters the body and affects every organ and tissue with the exception of bones and skeletal muscles. First of all, the virus causes disseminated intravascular coagulation syndrome (DIC), during which the blood first intensively clots, forming many clots and blood clots. The formed clots cover the inner wall of the blood vessels, increasingly narrowing the lumen of the capillaries and, ultimately, completely clogging them. As a result, blood stops flowing to various organs.

Then, due to the intensive use of various biological substances for blood clotting, their depletion occurs and the second phase of DIC syndrome begins. In the second phase of DIC, the blood simply does not clot under any circumstances, since the biological substances that ensure the formation of clots no longer exist; they were all used during the first phase. Due to the complete lack of blood coagulation in the second phase of DIC, a person begins to experience numerous internal and external bleeding.

Blood literally oozes from numerous wounds on the skin, from mucous membranes, from gums, from eyes, etc. On inner surface eyeballs It turns out there is a huge amount of non-coagulating blood that oozes from the eyes in bloody tears.

The skin and mucous membranes become covered with purplish-red spots from hemorrhages into the subcutaneous tissue. Hemorrhages look like a characteristic rash covering the entire human body. Exactly the same hemorrhages occur in the submucosal layer meninges, liver, lungs, intestines, kidneys, stomach, genital and respiratory organs, as well as the mammary gland.

The Ebola virus destroys connective tissue especially violently because it multiplies in collagen molecules. As a result, the structural proteins of the human body turn into an amorphous jelly-like mass, the subcutaneous tissue simply dies off and begins to decompose while the person is still alive. Due to lack subcutaneous tissue the skin becomes thin and inextensible, as a result of which cracks constantly appear on it. Blood oozes from these wounds. When the skin is strongly compressed, it breaks off in layers, revealing a terrible red-purple-purple wound surface oozing blood.

The tongue turns purple-red, and the mucous membrane falls off in pieces, after which it is spat out or swallowed. Sometimes the mucous membrane of the tongue is completely torn off during the next attack of vomiting. The mucous membranes of the throat, respiratory tract, lungs, stomach, intestines, and genitals also peel away from underlying tissues and are then swallowed, spat out, or excreted from the body in feces, vomit, or vaginal discharge.

The heart muscle softens, blood from the coronary vessels permeates the heart and splashes into the chest. The brain tissue becomes clogged with clots of dead red blood cells and platelets, but blood that no longer clots continues to flow through the vessels. As a result, damage to brain structures occurs, and the patient with Ebola fever begins to have epileptic seizures. During such seizures, blood sprays from his body in all possible directions, spreading the virus to others. In addition, the development of a stroke followed by complete or incomplete paralysis is possible.

The human body turns out to be filled with essentially dead blood, which flows out or into internal cavities body, does not collapse. If you examine a drop of blood under a microscope, you will see a terrible picture. It is impossible to distinguish any blood cells in the drop, since they are turned into minced meat. You might think that the blood directly in the body was swirled in a mixer, destroying all the elements and creating one homogeneous mass.

As a result, even during a person’s lifetime, necrosis begins, that is, the death of tissues and organs. In fact, the cadaveric decomposition of a still living person begins. A liver that has undergone necrosis becomes jelly-like and cracks. The kidneys become filled with dead cells and stop producing and excreting urine. The spleen becomes like a ball filled with blood. In such a situation, the body contains an incredible amount of toxic substances that can cause infectious-toxic shock followed by death.

If a person with Ebola fever dies, then his corpse literally decomposes before our eyes. This is due to the fact that, in fact, some time ago all the organs of the body died, since massive necrosis of their cells occurred, and the person was still alive. By the time of physical death, the organs have already partially decomposed, and therefore such rapid rotting of the corpse occurs, from which literally within a few hours only a fetid jelly remains.

Ebola fever - treatment

Currently, there are several experimental specific sera for the effective treatment of Ebola fever, but they are only undergoing clinical trials and are therefore not available worldwide. pharmaceutical market. Because of this, in the coming years it is possible that a drug will appear that can cure Ebola.

According to CNN reports, sick citizens of the United States and Britain were treated with the experimental drug Zmapp, which turned out to be effective because within a few hours after its administration the person's breathing returned to normal and the rash on the body began to disappear.

Ebola vaccine

Ebola fever - prevention

• Limit contact with sick animals;


• Limit contact with animals that are theoretically at risk of infection with Ebola, such as fruit bats, monkeys or great apes;


• Do not pick up, butcher or touch any dead animals accidentally discovered in tropical rainforests;


• Carefully process (cook, fry, bake, etc.) before eating products of animal origin, such as meat, blood, milk and offal (liver, kidneys, lungs, tongue, etc.);


• When caring for a sick person, use personal protective equipment, such as gloves, a water-repellent gown, goggles or a face shield and a mask;


• After any contact with a sick person, wash your hands and face thoroughly;


• Wash your hands and face after going outside or visiting the hospital;


• Avoid contact of blood or secretions of Ebola patients with skin;


• Do not touch the corpses of people who died from Ebola fever unless the person is wearing a special protective suit;


• In addition, a person suspected of having Ebola fever must be hospitalized in the infectious diseases department in an isolated box with a strict regime;


• A patient with Ebola fever is isolated from others and observes quarantine for at least 21 days from the onset of the infectious disease;


• A patient with Ebola fever is given separate, specially marked personal and household items (for example, dishes, personal hygiene items, etc.);


• All items used by an Ebola patient must be sterilized and stored in a separate box;


• Medical supplies used for various procedures (injections, dressings, etc.) must be burned;


• For ongoing disinfection of various surfaces and linen that have been in contact with an Ebola patient, a 2% phenol solution is used;


• The secretions of Ebola patients are also treated with a phenol solution before disposal.

In addition, there is an option specific prevention Ebola fever, when a special serum obtained from immunized horses (similar to anti-tetanus serum) is injected into a person who is not yet sick, but has been in contact with an infected person.

Ebola fever in the world - in which countries there were epidemic outbreaks

Ebola 2014

For the first time, the epidemic began in West Africa, and not in Central Africa. Doctors were not prepared for such an epidemic, so they succumbed to panic for a while and did not prevent the spread of misinformation and rumors among the population. This outbreak is the largest in the history of Ebola.

However, international organizations have now sent medical specialists and the necessary equipment, as well as money, to West African states to combat Ebola.

The first cases of Ebola fever were recorded in the capital of Guinea and in the south of the country on February 9. However, confirmation that we are talking about Ebola fever was received more than a month later - only on March 25, 2014, when all the necessary research was carried out at the Pasteur Institute in Lyon. The same research institution established that Ebola fever is caused by the Zaire subtype of the virus.

Since March 26, Guinea has banned the consumption of bat meat, which local residents catch and eat with pleasure. But these animals are the most dangerous sources and spreaders of the Ebola virus.

As of August 6, 2014, 1,711 cases of Ebola fever were confirmed in the territories of Guinea, Liberia and Sierra Leone, of which 932 were fatal.
The epidemic is threatening to spill out into the wider world as people infected with Ebola have found themselves in London, Nigeria and the United States.

Ebola in Africa

in Egypt and Tunisia

in Marocco

in Guinea

Ebola fever in Spain and Russia

Ebola fever has not been detected in Russia, and according to sanitary doctors, the infection cannot enter the country in the next few months. Therefore, residents of Russia can feel safe.

Only two cases of Ebola fever have been recorded in Russia. Both times, employees of specialized research institutions where experiments were carried out on animals using the Ebola virus were infected. Laboratory technicians accidentally pricked themselves with needles that were used to inject experimental animals containing Ebola viruses, resulting in infection.

The Ebola disease is decimating the population. The virus has spread to many other countries. It was identified in the UK and USA. The World Health Organization has recognized fever as a threat to countries around the world. Where did this come from? How dangerous is Ebola? The incubation period, symptoms, and methods of treating the disease still cause controversy today.

What is Ebola?

No one can say for sure where the virus came from and how a person first became infected with it. But it originated in Africa. They first started talking about him back in 1976. So this is not a new virus. Back in 1976, outbreaks of epidemics were noticed in several areas. However, the virus was discovered in Zaire (today Congo) on the coast. This is where it got its name.

Once in the body, the virus causes a disease, the official name of which is hemorrhagic. Photos of infected people are simply terrifying! The mortality rate reaches almost 90%. And the worst thing is that Ebola victims cannot hope for a life-saving vaccine. It simply doesn't exist. Even the treatment is in question. After all, there are no official medications for fever either.

Fever 2014

A new outbreak was recorded in Guinea in December 2013. The infection began to spread rapidly to neighboring countries. Patients with Ebola were recorded in Sierra Leone, Liberia, and Nigeria. This is the deadliest outbreak in the history of the virus.

Infected people were no longer found only in West Africa. Two American volunteer doctors picked up the virus in the very center of the fever. In the USA this caused real panic. After all, one patient is enough for the disease to rapidly spread throughout the country.

A new experimental drug was tested on doctor-patients with their full consent. A drug against the Ebola virus is being developed by a biotech company in San Diego. Even the creators did not know how the human body would react to this drug. After all, all experiments were carried out exclusively on monkeys. When all the signs of Ebola were evident in the poor doctors, they were given an experimental drug. After an hour, the fever symptoms began to subside.

How do you get infected with Ebola?

It is suspected that fruit bats became the “parents” of the virus (they are also called carriers; monkeys (gorillas, monkeys, chimpanzees), porcupines, forest antelopes and other animals can be carriers.

How is Ebola transmitted to humans? Initially, you can become infected from an animal. The virus is transmitted through secretions and saliva. Thus, if a sick monkey scratches or bites, the person will become infected. In addition, hunters who cut up animal carcasses are at risk.

How do people without contact with animals become infected with Ebola? Unfortunately, all it takes is one person to contract the deadly virus. And then it spreads along the chain. The virus is transmitted through blood and all biological fluids. Thus, even during a kiss you can get a fatal illness.

Sometimes people, even if they knew how to get infected with Ebola, got sick themselves. Sometimes, without noticing the smallest wound, invisible to the naked eye, they caught the virus. There are many known cases of infection in Africa from the dead. After all, even the body of a dead person is contagious. The virus can also spread due to contact with objects that were contaminated by a sick person.

Symptoms of the disease

Having an idea of ​​how Ebola is transmitted, you can recognize the disease in time by its characteristic signs.

So, initially the disease develops as colds. On initial stage The following symptoms of Ebola are characteristic:

• headache;
• temperature rise to 39-40 degrees;
• cardiopalmus;
• muscle pain;
• dry cough, sore throat;
• chest pain;
• facial expression, sunken eyes.

Further progression of the disease is characterized by new symptoms. It appears on the 2nd or 3rd day:

• vomit;
• abdominal pain;
• diarrhea with bloody impurities.

On the third, sometimes fourth day, hemorrhagic syndrome is clearly visible. There is bleeding in the whites of the eyes. Skin, internal organs begin to bleed.

On the 5th-7th day a measles-like rash appears. Visually it looks like red spots. In this case, the patient does not experience itching. Over time, peeling appears at the site of the rash. Most susceptible to damage inner side hips and shoulders. Patients experience lethargy and confusion. Sometimes the disease manifests itself with the opposite symptom -

On the 8-9th day, extensive bleeding and infectious-toxic shock lead to a sharp decline blood pressure. At this time, death may occur.

If fatal outcome managed to be avoided, improvement was observed on the 10-12th day. The patient's temperature returns to normal. The patient begins to recover. This process lasts from 2 to 3 months.

Incubation period

It is very important to understand how long it takes for the disease to appear. Most sources believe that a disease like Ebola has an incubation period of 2 to 21 days. On average, the interval between the infection process and the appearance of the first symptoms varies from 3 to 9 days. As a rule, this time is enough for Ebola to manifest itself in all its ugliness. The incubation period, it should be understood, still lasts up to 21 days. Therefore, the disease can manifest itself on any of these days.

Risk group

Absolutely no one can boast of being protected from terrible virus. However, there are categories of the population most at risk of infection:

1. Doctors who, by virtue of their profession, are forced to treat patients.
2. The relatives of those infected are probably at even greater risk. After all, they are entrusted with the mission of caring for the sick.
3. Hunters are in a special category.

Diagnosis of the disease

Initially, the epidemiological history is analyzed. In other words, the fact that the patient is in an unfavorable area is established. Possible contact with an infected person is being investigated. If such a possibility exists, then the diagnosis of Ebola becomes questionable. The incubation period, as noted above, is 21 days. During this time, the patient should be hospitalized.

IN this period The following studies are carried out:

1. A thorough study of the patient's complaints and medical history. Attention is paid to the time of temperature rise, massive bleeding, watery stool with blood, etc.
2. Virological diagnostics. Biological fluids are studied. The virus is isolated from human blood and saliva and introduced into the body of a laboratory animal. He is being monitored in order to identify the characteristic development of the infectious process.
3. Serological diagnosis. Antibodies are used to recognize the causative agent of the virus. In the future, they try to eliminate it.
4. Consultation with an infectious disease specialist.

Treatment of fever

Ebola patients are required to be hospitalized in special wards. Only trained personnel are allowed to treat such patients. Unfortunately, no clear program has been developed to defeat a disease such as Ebola. Treatment involves the following:

• taking antiviral drugs;
• introduction of donor immunoglobulins into the body - protective bodies are taken from people or horses who have suffered from the disease, and therefore are immune to the virus.

Therapeutic treatment comes down to combating symptoms:

• bed rest;
• consumption of easily digestible, semi-liquid food;
• administration of glucose or saline solutions if the patient has severe intoxication and dehydration;
• vitamin therapy ( ascorbic acid, B 6, RR);
• transfusion of platelets (donor) to normalize blood clotting;
• antipyretic medications;
• hemodialysis - purification of the blood by the artificial kidney system from toxins produced by the virus;
• antibiotics for the development of bacterial complications.

Is there a cure for Ebola?

This question plagues not only the patients themselves. It is asked by the broad masses of the people, fearing a possible epidemic. This is the goal that scientists set for themselves, trying to protect the population from the threat of danger. And although today the measures to combat such a disease as Ebola are quite questionable, a treatment will presumably be found soon.

Although no official vaccine has yet been registered, many potential drugs have already been invented. A clear confirmation of this is the experimental medicine that has been tested for American doctors. The Canadian pharmaceutical corporation was not far behind, creating a drug that can fight fever.

Russia also did not fade into the background. Near Novosibirsk, test systems are being developed that can diagnose. It is there, in scientific center“Vector”, work is underway to create a unique vaccine against Ebola fever. Today the new drug is being tested on animals. However, the center employees themselves keep all information secret.

Thus, we hope that very soon a unique vaccine against the deadly fever will be presented to the general public.

The issue of protecting the population from the deadly virus is not urgently raised. Indeed, to date, not a single confirmed case of infection has been recorded in our country. However, for the purpose of prevention, you should familiarize yourself with some recommendations. They will allow you to do everything correctly and in a timely manner. necessary measures to avoid becoming a victim of Ebola.

1. In order to prevent the possibility of contracting a fever, it is better to avoid visiting the countries of West and Central Africa.
2. If you need to travel to the above areas, you must use protective masks. You should try to avoid crowded places and, if possible, avoid contact with sick people.
3. From the point of view of prevention, you should constantly ventilate the room, carry out wet cleaning, and carefully observe the rules of hygiene. You should not make purchases at unauthorized retail outlets.
4. If you suspect you have Ebola disease, you should wear a protective mask and seek immediate medical attention.
5. If, upon returning from a trip, symptoms somewhat reminiscent of Ebola occur, you should promptly consult a specialist. The doctor must provide full information about the countries in which they stayed. Be sure to indicate travel dates.

Conclusion

More recently, the essence of the Ebola virus was not clear, and the fever itself seemed like something very distant: it was raging somewhere in Africa, measures would be taken, the disease would be stopped. But news of a patient from the UK and infected doctors from America made the virus a fairly concrete threat.

However, there is no need to panic. Rospotrebnadzor assures that the epidemic does not threaten Russians. However, it is better to avoid traveling to West African countries. But you can go to other countries without fear of bringing a terrible “souvenir”. After all, strict anti-epidemic measures taken can protect against the deadly virus. But upon returning, you should carefully listen to your body. After all, the incubation period of this unpleasant disease lasts 21 days.

Ebola hemorrhagic fever is an acute viral highly dangerous infectious disease characterized by severe course, severe hemorrhagic syndrome and high mortality rate. Synonym: Ebola fever.

ICD-10 code

A98.4. Ebola virus disease.

The distribution area of ​​the virus is Central and West Africa(Sudan, Zaire, Nigeria, Liberia, Gabon, Senegal, Cameroon, Ethiopia, Central African Republic). Outbreaks of Ebola hemorrhagic fever occur primarily in the spring and summer.

What causes Ebola hemorrhagic fever?

Ebola hemorrhagic fever is caused by Ebolavirus of the genus Marburgvirus of the Filoviridae family - one of the largest viruses. The virion has a different shape - filamentous, branching. arachnid, its length reaches 12,000 nm. The genome is represented by single-stranded negative RNA surrounded by a lipoprotein membrane. The virus consists of 7 proteins. The Ebola and Marbourg viruses are similar in their morphology, but differ in their antigenic structure. By antigenic properties glycoproteins (Gp) are distinguished by four serotypes of the Ebola virus, three of which cause disease of varying severity in humans in Africa (Ebola-Zaire - EBO-Z, Ebola-Sudan - EBO-S and Ebola-Ivory Coast - EBO-CI). No manifest cases of Ebola-Reston virus (EBO-R), which is highly pathogenic for monkeys, have been identified in humans.

The virus is highly variable. Passage in cell culture guinea pigs and Vero with a mild cytopathic effect.

Ebolavirus has an average level of resistance to damaging environmental factors (environmental pH, humidity, insolation, etc.).

Pathogenesis of Ebola hemorrhagic fever

The entrance gates for the pathogen are mucous membranes and skin. The Ebola hemorrhagic fever virus enters The lymph nodes and the spleen, where its replication occurs with the development of intense viremia in the acute period of the disease with multiorgan dissemination. As a result of direct exposure to the virus and autoimmune reactions There is a decrease in platelet production, damage to the vascular endothelium and internal organs with foci of necrosis and hemorrhage. The greatest changes occur in the liver, spleen, lymphoid formations, kidneys, endocrine glands, and brain.

Symptoms of Ebola hemorrhagic fever

The incubation period of Ebola hemorrhagic fever lasts 2-16 days (average 7 days).

The onset of Ebola hemorrhagic fever is sudden with a rapid rise in body temperature to 39-40 °C, intense headache, and weakness. Symptoms of Ebola hemorrhagic fever are as follows: severe dryness and sore throat (feeling of a “rope” in the throat), chest pain, dry cough. On the 2-3rd day, abdominal pain, vomiting, and bloody diarrhea (melena) appear, leading to dehydration. From the first days of the disease, an amicable face and sunken eyes are characteristic. On the 3-4th day, severe symptoms of Ebola hemorrhagic fever appear: intestinal, stomach, uterine bleeding, bleeding of mucous membranes, hemorrhages at injection sites and skin lesions, hemorrhages in the conjunctiva. Hemorrhagic syndrome progresses rapidly. On days 5-7, some patients (50%) develop a measles-like rash, after which peeling of the skin occurs. They reveal lethargy, drowsiness, confusion, and in some cases - psychomotor agitation. Death occurs on the 8-9th day from massive blood loss and shock. With a favorable outcome, the febrile period lasts 10-12 days; recovery is slow over 2-3 months. During the period of convalescence, severe asthenia, anorexia, cachexia, hair loss, trophic disorders, and mental disorders are observed.

Complications of Ebola hemorrhagic fever

Ebola hemorrhagic fever is complicated by infectious-toxic shock, hemorrhagic and hypovolemic shock.

Diagnosis of Ebola hemorrhagic fever

Diagnosis of Ebola hemorrhagic fever is difficult because specific symptoms there are no diseases. Ebola fever should be suspected in cases of acute development of a febrile illness with multiple organ lesions, diarrhea, neurological and severe hemorrhagic manifestations in a patient who was in an endemic area or was in contact with similar patients.

Specific and nonspecific laboratory diagnostics of Ebola hemorrhagic fever

Specific laboratory diagnosis of Ebola hemorrhagic fever is carried out using virological and serological methods. Isolation of the virus from the blood of patients, nasopharyngeal mucus and urine is carried out by infecting cell cultures; during electron microscopic examination of biopsy samples of skin or internal organs. PCR, ELISA, RNIF, RN, RSK, etc. are used. All studies are carried out in special laboratories with level IV biological safety.

Nonspecific laboratory diagnosis of Ebola hemorrhagic fever includes general analysis blood (characteristic: anemia; leukopenia, alternating with leukocytosis with a neutrophilic shift; the presence of atypical lymphocytes; thrombocytopenia; decreased ESR): biochemical analysis blood (increased activity of transferases, amylase, azotemia is detected); determination of the coagulogram (hypocoagulation is characteristic) and the acid-base state of the blood (identifies signs of metabolic acidosis); conducting a general urinalysis (pronounced proteinuria).

Instrumental diagnosis of Ebola hemorrhagic fever

Chest X-ray, ECG, ultrasound.

Differential diagnosis of Ebola hemorrhagic fever

The clinical picture of yellow fever is also characterized by an acute onset, severe intoxication with the development of thrombohemorrhagic syndrome. When differential diagnosis of Ebola fever takes into account the following data: stay in an endemic area no more than 6 days before the development of the disease; presence of two-wave fever, insomnia; swelling of the eyelids, puffiness of the face (“amaryl mask”); in the blood - neutropenia, lymphopenia.

Ebola fever is differentiated from a number of infectious diseases with hemorrhagic syndrome. In the first 1-3 days of the disease before the development hemorrhagic manifestations the clinical picture of fever is similar to a severe form of influenza with an acute onset, headache, high fever, injection of scleral vessels and leukopenia in the blood. However, with Ebola fever, symptoms of central nervous system damage are more pronounced, diarrhea and vomiting often occur, and catarrhal symptoms rarely develop or are completely absent.

Acute onset of the disease, severe intoxication, and hemorrhagic syndrome are characteristic of both Ebola fever and leptospirosis. however, it is not characterized by cough, chest and abdominal pain, vomiting, diarrhea, and leukopenia.

There are no difficulties in the differential diagnosis of Ebola fever with “non-infectious” hemorrhagic disease- hemophilia, characterized by severe bleeding, manifested by external and internal bleeding for minor injuries, joint hemorrhages, and absence of thrombocytopenia.

Indications for consultation with other specialists

Consultations with a hematologist, neurologist, gastroenterologist and other doctors are indicated when carrying out differential diagnosis with diseases that occur with a similar clinical picture or aggravate the course of hemorrhagic fever.

Indications for hospitalization

Ebola fever is a reason for emergency hospitalization and strict isolation in a separate box.

Treatment of Ebola hemorrhagic fever

No etiotropic treatment for Ebola hemorrhagic fever has been developed.

Pathogenetic treatment of Ebola hemorrhagic fever

In epidemic outbreaks, the use of convalescent plasma is recommended. The main treatment for Ebola hemorrhagic fever consists of the use of pathogenetic and symptomatic drugs. Fight against intoxication, dehydration, bleeding. shock is carried out using generally accepted methods.

Regime and diet

The patient needs strict bed rest and round-the-clock medical supervision.

The diet corresponds to table No. 4 according to Pevzner.

Approximate periods of incapacity for work

Taking into account the severity of the disease, convalescents are considered disabled for 3 months after discharge from the hospital.

Clinical examination

Ebola hemorrhagic fever does not require clinical observation of those who have recovered from the disease.

Memo for the patient

How is Ebola hemorrhagic fever prevented?

Specific prevention of Ebola hemorrhagic fever

Specific prevention of Ebola hemorrhagic fever has not been developed.

Nonspecific prevention of Ebola hemorrhagic fever

Nonspecific prevention of Ebola hemorrhagic fever consists of isolating patients in special departments or isolation wards, preferably in special plastic or glass-metal isolation cabins with autonomous life support. To transport patients, special transport isolators are used. Medical personnel must work in individual means protection (respirators or gauze masks, gloves, goggles, protective suit). Strict adherence to sterilization of syringes, needles, and instruments in medical institutions is necessary.

Ebola hemorrhagic fever is prevented using a specific immunoglobulin obtained from the serum of immunized horses (the method was developed at the Virology Center of the Research Institute of Microbiology).

In outbreaks, all patients are isolated and medical supervision and control over those in contact.

The most important preventive measure to prevent the introduction of hemorrhagic fever from endemic areas is the implementation of the International Epidemiological Surveillance System.

What is the prognosis for Ebola hemorrhagic fever?

Ebola hemorrhagic fever has serious prognosis. In diseases caused by EBO-S and EBO-CI, mortality reaches 50%, EBO-Z - 90%. With a favorable outcome, recovery is long-lasting.

Mortality and causes of death

Mortality is 50-90%. Causes of death: infectious-toxic shock, hypovolemic shock, DIC syndrome.