CC BY-NC-ND 4.0 · Avicenna J Med 2017; 07(03): 96-102
DOI: 10.4103/ajm.AJM_150_16
REVIEW ARTICLE

Ebola virus disease: Essential clinical knowledge

Mahmoud Tawfik Khalafallah
Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia
,
Omar Ali Aboshady
Dalaton Primary Health Centre, Ministry of Health; Egypt
Clinical Pharmacology, Faculty of Medicine, Menoufia University, Menoufia
Student Research Unit, Faculty of Medicine, Menoufia University, Menoufia
,
Shaban Ahmed Moawed
Student Research Unit, Faculty of Medicine, Menoufia University, Menoufia
,
Menna Said Ramadan
Student Research Unit, Faculty of Medicine, Menoufia University, Menoufia
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Since its initial outbreak in 1976, Ebola virus disease (EVD) has affected thousands of people, causing severe illness with high mortality rates. In the absence of a vaccine or effective specific treatment, as well as the lack of early diagnostic and detective methods, the EVD outbreak has generated a significant worldwide health concern. Insufficient health-care system resources, deficient infection control measures, and the shortage of appropriate personal protective equipment acted as amplifiers of the outbreak extension, especially in poorly resourced and unprepared communities. Operating on the frontlines, health-care workers must be familiar, not only with the identification of the disease, but also with the ability to protect themselves and initiate the appropriate response. This review seeks to provide essential information required to identify and manage the disease, with an emphasis on pathogenesis, transmission, diagnosis, treatment, and prevention. We conducted a literature search in MEDLINE/PubMed and Google Scholar using the following keywords: “Ebola, Ebola virus disease, Hemorrhagic Fever, Outbreak.” We included all types of publications. To augment our study, we searched the reference lists of identified reviews.



Publication History

Article published online:
09 August 2021

© 2017. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 World Health Organization. Ebola Virus Situation Report. Geneva, Switzerland: World Health Organization; 2016.
  • 2 Leroy EM, Gonzalez JP, Baize S. Ebola and Marburg haemorrhagic fever viruses: Major scientific advances, but a relatively minor public health threat for Africa. Clin Microbiol Infect 2011;17:964-76.
  • 3 Feldmann H, Geisbert TW. Ebola haemorrhagic fever. Lancet 2011;377:849-62.
  • 4 Fowler RA, Fletcher T, Fischer WA 2nd, Lamontagne F, Jacob S, Brett-Major D, et al. Caring for critically ill patients with ebola virus disease. Perspectives from West Africa. Am J Respir Crit Care Med 2014;190:733-7.
  • 5 Feldmann H, Jones S, Klenk HD, Schnittler HJ. Ebola virus: From discovery to vaccine. Nat Rev Immunol 2003;3:677-85.
  • 6 Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis 2011;204 Suppl 3:S810-6.
  • 7 Ramanan P, Shabman RS, Brown CS, Amarasinghe GK, Basler CF, Leung DW. Filoviral immune evasion mechanisms. Viruses 2011;3:1634-49.
  • 8 Feldmann H. Ebola – A growing threat? N Engl J Med 2014;371:1375-8.
  • 9 World Health Organization. Ebola Response Roadmap Situation Report. Geneva, Switzerland: World Health Organization; 2014.
  • 10 Dixon MG, Schafer IJ; Centers for Disease Control and Prevention (CDC). Ebola viral disease outbreak – West Africa, 2014. MMWR Morb Mortal Wkly Rep 2014;63:548-51.
  • 11 Bausch DG, Rojek A. West Africa 2013: Re-examining Ebola. Microbiol Spectr 2016;4:3.
  • 12 Parra JM, Salmerón OJ, Velasco M. The first case of Ebola virus disease acquired outside Africa. N Engl J Med 2014;371:2439-40.
  • 13 Whiteside LK, Fernandez R, Bammer J, Nichol G. Perception of the risks of Ebola, enterovirus-E68 and influenza among emergency department patients. West J Emerg Med 2016;17:391-5.
  • 14 World Health Organization. Ebola Virus Disease; 2016. Available from: http://www.who.int/mediacentre/factsheets/fs103/en/. [Last accessed on 2016 Sep 01].
  • 15 Osterholm MT, Moore KA, Kelley NS, Brosseau LM, Wong G, Murphy FA, et al. Transmission of Ebola viruses: What we know and what we do not know. MBio 2015;6:e00137.
  • 16 Ansari AA. Clinical features and pathobiology of Ebolavirus infection. J Autoimmun 2014;55:1-9.
  • 17 Olival KJ, Hayman DT. Filoviruses in bats: Current knowledge and future directions. Viruses 2014;6:1759-88.
  • 18 World Health Organization. Marburg Haemorrhagic Fever; 2012. Available from: http://www.who.int/mediacentre/factsheets/fs_marburg/en/. [Last accessed on 2016 Sep 01].
  • 19 World Health Organization. What We Know About Transmission of the Ebola Virus among Humans; 2014. Available from: http://www.who.int/mediacentre/news/ebola/06-october-2014/en/. [Last accessed on 2016 Sep 01].
  • 20 Beeching NJ, Fenech M, Houlihan CF. Ebola virus disease. BMJ 2014;349:g7348.
  • 21 Eichner M, Dowell SF, Firese N. Incubation period of ebola hemorrhagic virus subtype zaire. Osong Public Health Res Perspect 2011;2:3-7.
  • 22 Chippaux JP, Boyer LV, Alagón A. Post-exposure treatment of Ebola virus using passive immunotherapy: Proposal for a new strategy. J Venom Anim Toxins Incl Trop Dis 2015;21:3.
  • 23 Chertow DS, Kleine C, Edwards JK, Scaini R, Giuliani R, Sprecher A. Ebola virus disease in West Africa – Clinical manifestations and management. N Engl J Med 2014;371:2054-7.
  • 24 WHO Ebola Response Team. Ebola virus disease in West Africa – The first 9 months of the epidemic and forward projections. N Engl J Med 2014;371:1481-95.
  • 25 Dananché C, Bénet T, Vanhems P. Ebola: Fever definitions might delay detection in non-epidemic areas. Lancet 2014;384:1743.
  • 26 Mupere E, Kaducu OF, Yoti Z. Ebola haemorrhagic fever among hospitalised children and adolescents in Northern Uganda: Epidemiologic and clinical observations. Afr Health Sci 2001;1:60-5.
  • 27 Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y, et al. Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: Clinical observations in 103 patients. J Infect Dis 1999;179 Suppl 1:S1-7.
  • 28 Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A. Human infection due to Ebola virus, subtype Côte d'Ivoire: Clinical and biologic presentation. J Infect Dis 1999;179 Suppl 1:S48-53.
  • 29 Denizot M, Neal JW, Gasque P. Encephalitis due to emerging viruses: CNS innate immunity and potential therapeutic targets. J Infect 2012;65:1-16.
  • 30 Sonneville R, Verdonk F, Rauturier C, Klein IF, Wolff M, Annane D, et al. Understanding brain dysfunction in sepsis. Ann Intensive Care 2013;3:15.
  • 31 Centers for Disease Control and Prevention. Ebola Virus Disease Information for Clinicians in US Healthcare Settings; 2016. Available from: https://www.cdc.gov/vhf/ebola/healthcare-us/preparing/clinicians.html. [Last accessed on 2016 Sep 01].
  • 32 World Health Organization. Laboratory Guidance for the Diagnosis of Ebola Virus Disease: Interim Recommendations. Geneva, Switzerland: World Health Organization; 2014.
  • 33 Fletcher TE, Brooks TJ, Beeching NJ. Ebola and other viral haemorrhagic fevers. BMJ 2014;349:g5079.
  • 34 Centers for Disease Control and Prevention. Think Ebola: Early Recognition is Critical for Infection Control; 2016. Available from: http://www.cdc.gov/vhf/ebola/healthcare-us/evaluating-patients/think-ebola.html. [Last accessed on 2016 Sep 01].
  • 35 Centers for Disease Control and Prevention. Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure; 2015. Available from: https://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html. [Last accessed on 2016 Sep 01].
  • 36 Centers for Disease Control and Prevention. Infection Prevention and Control Recommendations for Hospitalized Patients under Investigation (PUIs) for Ebola Virus Disease (EVD) in U.S. Hospitals; 2015. Available from: http://www.cdc.gov/vhf/ebola/healthcare-us/hospitals/infection-control.html. [Last accessed on 2016 Sep 01].
  • 37 Centers for Disease Control and Prevention. Recommendations for Breastfeeding/Infant Feeding in the Context of Ebola; 2016. Available from: http://www.cdc.gov/vhf/ebola/hcp/recommendations-breastfeeding-infant-feeding-ebola.html. [Last accessed on 2016 Sep 01].
  • 38 World Health Organization. Sexual and Reproductive Health Interim Advice on the Sexual Transmission of the Ebola Virus Disease. Geneva, Switzerland: World Health Organization; 2016.
  • 39 Galvani AP, Ndeffo-Mbah ML, Wenzel N, Childs JE. Ebola vaccination: If not now, when? Ann Intern Med 2014;161:749-50.
  • 40 Stanley DA, Honko AN, Asiedu C, Trefry JC, Lau-Kilby AW, Johnson JC, et al. Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge. Nat Med 2014;20:1126-9.
  • 41 Ledgerwood JE, DeZure AD, Stanley DA, Novik L, Enama ME, Berkowitz NM, et al. Chimpanzee adenovirus vector ebola vaccine – Preliminary report. N Engl J Med 2014. [In press].
  • 42 Jacobs M, Aarons E, Bhagani S, Buchanan R, Cropley I, Hopkins S, et al. Post-exposure prophylaxis against Ebola virus disease with experimental antiviral agents: A case-series of health-care workers. Lancet Infect Dis 2015;15:1300-4.
  • 43 Wong KK, Davey RT, Hewlett AL, Kraft CS, Mehta AK, Mulligan MJ, et al. Use of post-exposure prophylaxis after occupational exposure to Zaire ebolavirus. Clin Infect Dis 2016;63:376-9.
  • 44 Canadian Critical Care Society. Ebola Clinical Care Guidelines – A Guide for Clinicians in Canada. Ontario, Canada: Canadian Critical Care Society; 2014. p. 1-62.
  • 45 World Health Organization. Clinical Management of Patients with Viral Haemorrhagic Fever: A Pocket Guide for Front-line Health Workers. Geneva, Switzerland: World Health Organization; 2016.
  • 46 World Health Organization. Potential Ebola Therapies and Vaccines; 2014. Available from: http://www.who.int/csr/resources/publications/ebola/potential-therapies-vaccines/en/. [Last accessed on 2016 Sep 01].
  • 47 World Health Organization. Use of Convalescent Whole Blood or Plasma Collected from Patients Recovered from Ebola Virus Disease for Transfusion, as an Empirical Treatment during Outbreaks; 2014. Available from: http://www.apps.who.int/iris/handle/10665/135591. [Last accessed on 2016 Sep 01].
  • 48 Mupapa K, Massamba M, Kibadi K, Kuvula K, Bwaka A, Kipasa M, et al. Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee. J Infect Dis 1999;179 Suppl 1:S18-23.
  • 49 Qiu X, Wong G, Audet J, Bello A, Fernando L, Alimonti JB, et al. Reversion of advanced Ebola virus disease in nonhuman primates with ZMapp. Nature 2014;514:47-53.
  • 50 Lyon GM, Mehta AK, Varkey JB, Brantly K, Plyler L, McElroy AK, et al. Clinical care of two patients with Ebola virus disease in the United States. N Engl J Med 2014;371:2402-9.
  • 51 Bishop BM. Potential and emerging treatment options for Ebola virus disease. Ann Pharmacother 2015;49:196-206.
  • 52 Sridhar S, Brouqui P, Fontaine J, Perivier I, Ruscassier P, Gautret P, et al. Risk perceptions of MSF healthcare workers on the recent Ebola epidemic in West Africa. New Microbes New Infect 2016;12:61-8.