Ebola Virus Disease

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Full Clinical Write-up

Synopsis

Note: If you are considering Ebola, contact a public health authority. Centers for Disease Control and Prevention (CDC) guidelines are summarized below.

If patient evaluation, based on relevant travel and/or exposure history AND clinical criteria, indicates possible Ebola virus disease (EVD), implement rapid isolation with immediate contact of public health authorities. Medical evaluation is required.

Precautions: A patient with known or suspected EVD should be isolated in a single room (with a private bathroom), and health care personnel should follow standard, contact, and droplet / airborne precautions including the use of appropriate personal protective equipment (PPE) for all persons entering the patient room (in practice, CDC recommendations include use of an N-95 respirator or powered air purifying respirator [PAPR], as the virus can aerosolize in specific situations). Use only essential health care workers trained in their designated roles for patient care and keep a log of everyone who enters and leaves the patient’s room. Perform only necessary tests and procedures and avoid aerosol-generating procedures.

Notify your facility’s Infection Prevention and Control Program and other health care personnel of a suspected EVD case. Contact the local or state health department for consultation about testing for EVD.

Testing: The decision to test for Ebola should be made in consultation with relevant health department. Hospitals should follow their state and/or local health department procedures for notification and consultation. Due to biosafety precautions for suspected Ebola, blood should only be drawn and processed at appropriately equipped facilities.

About Ebola: Ebola virus is an RNA virus of the Filoviridae family endemic to Asia and Africa. It is closely related to Marburg virus and is a zoonotic (animal-borne) infection. Ebola virus is believed to be transmitted to humans by contact with blood, secretions, organs, or other bodily fluids of infected animals such as non-human primates (monkeys, gorillas, chimpanzees).

The mortality rate of naturally occurring Ebola is approximately 25%-90%, depending on the infecting viral strain. Individuals who recover from EVD develop antibodies lasting for 10 or more years. There are 5 identified strains of Ebola virus: the Zaire strain, the Sudan strain, the Tai Forest strain, the Reston strain, and the Bundibugyo ebolavirus strain (Orthoebolavirus bundibugyoense). rVSV-ZEBOV (Ervebo) is an Ebola vaccine approved by the US Food and Drug administration (FDA) for prevention of Zaire ebolavirus. It does not provide protection against the Sudan, Tai Forest, Reston, or Bundibugyo ebolavirus strains.

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Public Health Resources
Links to public health guidelines and protocols for cases of suspected or known Ebola virus disease including patient evaluation and monitoring, precautions and personal protection equipment, patient care considerations, and diagnostic tests.