Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan.
Infez Med. 2020 Jun 1;28(2):212-222.
Ebola Virus Disease (EVD), also known as Ebola Hemorrhagic Fever (EHF), initially emerged over 40 years ago in the Democratic Republic of Congo. Endemic to Africa, outbreaks have been recorded in six African countries since its detection in 1976. Fruit bats are believed to be the natural hosts of Ebola viruses (EBoV), with humans and other mammals serving as accidental hosts. Transmission of EBoV has been reported in various ways, including human to human transmission through close contact with blood and bodily fluids. The virus has an incubation period ranging from two to twenty-one days, followed by a multitude of clinical manifestations such as the sudden onset of high fever, chills and myalgia depicting a flu-like syndrome. It is usually diagnosed based on several clinical symptoms such as the sudden onset of illness, high fevers for less than three weeks, and at least two hemorrhagic symptoms despite no predisposing factors. This generally provides enough evidence for clinicians to consider EHF and begin supportive treatment until the virus is confirmed through laboratory findings. Management of patients involves supportive care such as maintaining fluid along with electrolyte balance, blood pressure and oxygen saturation. This also includes treating complications arising from secondary infections. The main options include: prophylactic strategies, anti-viral therapy for EVD, immunotherapies, vaccines, and ZMapp. Finally, the key to managing EBoV epidemics is to stop the transmission of disease in the most severely affected population, as prevention has become of utmost importance to alleviate the significant physical and economic burden.
埃博拉病毒病(EVD),又称埃博拉出血热(EHF),最初于 40 多年前在刚果民主共和国出现。该病流行于非洲,自 1976 年被发现以来,已在六个非洲国家发生过疫情。果蝠被认为是埃博拉病毒(EBoV)的自然宿主,而人类和其他哺乳动物则是偶然宿主。据报道,EBoV 的传播方式多种多样,包括通过密切接触血液和体液在人与人之间传播。该病毒的潜伏期为 2 至 21 天,随后出现多种临床表现,如突发高热、寒战和肌痛,表现为流感样综合征。通常根据多种临床症状进行诊断,例如突然发病、不到三周的高热、至少有两个出血症状且无诱发因素。这通常为临床医生提供了足够的证据,使其考虑埃博拉出血热并开始支持性治疗,直到通过实验室结果确认病毒。患者的治疗包括支持性护理,例如保持液体和电解质平衡、血压和血氧饱和度。这还包括治疗继发感染引起的并发症。主要的治疗方法包括:预防策略、埃博拉病毒病的抗病毒治疗、免疫疗法、疫苗和 ZMapp。最后,管理埃博拉病毒病疫情的关键是在受影响最严重的人群中阻止疾病的传播,因为预防已变得至关重要,以减轻巨大的身体和经济负担。