Ebola virus disease

=================================================================================

Ebola virus disease (EVD; also Ebola hemorrhagic fever, or EHF), or simply Ebola, is a disease of 

and other primatescaused by ebolaviruses. Signs and symptoms typically start between two days and three weeks after contracting the virus as a fever,sore throat, muscle pain, and headaches. Then, vomiting, diarrhea and rash usually follow, along with decreased function of the liverand kidneys. At this time some people begin to bleed both internally and externally.^[1] The disease has a high risk of death, killing between 25 percent and 90 percent of those infected with the virus, averaging out at 50 percent.^[1] This is often due to low blood pressure from fluid loss, and typically follows six to sixteen days after symptoms appear.^[2]

The virus spreads by direct contact with blood or other body fluids of an infected human or other animal.^[1] Infection with the virus may also occur by direct contact with a recently contaminated item or surface.^[1] Spread of the disease through the air has not been documented in the natural environment.^[3] EBOV may be spread by semen or breast milk for several weeks to months after recovery.^[1][4] African fruit bats are believed to be the normal carrier in nature, able to spread the virus without being affected by it. Humans become infected by contact with the bats or with a living or dead animal that has been infected by bats. After human infection occurs, the disease may also spread between people. Other diseases such as malaria, cholera, typhoid fever, meningitisand other viral hemorrhagic fevers may resemble EVD. Blood samples are tested for viral RNA, viral antibodies or for the virus itself to confirm the diagnosis.^[1]

Control of outbreaks requires coordinated medical services, along with a certain level of community engagement. The medical services include: rapid detection of cases of disease, contact tracing of those who have come into contact with infected individuals, quick access to laboratory services, proper care and management of those who are infected and proper disposal of the dead through cremation or burial.^[1][5] Prevention includes limiting the spread of disease from infected animals to humans.^[1] This may be done by handling potentially infected bush meat only while wearing protective clothing and by thoroughly cooking it before consumption.^[1] It also includes wearing proper protective clothing and washing hands when around a person with the disease.^[1]Samples of body fluids and tissues from people with the disease should be handled with special caution.^[1]

 Two nurses standing near Mayinga N'Seka, a nurse with Ebola virus disease in the 1976 outbreak in Zaire. N'Seka died a few days later.

  

No specific treatment or vaccine for the virus is commercially available. Efforts to help those who are infected are supportive; they include either oral rehydration therapy (drinking slightly sweetened and salty water) or giving intravenous fluids as well as treating symptoms. This supportive care improves outcomes. EVD was first identified in 1976 in an area of Sudan (now part of South Sudan), and in Zaire (now the Democratic Republic of the Congo). The disease typically occurs in outbreaks in tropical regions of sub-Saharan Africa.^[1] Through 2013, the World Health Organization reported a total of 1,716 cases in 24 outbreaks.^[1][6] The largest outbreak to date is the ongoing epidemic in West Africa, which is centered in Guinea, Sierra Leone and Liberia.^[7][8][9] As of 4 November 2014, this outbreak has 13,268 reported cases resulting in 4,960 deaths.^[10]