Ebola virus disease

Rare, Ebola-like Disease Kills One In Iowa: What To Know.

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Ebola Virus Disease

Ebola virus disease is a rare but often deadly condition that causes fever, body aches, diarrhea, and sometimes bleeding inside and outside the body. It's caused by viruses commonly called Ebola viruses. 

As these viruses spread through the body, they damage the immune system and organs. Ultimately, they cause levels of blood-clotting cells to drop. This can lead to severe, uncontrollable bleeding.

The disease was known as Ebola hemorrhagic fever but is now referred to as Ebola disease or Ebola virus disease (EVD). 

While Ebola outbreaks have had death rates ranging from 25% to 90%, the average death rate is about 50%.

Ebola virus is actually a group of viruses, known as orthoebolaviruses.

These viruses first appeared in humans during two 1976 outbreaks in Africa, but they likely have existed for a very long time. Ebola gets its name from the Ebola River, which is near one of the villages in the Democratic Republic of Congo where the disease first appeared. 

The viruses are found mostly in sub-Saharan Africa. They are thought to live mostly in fruit bats, which seem to live with the Ebola viruses without getting sick. But they can spread to other animals and humans, who do get sick from them. It's not clear why Ebola disease showed up in humans when it did.

There are four species of orthoebolaviruses that cause Ebola disease in people. They are named for the places they were found :

Ebola virus (Orthoebolavirus zairense), which is the most common cause of outbreaks

Sudan virus (Orthoebolavirus sudanense) 

Taï Forest virus (Orthoebolavirus taiense) 

Bundibugyo virus (Orthoebolavirus bundibugyoense)

Scientists have found two other species of orthoebolaviruses:

Reston virus (Orthoebolavirus restonense), which can cause illness in nonhuman primates and pigs

Bombali virus (Orthoebolavirus bombaliense), found in bats, but not known to cause illness in animals or people

Ebola isn't as contagious as more common viruses like colds, influenza, or measles. You can't get it by breathing the air. Instead, outbreaks start when it infects people who come in contact with the blood, secretions, or organs of an infected animal, like a monkey, chimp, or fruit bat. It's possible for this to happen when someone prepares or eats an infected animal.

Once inside one person, Ebola viruses can move from person to person through infected body fluids. Those who care for a sick person or bury someone who has died from the disease can get it if they come in contact with blood and other body fluids, either directly or through contaminated objects.

The virus can get in through breaks in your skin or through your eyes, nose, or mouth. 

Ebola can spread through:

Blood

Sweat

Tears

Pee 

Poop

Vomit

Breast milk

Amniotic fluid

Semen

Vaginal fluids

Pregnancy fluids 

People who recover from Ebola may still be able to pass on the virus – through sex and breastfeeding, for example – as long as the virus remains in their bodies. Ebola can be present in breast milk and semen, even after recovery. 

Other ways to get Ebola include touching contaminated needles, clothing, bedding, or medical equipment. There's no evidence that mosquitoes or other insects can spread it.

You're most likely to get Ebola if you come in physical contact with infected blood or body fluids of someone who has it. Generally, your risk of getting it isn't high if you're simply traveling to a country with an Ebola outbreak. But you should avoid going to the area or areas with an active outbreak unless you have a crucial health care or support role there.

Most infections happen in communities where outbreaks are active and in health care facilities where people from those communities go for help. The risk is highest if you're a:

Caregiver for a person with Ebola

Health care worker, like a doctor, nurse, or staff member at a hospital or clinic treating people with Ebola

Volunteer or aid worker responding to an outbreak

Lab worker who handles Ebola samples

Close family or friend of someone with Ebola

Infections are most likely when caregivers or health providers don't use strict infection control methods, like wearing gowns, gloves, eye goggles, and respirators, and using disinfectants on contaminated surfaces.

Early on, Ebola can feel like the flu or other illnesses. Symptoms show up two to 21 days after an infection and usually include:

As the disease gets worse, it can cause bleeding inside the body, as well as from the eyes, ears, and nose. Some people will vomit or cough up blood, have bloody diarrhea, and get a rash.

Sometimes it's hard to tell if a person has Ebola from the symptoms alone. Doctors may test to rule out other diseases like cholera or malaria.

Tests of blood and tissues are the best ways to diagnose Ebola. Doctors can test for the virus or antibodies to the virus.

If you have Ebola, you'll be isolated from other people right away to prevent spreading the disease to others.

There's no cure for Ebola, though researchers are working on it. 

 Two drugs are approved for treating Ebola caused by the Zaire species (Orthoebolavirus zairense). Both are monoclonal antibody drugs, which work like your body's natural antibodies to target a particular infection. The drugs are Inmazeb, which is a combination of three monoclonal antibodies, and Ebanga, made from a single monoclonal antibody. These medicines are given through an IV (intravenous) line so that the drug goes directly into a vein. 

Ebola treatment also includes supportive measures that can relieve symptoms and improve survival. These include: 

Fluids and electrolytes

Oxygen

Blood pressure medication

Blood transfusions

Medicines to reduce vomiting and diarrhea

Medicines to reduce pain and fever

Treatment for other infections

These treatments may vary, depending on which symptoms and other conditions someone has.

Research shows that you're at risk of getting complications when you have Ebola, such as:

Coma

Multi-organ failure

Septic shock

Hypoxia (lack of oxygen in your body)

Electrolyte imbalance

Disseminated intravascular coagulation (DIC), a rare condition that causes clots in your blood vessels

Hypovolemia, a condition where your body has low levels of blood or fluid 

Refractory shock, when your body continuously has low blood pressure 

Long-term effects of the Ebola virus

Research has also shown that you're at risk of having symptoms and complications after you recover from Ebola, too, including:

Seizures

Memory loss

Headaches

Cranial nerve problems that may include pain, vertigo, weakness, and hearing loss 

Tremors

Meningoencephalitis (inflammation of the brain and membranes in the skull and spinal column)

Eye pain and vision problems

Weight gain

Belly pain 

Low appetite

Hair loss

Skin problems

Trouble sleeping

There are two types of licensed vaccines available to prevent Ebola in people at risk:

Ervebo. This vaccine is approved by the U.S. FDA and by health agencies in several other countries to prevent illness from the Zaire strain of the virus. It can be used during an outbreak to try to limit spread.

The vaccine is approved for people ages 1 year and older. Ervebo isn't generally recommended for anyone pregnant or breastfeeding, but the World Health Organization says pregnant or breastfeeding people can consider whether their possible risks may be outweighed by potential benefits during an active Ebola outbreak. 

Zabdeno and Mvabea. This vaccine is given in two doses. The European Medicines Agency authorized it in May 2020. People age 1 year or older can get the vaccine. 

You'll get Zabdeno as your first vaccine dose. The second-dose Mvabea is given up to eight weeks later. But experts don't recommend this two-dose vaccine plan during an outbreak. That's because it's not designed to give you protection right away. 

For high-risk people like health care workers or volunteers living and working in areas with an Ebola outbreak, if you've completed the two doses, you can get a Zabdeno booster shot four months after your second dose. 

Keep in mind that Ebola poses little risk to most people. Caregivers and health workers responding to an outbreak are most at risk. If you are at risk, there are several ways you can protect yourself:

Get vaccinated, if it's recommended for you – but don't let up on other prevention practices after vaccination.

If someone has Ebola, avoid contact with their blood or other bodily fluids.

Avoid contact with semen from a man who has recovered from Ebola until testing can show the infection has cleared.

Avoid touching or handling things a person sick with Ebola may have come in contact with, such as bedding, clothes, needles, and medical equipment, and wash your hands frequently.

Avoid going to burials during an outbreak, especially where customs may involve touching the dead person's body. 

If you're in an area where Ebola is present, avoid contact with bats, monkeys, chimpanzees, and gorillas, since these animals can spread Ebola to people. 

If you're a health care worker, wear masks, gloves, and goggles whenever you come into contact with people who may have Ebola, and keep up standard infection control practices even when you don't know someone's possible diagnosis.

If you've traveled back from a place with an Ebola outbreak, watch out for symptoms for as long as 21 days. If you notice any, tell your doctor right away. 

There's never been an Ebola disease outbreak in the United States. All the outbreaks have happened in sub-Saharan Africa.

A few cases of Ebola have been reported and treated in the United States, all related to a major outbreak in western Africa in 2014-2016. During that outbreak, 11 people with Ebola were treated in the United States. Nine of those people, mostly health workers, were infected in western Africa. Two died, including a Liberian visitor to the U.S. And a doctor who had treated Ebola patients in Sierra Leone. Two U.S. Nurses got Ebola while treating the Liberian patient, but both of them recovered. 

In addition, four people in the United States who worked with infected lab monkeys got infected with the Reston strain of Ebola in 1989. But none of those people got sick. 

Health experts say the risk of Ebola in the United States remains very low and that the U.S. Can help keep it low by helping other countries prevent and respond to outbreaks.

Ebola is a rare but serious disease that has caused outbreaks in Africa since since it was discovered in 1976. It's never caused a disease outbreak in humans in the United States. Risks for Americans, including travelers, remain low. Some drugs and vaccines are now available to help save lives and control outbreaks. Improved infection control practices and supportive care for patients can also make a difference.

Woman Dies Of Horror 'rat Fever' That Triggers Bleeding From The Eyes As Officials Race To Trace Contacts

A WOMAN has died of Lassa fever, an Ebola-like disease also known as 'rat fever', prompting urgent contact tracing.

The horrific virus can cause bleeding from the eyes, though 80 per cent of victims show no symptoms.

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A middle-aged woman from Iowa has died of Lassa feverCredit: Getty - Contributor

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The horrific disease which kills thousands in Africa each year is spread by ratsCredit: Getty

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Lassa is on the WHO's list of diseases with pandemic potential

The woman, from Iowa, US, was diagnosed with the virus after visiting Africa and travelling back by plane, health authorities said.

Lassa fever, which is in the same viral hemorrhagic fever category as Ebola, is rarely seen in the US.

The US has reported just eight known imported cases of the bug in the past 55 years, including this latest.

It's endemic to West Africa, where it causes hundreds of thousands of infections — and 5,000 deaths — every year.

There is currently no vaccine to treat or prevent it.

The middle-aged woman returned to the US from West Africa early this month [October].

The patient was not sick while travelling so the risk to fellow plane passengers is "extremely low", the US Centre for Disease Control and Prevention (CDC) said in a release published on Monday.

"The patient was hospitalised in isolation at the University of Iowa Health Care Medical Center when they died earlier this afternoon," they added.

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Preliminary tests were positive for the virus, and the CDC is working to confirm the diagnosis.

Iowa public health officials are racing to find close contacts of the woman who may be carrying the bug.

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Those identified will be monitored for 21 days to make sure they don't develop symptoms.

Lassa fever is an illness caused by the Lassa virus, which is listed on the World Health Organisation's list of notorious pathogens that have epidemic or pandemic potential.

The virus causes headaches, weakness, coughing, vomiting, diarrhoea, muscle pains and a sore throat.

In severe cases, the disease can affect many organs and can damage the body's blood vessels.

This can lead to bleeding from the ears, eyes, nose, mouth and other body openings, as well as breathing problems, facial swelling, chest pain and shock.

Around one per cent of people who are infected die, although this rises to 15 per cent in people who are admitted to the hospital with severe symptoms, and up to 70 per cent in some areas.

It is spread through contact with the urine, faeces, saliva or blood of infected rats, and is particularly prevalent in poorer communities.

The virus can spread from human to human in rare circumstances, especially when healthcare workers come in contact with an infected person's bodily fluids or via sex.

Lassa Fever: Signs, symptoms and how to stay safe

The incubation period of Lassa fever ranges from six to 21 days.

The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise.

After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow.

In severe cases, facial swelling, fluid in the lung cavity, bleeding from the eyes, mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop.

How to stay safe

UK travellers planning to visit areas at risk of Lassa fever should consider their plans carefully, in consultation with a travel health specialist.

All travellers to Lassa fever endemic areas should:

Avoid contact with anyone with symptoms

Avoid contact with blood and body fluids and items that might have been contaminated with blood and body fluids, like clothes, bedding or medical equipment

Avoid areas with a risk of contamination with rat urine or droppings

Avoid eating, cooking or preparing any meat from an unknown source

Always wash and peel fruit and vegetables carefully

Store food in rodent-proof containers

Follow good food, water and personal hygiene advice, including careful, regular hand washing with soap and water (or alcohol gel if soap and water is unavailable)

Follow safer sex advice - always use a condom

At funerals, mourners should avoid all contact with the deceased, their body fluids and their personal property

Check each Country Information page here for destination specific news and outbreaks.

Source: The WHO

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