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INITIAL SYMPTOMS:
Severe flu-like illness with fever, myalgia, and headache followed by sore throat, vomiting, diarrhea, and maculopapular rash; Patients with severe cases have hemorrhagic diathesis, hepatic damage, renal failure, CNS involvement, and shock; [CCDM]
FINDINGS
Findings include fever, weakness, headache, sore throat, vomiting, diarrhea, and rash. [WHO website] Hemorrhage, shock, liver injury, and renal failure are prominent findings. Laboratory studies show thrombocytopenia, lymphopenia, and liver transaminase elevations. [CCDM, p. 173] Other symptoms include: chest and abdominal pain, cough, conjunctivitis, jaundice, pancreatitis, lymphadenopathy, delirium, and coma. Other complications after the second week of infection include transverse myelitis, hepatitis, orchitis, and uveitis. [Merck Manual, p. 1436; PPID, p. 2262] A maculopapular rash that later desquamates appears on about the 5th day of the illness. Bleeding is common from the skin, nose, mouth, GI tract, and vagina. Laboratory abnormalities include thrombocytopenia and leukopenia with left shift; leukocytosis develops after the initial phase. Serum bilirubin levels are normal or slightly elevated. Shock is frequently the cause of death. [ID, p. 2138-40] Serum amylase may be elevated. When associated with abdominal pain, pancreatitis is suggested. Acute renal failure occurs as a consequence of shock. [Harrison ID, p. 1054] Blindness is a complication. [Cohen, p. 1250]
EPIDEMIOLOGY:
In Africa, Ebola has a case-fatality rate of 32-88%. At highest risk are patients injected with contaminated needles, family caregivers, healthcare workers, laboratory workers, and people working with bats or primates from central Africa. [CCDM, p. 173-6] "Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. . . . Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest." The virus was isolated from semen of an infected laboratory worker 61 days after the onset of his illness. "Unlike influenza or tuberculosis, Ebola does not spread through the air." [WHO website]
For updated text and symptoms of infectious diseases, see iddx.com.