Ebola virus disease: clinical management and guidance
Gov.uk has a dedicated webpage with guidance, resources and information for professionals about Ebola virus disease, a severe viral haemorrhagic fever (VHF).
Additional information about Ebola Virus Disease
Ebola is a Filovirus, first recognised in 1976.
The virus is believed to be zoonotic or arboviral (dependent on animals or insect hosts for transmission). However, humans are not reservoirs of these viruses.
There are 5 species of Ebola, 4 of which have been known to infect humans causing Ebola Virus Disease.
The environmental conditions in the UK do not support any natural reservoirs or vectors of Ebola or any of the Viral haemorrhagic fevers. Therefore ALL cases arising in the UK would have been acquired abroad, (or via needlestick injury).
Ebola is only transmitted via direct contact with the blood or body fluids of a symptomatic infected person or infected environment, (e.g. soiled clothing, bed linen, used needles,).
It is NOT transmitted through intact skin or routine social contact.
It is transmitted through contact with eyes, nose, mouth, open cuts or wounds and abrasions, and sexual contact.
There is no evidence that pregnant women are more susceptible to contract the virus, but they are at more risk of complications & death from the illness and particularly third trimester complications. Pregnant female paramedic & hospital staff are allowed to decline treating these patients.
Ebola is a Viral Haemorrhagic Fever (VHF). Incubation is usually 5-7 days, but can range from 2-21 days.
Differential diagnosis includes: Malaria (most likely), Typhoid fever, SARS and possibly MERS.
The vascular system is directly impaired leading to haemorrhage and inability to auto-regulate.
Initial clinical signs (as previously) can lead to Liver and Renal failure and clinical shock.
Initial diagnostic tests will include blood tests, (FBC, U&E, LFT, CRP, glucose, coagulation studies, blood cultures and malaria screen), urine & stool cultures, and CXR. A sudden rise in AST and sudden drop in platelets are likely with possible increased oxygen requirement in the absence of other obvious cause.
Specialist testing (Ebola PCR analysis) is undertaken at the Rare & Imported pathogens laboratory (RIPL), PHE Porton, or possibly at Colindale, London.