Disease Description (Causes and Symptoms)
- Cause: Caused by infection with the Ebola virus. Known subtypes include several types such as Zaire, Sudan, Ivory Coast, Reston, and Bundibugyo.
- Pathophysiology: The virus infects macrophages, dendritic cells, endothelial cells, and others, causing strong inflammatory cytokine secretion, vascular endothelial injury, and coagulation abnormalities (DIC), which may lead to increased vascular permeability, a tendency to bleed, and multiple organ failure.
- Incubation period: Approximately 2–19 days.
- Main symptoms: Sudden high fever, headache, muscle pain, generalized weakness, abdominal pain, diarrhea, vomiting, chest pain, sore throat, rash (around days 5–7 after onset), petechial bleeding, bruising, mucosal bleeding (such as oral and conjunctival bleeding), conjunctival injection, hepatomegaly, and swelling of the face, neck, and testicles. In some cases, the disease may rapidly worsen to shock and multiple organ failure.
- Transmission: Spread through direct or indirect contact with the bodily fluids of an infected person, such as blood, bloody stool, and saliva, or with equipment and objects contaminated by these secretions. The virus may be detectable in blood and other secretions for up to several weeks after infection (up to 61 days according to some sources), so contagiousness may persist.
- Prognosis: The case fatality rate is high (reported in some sources as approximately 75% for acute infection), but prognosis may improve with early supportive treatment and infection control.
Treatment Methods
- Basic principles: Medical isolation and strict infection control (compliance with personal protective equipment, standard, droplet, contact, and transport precautions) take priority. Suspected patients should be immediately isolated and transferred to a specialized treatment facility.
- Supportive care (standard treatment)
- Fluid and electrolyte replacement (oral or intravenous), and maintenance of blood pressure and oxygen saturation (oxygen therapy and positioning).
- If circulatory failure occurs, administration of vasopressors and intensive care (such as hemodialysis and mechanical ventilation) may be considered.
- Replacement of lost blood and clotting factors (blood transfusion, plasma, etc.).
- Appropriate antibiotic use for complications (such as bacterial infection), when necessary.
- Specific antibody therapy, vaccines, etc.: Basic supportive care is central. (Some sources state that no specific treatment or vaccine had been developed.)
- Infection control and prevention: Avoid contact with the patient's blood and bodily fluids; appropriately disinfect contaminated surfaces and equipment and safely handle contaminated materials; and follow safe funeral procedures. Contact tracing and isolation should be carried out according to health authorities' guidelines.
- Complications and long-term management: During the acute phase, there is a risk of DIC, hemorrhagic shock, and multiple organ failure. During recovery, monitor for sequelae involving the eyes (such as uveitis), reproductive organs (persistence of the virus in semen), the musculoskeletal system, and psychological and physical symptoms.
Precautions (Patients, Family Members, and Caregivers)
- If you have suspected symptoms or a history of exposure, do not visit a medical facility on your own; contact a public health center or medical institution first and follow their instructions.
- Caregivers should avoid direct contact with bodily fluids and strictly follow instructions on wearing personal protective equipment.
- Follow guidelines concerning the safe handling of bodies and funeral procedures.
- Even after recovery, the virus may remain detectable in certain bodily fluids (such as semen) for a certain period, so take precautions regarding sexual contact and blood donation.
Outpatient Visit Checklist (Including Preparation Items and Sample Questions)
- Preparation items (prepare before visiting/for consultation)
- A list of medications currently being taken (including prescription drugs, OTC drugs, and herbal medicines) and a history of allergies
- Copies of recent test results (blood tests, imaging tests, etc.), if available
- Notes recording the date symptoms began and their progression (the times when fever, bleeding, diarrhea, etc. occurred)
- Travel history within the past 21 days (or the period recommended by the local health authorities), including countries and regions visited and whether you visited a hospital, as well as whether you had contact with an infected person
- Information about possible exposure situations (such as exposure to blood from an injury or participation in a funeral)
- Emergency contact information (family and workplace contacts)
- Important actions before an outpatient visit
- If you have fever or bleeding symptoms and Ebola is suspected: Contact the hospital in advance and travel according to its instructions (avoid using public transportation), wear a mask, etc.
- Sample questions (questions to submit to medical staff or record for yourself)
- When did the symptoms begin? / Have you recently had contact with anyone or experienced any possible exposure?
- Do the medications I am currently taking affect the treatment?
General Sample Questions to Ask the Doctor
- What is the purpose of the treatment I received (medications, fluids, etc.), and what side effects can be expected?
- Based on my condition, what are the criteria for hospitalization or intensive care?
- What measures should my family take to prevent transmission?
- What tests should I undergo, and when, to prevent or detect complications (such as bleeding or kidney failure) early?
- When can I return to daily life and work after recovery? What restrictions will apply?
Disease-Specific Sample Questions
- How long may the virus remain detectable in my blood or semen? (The duration of detectability and criteria for safe sex and blood donation)
- Considering the specific region (country/facility) I recently visited and the date my symptoms began, how likely is exposure, and what are the procedures for epidemiological investigation and contact management for those exposed?
(Note: Suspected patients should be immediately connected with health authorities and specialized medical institutions. Patient and contact management, as well as testing and treatment plans, may vary according to local public health guidelines.)