Ebola – the signs and symptoms

EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.


Other diseases that should be ruled out before a diagnosis of EVD can be made include:  malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other  viral haemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several  types of tests:

  • antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • antigen detection tests
  • serum neutralization test
  • reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • electron microscopy
  • virus isolation by cell culture.

Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

SOURCE : World Health Organisation

Ebola outbreak: Royal Air Force ‘on standby’

The Royal Air Force’s Infection Prevention Control Team is likely to be placed on standby to collect UK citizens and return them to Britain in quarantine conditions if they are infected with Ebola reports the Telegraph Online

The Royal Air Force could be called in to bring back UK citizens infected with the deadly Ebola disease from West Africa.

David Cameron has said that Ebola outbreak is a ‘very serious threat’ to the UK and the foreign secretary, Philip Hammond, is preparing to chair an emergency meeting today on how to tighten Britain’s defences against the virus.

Major Thomas Fletcher, of the Royal Army Medical Corps said it was likely the meeting would discuss putting the military on alert to ‘repatriate’ Britons infected with the disease.

The Royal Air Force’s Infection Prevention Control Team is likely to be placed on standby to collect UK citizens and return them to Britain in quarantine conditions.

The ‘Deployable Air Transportable Isolator Team’ is made up of military doctors and specialists from the London Royal Free Hospital.

The team was last deployed in 2012 and has been used five times over-all for the repatriation of 3 suspected cases of Lassa fever, 1 suspected case of multi-drug resistant tuberculosis, and 1 case of Crimean-Congo Hemorrhagic Fever.

Speaking to The Telegraph, Major Fletcher, a consultant on infectious diseases who has been seconded to the World Health Organisation to help with the outbreak, said: “The UK has a close relationship with West Africa and there will be British citizens in those countries.

“The COBRA meeting is probably discussing the possibility of the Royal Air Force offering assistance to UK nationals aboard who may become infected and who need to be repatriated.

“There is no doubt about it that this outbreak is going to last for many months so it is a big deal. It is the largest and most complicated outbreak we have ever seen and it is clearly not under control yet.

“With the advent of global travel there is increasing risk of importing Ebola into the UK.

“The main risk is of contact with an Ebola sufferer who has the disease but hasn’t begun to show symptoms. There is also a risk from healthcare workers coming back.

“That is why the passenger who died in Nigeria is clearly a concern as it is highly likely he was infectious during the flights he took and potentially there are people out there who are also now infected. “

The disease, which can be fatal for up to 90 per cent of infected victims, has now killed more than 670 people across Guinea, Liberia and Sierra Leone.

Public Health England has issued an urgent warning to British doctors to watch for signs of the lethal disease after an infected man was allowed to travel through an international hub. They said the virus was ‘clearly not under control.’

The government’s Chief Scientific Advisor Sir Mark Walport has said that the increasingly ‘interconnected’ world was placing Britons at risk.

Another health expert has warned could spread to Britain in the same way that AIDS did in the 1980s, a health expert has warned.

Dr Derek Gatherer, a specialist in the evolution of viruses from Lancaster University, warned that the virus was as easy to catch as flu and passengers on flights from infected areas risked catching the deadly disease.

American Patrick Sawyer died in Lagos, Nigeria, after being allowed on several flights despite showing symptoms of the disease.

The airline he flew with his attempting to contact dozens of passengers who came into contact with Mr Sawyer over fears they may also be infected.

Dr Gatherer said that those passengers could be ‘anywhere else in the world now.’

“Aids spread from Central Africa to the western world in the 1980s – Ebola could do the same,” he said.

“Anyone on the same plane could have become infected because Ebola is easy to catch. It can be passed on through vomiting, diarrhoea or even from simply saliva or sweat – as well as being sexually transmitted.

“That is why there is such alarm over Mr Sawyer because he became ill on the flight so anyone else sharing the plane could have been infected by his vomit or other bodily fluids.

“Only about 10 per cent recover. The outlook is pretty bleak. They will need to trace everyone on the passenger list and isolate them as a precaution.

“I believe they have contacted about half so far but the others could be anywhere else in the world now.”

Two Britons have already been tested for the disease in London and Birmingham after reporting symptoms, but neither had the disease.

Mr Hammond said no British national so far had been affected by the outbreak, and there had been no cases in the UK but he would be chairing the Government’s Cobra emergencies committee later today to assess the situation.

“As far as we are aware, there are no British nationals so far affected by this outbreak and certainly no cases in the UK. However the Prime Minister does regard it as a very serious threat and I will be chairing a Cobra meeting later today to assess the situation and look at any measures that we need to take either in the UK, or in our diplomatic posts abroad in order to manage the threat,” he told Sky News.

“We are very much focused on it as a new and emerging threat which we need to deal with.”

Ebola first appeared in 1976 in two simultaneous outbreaks – in Nzara, Sudan; and in Yambuku, in the Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

It is introduced into the human population through close contact with the sweat, blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines.

The virus then spreads in the community through human-to-human transmission.

Symptoms begin with fever, muscle pain and a sore throat, then rapidly escalate to vomiting, diarrhoea and internal and external bleeding. The incubation period can be up to 21 days.

SOURCE : The Telegraph Online