Background
Microbiology
- Negative-sense single-stranded RNA virus in the Filoviridae family
- Genus contains two species
Epidemiology
- Rare, with 11 outbreaks since discovery in 1967, totalling 470 cases
- Animal reservoir is fruit bat, with a sylvian cycle that occasionally spills over into human populations
- The range of the reservoir extends into Middle East, South Asia, and south Pacific, but the virus is essentially limited to subsaharan Africa
Clinical Manifestations
- Incubation period 2 to 21 days
- Starts with high fever, severe headache malaise
- Followed by multi-system involvement as early as day 3
- Nausea, vomiting, anorexia, abdominal pain, diarrhea (can persist for a week)
- Chest pain, dyspnea, cough
- Hypotension, edema, maculopapular rash
- Headache, confusion
- Mortality 23 to 90%
Management
- Good supportive care decreases mortality substantially
- Experimental therapies include favipiravir and monoclonal antibodies
Prevent
- Vaccination is under investigation
