Ebola: A clinical guide

DANGER ZONE

PERSONAL PROTECTIVE
EQUIPMENT

SYMPTOMS

If a patient has the

symptoms below,
and may have
TRAVEL
been exposed to
bodily uids or
CONTACT
bodies infected with
Ebola, they could have Ebola
virus disease. Such symptoms should
be of particular concern if the patient visited
an aected area within the past 21 days.

1
INFECTION

SYMPTOMS

221
days1

Observed in the current outbreak6:

87% Raised body
temperature
76%

Fatigue

67% Nausea/

38% Muscle pain

WHO recommends that those caring for

patients with Ebola should wear:1, 8
An impermeable
long sleeved gown
Boots or closed-toe shoes
with overshoes
Face protection
Gloves

TRANSMISSION

INCUBATION

Ebola is spread by direct

contact with infected bodily
uids or contaminated
objects, through mucous
membranes or broken skin.

30% Dry cough

Vomiting

21%

Sore throat

65%

Diarrhoea

18%

Internal/
external
bleeding

53%

Headache

11%

Hiccups
(poor prognosic sign)

Conjunctival

5%

Rash

40% injection

LAST UPDATED:
31st Oct 2014

12
weeks3

BODILY FLUIDS
After symptoms develop, there
is evidence2, 7 of infectivity in:

SYMPTOMS
DEVELOP

Tears
Saliva

Stool
Blood

TREATMENT6
Symptomatic
To reduce fever, pain,
nausea & vomiting.

Fluids
Oral/IV to replace lost
uids and electrolytes.

Treat comorbidities
Treat malaria and
sepsis (both common
in endemic settings).

New therapies
Drugs, vaccines, and
blood therapies are
being safety tested.

Ebola can be fatal in between 30% and 90%

of cases.6 WHO estimates are that time of death
for fatal cases is usually around seven days after
symptom onset (6.8 days).5 Those still alive after
two weeks are 75% likely to recover.3

OUTCOMES

REFERENCES
1. http://www.who.int/mediacentre/factsheets/fs103/en/
2. http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full
3. http://jid.oxfordjournals.org/content/204/suppl_3/S810.full
4. http://jid.oxfordjournals.org/content/179/Supplement_1/S24.full
5. http://www.nejm.org/doi/full/10.1056/NEJMoa1411100
6. http://bestpractice.bmj.com/best-practice/monograph/1210.html
7. http://www.nejm.org/doi/full/10.1056/NEJMoa1411677
8. http://www.who.int/csr/resources/publications/ebola/lovirus_infection_control/en/

Semen

Patients with Ebola should be

isolated in a room with a closed door
and separate bathroom.
Contacts should be traced to
determine whether they could have
transmitted the disease to others.

weeks
to
months3

Urine

INFECTION CONTROL

Patient
becomes
infectious

DEATH

Breast Sweat
milk

CONVALESCENCE
The recovery process can be
lengthy, with sequelae including:3
Asthenia
Weight loss
Headache
Dysaesthesias

Migratory arthralgias
Sloughing of skin
Loss of scalp hair
Persistent anaemia

BODILY FLUIDS
REMAIN INFECTIOUS
(even after death)
Infographic designed by Dr Will Stahl-Timmins for The BMJ. 2014.