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Last reviewed: 5 Apr 2025
Last updated: 04 Oct 2024

Summary

Definition

History and exam

Key diagnostic factors

  • exposure to an orthoebolavirus in previous 21 days
  • fever
  • myalgia
  • conjunctival injection

Other diagnostic factors

  • fatigue
  • anorexia
  • diarrhea
  • vomiting
  • severe headache
  • abdominal pain or heartburn
  • cough, dyspnea, chest pain
  • sore throat
  • prostration
  • tachypnea
  • maculopapular rash
  • bleeding
  • hepatomegaly
  • lymphadenopathy
  • hiccups
  • tachycardia
  • hypotension
  • neurologic signs

Risk factors

  • living or working in, or arrival from, endemic area in previous 21 days
  • contact with infected body fluids
  • occupational exposure
  • butchering or consumption of meat from infected (or potentially infected) animals
  • bioterrorism

Diagnostic tests

1st tests to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR)
  • malaria investigations

Tests to consider

  • serum electrolyte levels
  • BUN/serum creatinine
  • blood lactate
  • ABG
  • CBC
  • coagulation studies
  • urinalysis
  • LFTs
  • serum amylase level
  • blood cultures
  • serum blood glucose
  • antigen-capture enzyme-linked immunosorbent assay (ELISA)
  • IgM and IgG antibodies
  • chest x-ray

Emerging tests

  • rapid diagnostic tests

Treatment algorithm

Contributors

Authors

Catherine F. Houlihan, MSc, MB ChB, MRCP, DTM&H

Clinical Lecturer

University College London

Honorary Clinical Lecturer

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

CFH has been on a scientific advisory board for Valneva regarding Chikungunya vaccines.

Manuel Fenech, MD, MRCP, DTM&H

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital

Liverpool

UK

Disclosures

MF declares that he has no competing interests.

Tom E. Fletcher, MBE, MBChB, MRCP, DTM&H

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Disclosures

TEF is an author of a number of references cited in this monograph. TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General and the Wellcome Trust. TEF has received research grants from the Medical Research Council and the UK Public Health Rapid Support Team (UK-PHRST).

Acknowledgements

Dr Catherine F. Houlihan, Dr Manuel Fenech, and Dr Tom E. Fletcher would like to thank Dr Nicholas J. Beeching, a previous contributor to this topic, and Dr Colin Brown (Infectious Disease Lead, Kings Sierra Leone Partnership) for his helpful comments and insights.

Disclosures

NJB was partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. NJB is an author of references cited in this topic. CB declares that he has no competing interests.

Peer reviewers

William A. Petri, Jr, MD, PhD, FACP

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA

Professor of Medicine and Epidemiology

UT Health Medical School

Medical Director of Epidemiology

Memorial Hermann Texas Medical Center

Houston

TX

Disclosures

LO-Z declares that he has no competing interests.

Stephen Mepham, MRCP (UK), FRCPATH, DTM&H, MD

Consultant in Microbiology and Infectious Diseases

Royal Free London NHS Foundation Trust

London

UK

Disclosures

SM declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization. Clinical care for survivors of Ebola virus disease: interim guidance. Apr 2016 [internet publication].Full text

World Health Organization. Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease. 2020 [internet publication].Full text

World Health Organization. Infection prevention and control guideline for Ebola and Marburg disease. Aug 2023 [internet publication].Full text

World Health Organization. Optimized supportive care for Ebola virus disease. July 2019 [internet publication].Full text

Lamontagne F, Fowler RA, Adhikari NK, et al. Evidence-based guidelines for supportive care of patients with Ebola virus disease. Lancet. 2018 Feb 17;391(10121):700-8.Full text  Abstract

World Health Organization. Clinical management of patients with viral haemorrhagic fever: a pocket guide for the front-line health worker. Feb 2016 [internet publication].Full text

World Health Organization. Therapeutics for Ebola virus disease - Democratic Republic of the Congo. Aug 2022 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available here.

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