infectious diseases
Marburg and Ebola Virus Infections
Symptoms and Signs of Marburg and Ebola Virus Infections
Symptoms of Marburg and Ebola virus infection are very similar. After an incubation period of 2 to 20 days, fever, myalgia, and headache occur, often with abdominal pain, nausea, and upper respiratory symptoms (cough, chest pain, pharyngitis). Photophobia, conjunctival injection, jaundice, and lymphadenopathy also occur. Vomiting and diarrhea may soon follow. Delirium, stupor, and coma may occur, indicating central nervous system involvement. Hemorrhagic symptoms begin within the first few days and include petechiae, ecchymoses, and frank bleeding around puncture sites and mucous membranes. A maculopapular rash, primarily on the trunk, begins around day 5. Severe hypovolemia can develop, resulting from Extensive fluid loss due to diarrhea and vomiting Capillary leakage, resulting in hypoalbuminemia and loss of fluid from the intravascular space Loss of electrolytes can cause severe hyponatremia, hypokalemia, and hypocalcemia. Cardiac arrhythmias can result. During the 2nd week of symptoms, either defervescence occurs and patients begin recovery, or patients develop fatal multiple organ failure. Recovery is prolonged and may be complicated by recurrent hepatitis, transverse myelitis, and orchitis. The case fatality rate ranges from 25 to 90%. Eye lesions (eg, severe cataracts in children) may develop after recovery from Ebola virus infection. In one adult, severe acute unilateral uveitis developed during the convalescent phase after infection. A recent follow-up study of patients during convalescence after Ebola virus infection reported that many survivors had major limitations in cognition and vision and in mobility due to joint pain ( Symptoms and signs reference ). Ebola virus can persist in the central nervous system and ultimately cause a relapse. 1.Jagadesh S, Sevalie S, Fatoma R, et al: Disability among Ebola survivors and their close contacts in Sierra Leone: A retrospective case-controlled cohort study.Clin Infect Dis66 (1):131–133, 2018. doi: 10.1093/cid/cix705 