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In Africa, Ebola has a case-fatality rate of 50-90%. Hemorrhage, shock, liver injury, and renal failure are prominent findings. Laboratory studies show thrombocytopenia, lymphopenia, and liver transaminase elevations. The infection can be transmitted by semen up to 7 weeks after recovery. Suspected reservoirs are monkeys, chimpanzees, gorillas, and duikers. [CCDM, p. 180-2] Bats may maintain the virus in tropical forests. [WHO website] Other symptoms include: chest and abdominal pain, cough, conjunctivitis, jaundice, pancreatitis, lymphadenopathy, delirium, and coma. Other complications after the second week of infection include transverse myelitis, hepatitis, orchitis, and uveitis. [Merck Manual, p. 1624; PPID, p. 2058] A maculopapular rash that later desquamates appears on about the 5th day of the illness. Bleeding is common from the skin, nose, mouth, GI tract, and vagina. Laboratory abnormalities include thrombocytopenia and leukopenia with left shift; leukocytosis develops after the initial phase. Serum bilirubin levels are normal or slightly elevated. Shock is frequently the cause of death. [ID, p. 2138-40] |
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