Ebola Information For Healthcare Professionals
Ebola, also known as Ebola Virus Disease, is one of numerous Viral Hemorrhagic Fevers and is a rare and deadly viral illness. Early recognition of symptoms and strict adherence to infection control practices are critical to controlling the spread of Ebola. To date, there have been no cases of Ebola in Rhode Island.
Click here for CDC information about Viral Hemorrhagic Fevers for healthcare professionals.
What You Should Do
Remain alert and evaluate for Persons Under Investigation
You should continue to remain alert and evaluate any patients suspected of having Ebola as a result of international travel within the last 21 days, and other epidemiologic risk factors. Consider Ebola if:
- The patient has travelled internationally within the last 21 days; or
- The patient has history of exposure to a person with Ebola within the last 21 days and the patient has a fever and other symptoms consistent with Ebola.
Early symptoms of Ebola, such as fever, are often seen in more common infectious diseases, such as malaria. A full investigation of other potential causes of the patient’s signs and symptoms should occur without delay in patient care.
Follow Maximum Infection Control Protocols for Persons Under Investigation for Ebola
Persons Under Investigation, or PUIs, include patients for whom a diagnosis of Ebola is being considered. PUIs should be isolated in a single room with a private bathroom, and healthcare personnel should follow enhanced standard, contact, and droplet precautions, including the use of appropriate personal protective equipment. You must report any suspect case of Ebola to RIDOH at (401) 222-2577 or (401) 276-8046 (after hours). If PUI criteria are met and the patient is not at an assessment hospital, RIDOH staff will arrange for transportation of the patient to an assessment hospital where laboratory testing and further evaluation will be performed.
Therapeutics
Two treatments are approved by the U.S. Food and Drug Administration (FDA) to treat Ebola disease caused by Ebola virus (species Zaire orthoebolavirus). Inmazeb® is a combination of three monoclonal antibodies and Ebanga® is a single monoclonal antibody. Monoclonal antibodies, or mAbs, are artificially produced antibodies that act like natural antibodies to stop the virus from replicating in a person's body. These mAbs bind to a portion of the virus called the glycoprotein and prevent the virus from entering the person's cells.
Both treatments were evaluated, along with two others, in a randomized controlled trial in the Democratic Republic of the Congo. Overall survival was higher for patients who received either Inmazeb® or Ebanga®. The efficacy of these treatments has not been established for viruses other than Ebola virus (species Zaire orthoebolavirus).
Supportive Care
Clinical management of patients with Ebola disease should focus on supportive care for complications, such as hypovolemia, electrolyte abnormalities, hematologic abnormalities, refractory shock, hypoxia, hemorrhage, septic shock, multiorgan failure, and disseminated intravascular coagulation (DIC).
Recommended care includes volume repletion, maintenance of blood pressure (with vasopressors if needed), and maintenance of oxygenation, pain control, nutritional support, and treatment of secondary bacterial infections and pre-existing comorbidities.
Large volumes of intravenous fluids are often required to correct dehydration due to diarrhea and vomiting. Some patients may develop profound third-spacing of fluids due to vascular leak.
To report cases or consult
Call 401-222-2577
After hours 401-276-8046