What You Need to Know About the Ebola Virus

A lthough the Journal of the Advanced Prac titioner in Oncology (JADPRO) is focused on publishing issues and content specific to oncology, we recognize that the current outbreak of the Ebola virus is a critical issue and one that readers should be aware of. The Ebola virus was first noted in 1976, when two outbreaks occurred in the Sudan and the Democratic Republic of the Congo. The adjacent Ebola River in the Congo location is where the hemorrhagic fever gets its name. Periodic outbreaks in Africa have occurred since its discovery (World Health Organization [WHO], 2014). The current outbreak is the longest of all known outbreaks—and the deadliest—with ~5,000 deaths as of this month (Centers for Disease Control and Prevention [CDC], 2014). As we go to press, the CDC reports 8,168 laboratory-confirmed cases as well. The Ebola virus affects both humans and nonhuman primates and is spread by close contact with patients or exposure to infected biologic fluids. The virus has been found in the blood, saliva, feces, breast milk, tears, and genital secretions of infected patients (Chippaux, 2014). The Ebola virus has a high mortality rate, with a current case fatality rate estimated to be around 50%. Mortality rates for previous outbreaks have varied from 25% to 90%, and those outbreaks have been relatively short-lived (WHO, 2014). The onset of symptoms for infection with the Ebola virus varies, given the fact that the incubation period is 2 to 21 days (WHO, 2014). Infection with the Ebola virus causes significant immune suppression and a systemic inflammatory response, leading to multiorgan failure and shock (Gajdosik, 2014). Patients may develop vomiting and diarrhea; kidney and liver function may be affected; and some patients may experience bleeding, both internal and external (WHO, 2014). Treatment for infection with the virus is largely supportive care, as rehydration and treatment of symptoms improve survival in affected patients. Although experimental vaccines are in the testing phase, adequate control of the outbreak is essential, requiring management of cases, surveillance, and contact tracing (WHO, 2014). Wearing appropriate protective gear while caring for this population of patients is critical to prevention of virus transmission. On the next pages you'll find several resources for health-care professionals interested in the most current and relevant information on the Ebola virus. Revisit these sites frequently, as information regarding the virus and its treatments as well as guidelines for prevention of transmission are constantly updated. l