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Ebola Diagnosis

It can be difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis.

To determine whether Ebola virus infection is a possible diagnosis, there must be a combination of symptoms suggestive of EVD AND a possible exposure to EVD within 21 days before the onset of symptoms.

An exposure may include contact with:

  • Blood or body fluids from a person sick with or who died from EVD
  • Objects contaminated with blood or body fluids of a person sick with or who died from EVD
  • Infected fruit bats and primates (apes or monkeys)
  • Semen from a man who has recovered from EVD

If a person shows early signs of EVD and has had a possible exposure, he or she should be isolated (separated from other people) and public health authorities notified. Blood samples from the patient should be collected and tested to confirm infection. Ebola virus can be detected in blood after onset of symptoms, most notably fever. It may take up to three days after symptoms start for the virus to reach detectable levels. A positive laboratory test means that Ebola infection is confirmed. Public health authorities will conduct a public health investigation, including tracing of all possibly exposed contacts.

To confirm that symptoms are caused by Ebola virus infection,

Following diagnostic methods are used:

  • Antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • Antigen-capture detection tests
  • Serum neutralization test
  • Reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • Electron microscopy
  • Virus isolation by cell culture.

Careful consideration should be given to the selection of diagnostic tests, which take into account technical specifications, disease incidence and prevalence, and social and medical implications of test results. It is strongly recommended that diagnostic tests, which have undergone an independent and international evaluation, be considered for use.

Current WHO recommended tests include:

  • Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
  • Rapid antigen detection tests for use in remote settings where NATs are not readily available. These tests are recommended for screening purposes as part of surveillance activities, however reactive tests should be confirmed with NATs.

Preferred specimens for diagnosis include:

  • Whole blood collected in ethylenediaminetetraacetic acid (EDTA) from live patients exhibiting symptoms.
  • Oral fluid specimen stored in universal transport medium collected from deceased patients or when blood collection is not possible.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

 

 

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References:

https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease

https://www.cdc.gov/vhf/ebola/diagnosis/index.html

 

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