Dx of Ebola

Diagnosing Ebola

Distinguishing the Ebola virus from other infectious diseases such as malaria, typhoid fever and meningitis. Ways to confirm that symptoms are being caused by the Ebola virus and not anything else are made using the following:

• "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.
• Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions" (1). 

Here is a good article to read more on the diagnosis of Ebola:

http://www.who.int/mediacentre/factsheets/fs103/en/

What the symptoms probably look like and some ways to distinguish Ebola between different common similar sicknesses are shown in the diagrams below.

Below is an excellent video showing how Ebola is diagnosed in just 10 minutes. 

Making a accurate Ebola diagnosis in a person who has been recently infected for only a few days is very difficult. This is because the early symptoms they most likely experience most commonly fever are not specific to being infected with the Ebola virus. These symptoms are usually seen from more common diseases like malaria and typhoid fever as stated previously in the above section. 

"However, a person should be isolated and public health authorities notified if they have the early symptoms of Ebola and have had contact with

• blood or body fluids from a person sick with or who has died from Ebola,
• objects that have been contaminated with the blood or body fluids of a person sick with or who has died from Ebola,
• infected fruit bats and primates (apes and monkeys), or
• semen from a man who has recovered from Ebola

Samples from the patient can then be collected and tested to confirm infection" (CDC).

The Ebola virus can be detected in blood only after the person becomes symptomatic. This is especially true for fevers "which accompany the rise in circulating virus within the patient's body, it may take up to three days after symptoms start for the virus to reach detectable levels" (CDC). 

The table below is from the CDC website and shows more laboratory tests used in the diagnosis process. 

Timeline of Infection	Diagnostic tests available
Within a few days after symptoms begin	Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing IgM ELISA Polymerase chain reaction (PCR) Virus isolation
Later in disease course or after recovery	IgM and IgG antibodies
Retrospectively in deceased patients	Immunohistochemistry testing PCR Virus isolation

References:

1.) Centers for Disease Control and Prevention. (2015, April 10).  Ebola Virus Disease. Retrieved April 15, 2015 from http://writingcenter.waldenu.edu/706.htm#sthash.ONwAhsD4.dpuf

2.) Mayo Clinic (2014, August 6) Ebola Virus and Marburg Virus. Retrieved April 14, 2015 from http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/causes/con-20031241

3.) MedShare. (2014, July 1). Retrieved April 3, 2015, from http://www.medshare.org/donate/urgent-relief/ebola-basics

4.)  UpToDate (2014, October 27).  Ebola Virus Disease. Retrieved April 9, 2015, from http://jama.jamanetwork.com/article.aspx?articleid=1915432

5.)  WHO (2015, April) Ebola Virus Disease. Retrieved April 14, 2015 from http://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-ebola-virus-disease