Filovirus - Clinical syndromes, Manifestation

Clinical syndromes/manifestation of Filovirus

The incubation period of Filovirus is around 2-21 days. The infection manifests as sudden onset of relatively non-specific symptoms including:

• fever (>38.3°C) / chills

• general malaise (discomfort feeling)

• myalgia (muscle pain)

• headache

• nausea

• vomiting

• sore throat

• diarrhea

• abdominal pain

• chest pain

In 50% of cases, maculopapular rash associated with varying degrees of erythema will develop especially in the trunk region. In fatal cases, the disease progresses to:

• conjunctival hemorrhages

• bruising

• bleeding from mucosal membranes, venipuncture sites

• melaena (black stool) and hematuria

Coagulation disorder along with increased D-dimer (type of anticoagulant) is observed in almost all patients' plasma. The later stage of the disease is characterized by severe nausea, obtundation (less than full alteration), tachypnoea (abnormally rapid breathing), vomiting, prostration (marked loss of strength), increased respiratory rate, anuria (lack of urine), and decreased body temperature leading to shock.

Death occurs due to impairment of cardiovascular regulation leading to a lack of control of blood pressure, coagulation/anti-coagulation, and fluid distribution. The body cannot amount appropriate immune response. Altogether, multiple organ failure takes place resulting in shock and death.

Survivors have prolonged myelitis (infection of the white matter of the spinal cord), arthralgia (joint pain), headache, lethargy, psychosis (loss of contact with reality), recurrent hepatitis, ocular disorders, etc. The case fatality and symptom severity rate depend upon viral species:

• ZEBOV = 60-90%

• MARV = 25-90%

• SEBOV = 50-60%

• BEBOV = 25%

• CIEBOV = 0%

• REBOV = 0%