Ebola virus infection is caused by an unclassified RNA virus that’s passed from person to person by direct contact with infected blood, body secretions, or organs. Nosocomial and community-acquired transmission can occur. Contaminated needles can also cause the infection. Transmission through semen may occur up to 7 weeks after clinical recovery. The virus remains contagious even after the patient has died.

As the infection progresses, severe complications, including liver and kidney dysfunction, dehydration, and hemorrhage, may develop. In pregnant females, the Ebola virus leads to spontaneous abortion and massive hemorrhage. Death usually results during the second week of illness from organ failure or hemorrhage.

The patient’s health history usually reveals contact with an infected person. However, no clear line of infection may be apparent at the beginning of an Ebola virus outbreak. The patient usually complains of flulike symptoms, which first appear within 3 days of infection.

As the virus spreads through the body, inspection reveals bruising as capillaries rupture and dead blood cells infiltrate the skin. A maculopapular eruption appears after the fifth day of infection. The patient may also display melena, hematemesis, epistaxis, and bleeding gums. In the final stages of the disease, the skin blisters and sloughs off, blood seeps from all body orifices, and the patient begins vomiting his liquefied internal organs.

Specialized laboratory tests reveal specific antigens or antibodies and may show the isolated virus. As with other types of hemorrhagic fever, tests also demonstrate neutrophil leukocytosis, hypofibrinogenemia, thrombocytopenia, and microangiopathic hemolytic anemia.