Ebola Virus Disease: A Pediatrics Primer

Summary and Comment |
October 28, 2014

Ebola Virus Disease: A Pediatrics Primer

  1. Deborah Lehman, MD

What pediatric healthcare providers need to know about this disease as the current outbreak evolves

  1. Deborah Lehman, MD

Ebola virus disease (EVD) is a zoonotic viral infection that was first recognized in 1976 near the Ebola River in Zaire (now the Democratic Republic of the Congo). Several outbreaks have occurred since then, but the largest is now occurring in the West African countries of Liberia, Sierra Leone, and Guinea, where >8000 cases have been diagnosed and the estimated case-fatality rate is 70%.

The index case in the current outbreak is thought to be a 2-year-old child in Guinea; however, the proportion of children among current cases is uncertain. The virus is transmitted through close contact with body fluids, and transmission risk is highest toward the end of the illness when viral loads are highest. Because children are less frequently in contact with sick or dying family members compared with adults and not usually involved in burial rites, they may be at lower risk for disease acquisition. This was not true in the Uganda outbreak in 2000 to 2001 in which children were infected at a high rate, possibly from caring for an infected family member.

Signs and symptoms of EVD are nonspecific and include fever, headache, and myalgia followed by vomiting and diarrhea. These symptoms are common to other viral illnesses that may infect returning travelers such as malaria, measles, influenza, or typhoid. Hospitals and outpatient clinics are developing screening protocols to identify high-risk patients, and the CDC is frequently updating recommendations for management, including isolation precautions.

Comment

The Ebola outbreak is evolving rapidly, and all healthcare workers, including pediatricians, need to be aware of the current situation and have a low threshold for concern when evaluating a child who recently traveled from an endemic area or had contact with someone who did. When speaking with children who might have questions about the Ebola outbreak, caregivers should use developmentally appropriate language and factual information when responding to their concerns.

Editor Disclosures at Time of Publication

  • Disclosures for Deborah Lehman, MD at time of publication Nothing to disclose

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