The treatment goals for Ebola Virus Disease (EVD) are to alleviate symptoms, support organ function, and improve patient survival rates. Modern medicine combines pharmacological treatments with supportive therapies and continues to develop new therapies through international cooperation. Timely diagnosis and early intervention are key to successful treatment, especially in controlling viral replication and immune response during the early stages of the disease.
Treatment strategies need to be adjusted based on the patient's disease stage and the severity of symptoms. Basic supportive therapy is the cornerstone of all treatments, while the use of new antiviral drugs must strictly adhere to drug approval conditions and clinical trial results. Medical teams typically provide treatment in isolated environments to prevent virus transmission.
Supportive therapy is at the core of treatment, including fluid replacement and electrolyte balance adjustments. Patients often experience dehydration due to severe vomiting and diarrhea, necessitating intravenous or oral rehydration salts to replenish fluids and minerals. Hemodynamic monitoring can provide real-time feedback on renal and circulatory system status, and vasopressors may be used to maintain blood pressure when necessary. For nutritional support, a liquid diet is primarily recommended in the early stages of the disease, progressing to a high-calorie, high-protein diet once solid food can be tolerated.
Monoclonal antibody combination therapy is currently the most effective pharmacological treatment method. REGN-EB3 and mAb114 are FDA-approved monoclonal antibody combinations that can neutralize viral surface proteins and block the virus from binding to host cells. Clinical trials in 2023 showed that these antibody drugs could reduce mortality rates from 60% to below 30%.
The antiviral drug Ricitrevir has shown in laboratory studies to inhibit viral RNA replication, but it has not yet received full clinical application approval. Vaccination is used for high-risk contacts during outbreaks, with the rVSV-ZEBOV vaccine generating protective antibodies within 10 days of administration.
REGN-EB3 consists of four monoclonal antibodies targeting different viral strains, capable of neutralizing various antigenic epitopes. mAb114 mimics the antibody structure of naturally recovered patients, and both must be administered within five days of symptom onset for optimal efficacy.
These antibody drugs must be administered in isolation wards by trained healthcare personnel, with close monitoring for allergic reactions. Drug supply chain management must coordinate with international health organizations to ensure stable supply in outbreak areas.
Development of small-molecule antiviral drugs focuses on blocking the viral replication process. T-705 (favipiravir) has shown inhibition of RNA polymerase activity in animal studies, but human clinical trial results have not been fully published. Combination therapy research is testing the synergistic effects of different antiviral drugs to reduce the risk of resistance.
Patients must be placed in negative pressure isolation rooms, and healthcare personnel must wear level PAPR respirators and full protective gear. All medical waste must be handled using double-layer biohazard containers, and environmental surfaces must be disinfected with sodium hypochlorite every 4 hours. Personnel who have been in contact with patients must undergo health monitoring for 21 days.
Patients with bleeding tendencies should use prothrombin complex but must avoid anticoagulants like heparin. High fever patients can use ice packs and environmental cooling, avoiding alcohol sponge baths to prevent skin irritation. For respiratory distress, high-flow oxygen should be used, but intubation should be avoided to prevent the risk of viral spread.
Recovered patients need to be monitored for 6 months, as the virus may persist in bodily fluids such as semen for several months. Male patients are advised to use condoms within 3 months post-recovery and to avoid unprotected sexual intercourse. Dietary recommendations include low-fiber, easily digestible soft foods to avoid irritating gastrointestinal ulcers.
Patients often experience post-traumatic stress syndrome and require mindfulness-based stress reduction therapy from psychologists. Community education programs should explain the modes of virus transmission to patients' families to reduce social stigma. It is recommended that recovered individuals participate in a 12-week community support group follow-up after returning home.
RNA interference technology is being tested to use siRNA to inhibit viral gene expression, but the cell permeability of nucleic acid drugs remains a technical bottleneck. CRISPR gene editing technology is attempting to repair the damaged antiviral mechanisms of host cells and is currently in the animal testing stage.
Genotype analysis can assist in selecting the most effective antibody combinations, such as the Zaire strain virus responding better to REGN-EB3. Machine learning models are being developed to predict the risk of patient deterioration, allowing for early adjustments to treatment plans.
Any individual who has been in contact with an Ebola patient and exhibits fever, muscle pain, or bleeding tendencies should immediately seek treatment at an isolation center. Travelers who have visited outbreak hotspots and develop symptoms within the 21-day incubation period must promptly report to public health authorities.
Healthcare workers who suspect exposure to the virus should immediately receive post-exposure prophylaxis (PEP), including a combination of monoclonal antibodies and vaccination. High-risk contacts should undergo 14 days of quarantine observation, with daily monitoring of temperature and blood indices.
Early diagnosis allows for timely isolation of patients, reducing the risk of virus transmission, and enables patients to receive antiviral drugs and supportive therapy in the early stages of the disease, improving survival rates. The virus replicates rapidly after symptoms appear, and delayed treatment may lead to organ failure, making immediate intervention crucial.
Why is vaccination conducted alongside treatment in outbreak hotspots for Ebola?Vaccination effectively prevents the spread of infection, while antiviral drugs (such as mAb114 and REGN-EB3) can inhibit viral replication in confirmed patients. The combination of both can treat patients while simultaneously blocking transmission chains, synergistically controlling the outbreak.
Do Ebola patients remain infectious after recovery from treatment?Recovered patients' blood and secretions may still carry the virus, especially in semen, where the virus may persist for months. Therefore, healthcare institutions continue to monitor recovered individuals and recommend safe sexual practices for several months post-recovery to prevent secondary transmission.
In areas lacking modern medical resources, can traditional therapies be combined with modern treatments?Traditional therapies may increase the risk of infection due to inadequate hygiene conditions, so reliance on modern medicine is recommended. The World Health Organization emphasizes that antiviral drugs, intravenous fluids, and electrolyte supplementation are core to treatment, while traditional therapies may delay the golden treatment window.
What is the risk of long-term health sequelae for patients treated for Ebola Virus Disease?Some recovered individuals may experience sequelae such as joint pain, fatigue, or vision problems, but the severity varies from person to person. Medical teams will provide follow-up monitoring, including Eyes and Ears medical surveillance, to detect and manage these subsequent issues early.
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