The Ministry of Health has issued a new Decision on the publication of professional documents "Guidelines for diagnosis and treatment of Ebola virus diseases", applied nationwide. This Decision replaces Decision No. 2968/QD-BYT issued in 2014 to update the latest knowledge and treatment measures for this dangerous infectious disease.
According to the Ministry of Health, the disease caused by the Ebola virus is a dangerous acute infectious disease, with the potential to break out into a major epidemic with an average mortality rate of about 50%, even up to 90% in some outbreaks. The disease was first discovered in 1976 in the Democratic Republic of Congo, near the Ebola River - where the disease was named.
The Ebola virus is mainly transmitted through direct contact with blood, tissues and body fluids of infected people or animals such as urine, feces, saliva and semen. In addition, contaminated items such as used clothes, blankets, or needles can also become a source of infection.
The new guidelines state that the genus Ebolavirus currently includes 6 different species, including Zaire ebolavirus (EBOV), Sudan ebolavirus (SUDV) and Bundibugyo ebolavirus (BDBV) which have caused many major epidemics in Africa. Notably, Zaire ebolavirus alone currently has vaccines to prevent the disease and specific treatments with monoclonal antibodies.
High-risk groups for the disease include hunters, people living in forests who have been exposed to sick or dead wild animals such as fruit bats, primates, porcupines; people exposed to blood and fluids from patients; and medical staff directly caring for patients.
The Ebola incubation period lasts from 2 to 21 days. Patients often have symptoms such as sudden high fever, headache, muscle pain, fatigue, sore throat, vomiting, diarrhea and abdominal pain. In many severe cases, patients may experience whole-body red rash, bleeding, black stools, coughing up blood, bleeding gums, multiple organ failure and shock.
To diagnose the disease, the Ministry of Health identifies RT-PCR as the gold standard for detecting the Ebola virus. Other tests such as rapid antigen testing, blood tests, blood clotting and biochemistry are also used to support diagnosis and monitoring disease progression.
A suspected case is identified when the patient has a fever of 38°C or higher accompanied by symptoms such as headache, vomiting, diarrhea, abdominal pain or unexplained bleeding and has an epidemiological factor within 21 days before the onset of symptoms. Epidemiological factors include previous contact with Ebola patients, traveling from an epidemic area, or contact with infected animals.
Regarding treatment, the Ministry of Health emphasizes the principle of complete isolation and active supportive treatment. Currently, two monoclonal antibodies, INMAZEB and EBANGA, have been recorded to be effective in treating the Zaire ebolavirus strain. However, other Ebola strains have not yet had approved specific treatments.
Main treatments include fever reduction with Paracetamol, electrolyte rehydration, anti-nausea treatment, anticonvulsant, blood transfusion in case of acute blood loss, and active resuscitation support in case of shock or multiple organ failure. The Ministry of Health also recommends avoiding the use of non-steroidal anti-inflammatory drugs such as Ibuprofen or Diclofenac as they may worsen blood clotting disorders.
For pregnant women, children, the elderly and immunocompromised people, the risk of severe progression is assessed higher, so close monitoring is needed. Breastfeeding women are advised to stop breastfeeding because the virus can be transmitted through breast milk.
In infectious disease prevention and control, the Ministry of Health requires all suspected or identified cases to be isolated and treated at medical facilities, absolutely not treated at home. Medical examination and treatment facilities must strictly implement infection control measures, fully equip personal protective equipment for medical staff and caregivers.
People who have had close contact with the case need to be monitored for health within 21 days from the last contact. If suspicious symptoms appear, immediately report to a medical facility for isolation and timely treatment.
The Ministry of Health also said that the Ervebo vaccine has been approved by the World Health Organization (WHO) and the US Food and Drug Administration (FDA) since 2019 to prevent disease caused by the Zaire ebolavirus strain. However, there is currently no effective vaccine for other Ebola strains.
For cases of death from Ebola, the body must be disposed of according to regulations for group A infectious diseases and cremation must be performed to limit the risk of disease spread.
