Diagnose Ebola vs Flu vs Other: Is it Ebola or Flu? - The Gypsy Nurse

By The Gypsy Nurse Staff

October 16, 2014

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Diagnose Ebola vs Flu vs Other: Is it Ebola or Flu?

How do you tell if it’s Ebola or Flu? Is there a rapid test to Diagnose Ebola?

**Please Note:  This is the most current information that I can find. If you have updated information, please feel free to post in the comments. Just trying my best to answer questions.

There is a rapid test that can rule out or diagnosis the FLU. For Enterovirus D68, the CDC states “EV-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat. Many hospitals and some doctor’s offices can test ill patients to see if they have enterovirus infection. However, most cannot do specific testing to determine the type of enterovirus, like EV-D68. CDC and some state health departments can do this sort of testing.CDC developed, and started using on October 14, a new, faster lab test for detecting EV-D68.”  Read more about what CDC is doing about EV-D68 in 2014.
“….but, What about Ebola?”
symptoms graphic

 

 

Diagnosing EBOLA

There are several blood tests that can diagnose Ebola.  It’s important to note that according to WHO “Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.”  According the the information found on Wikipedia, Ebola is included in the Level-IV Viruses; there are a limited number of facilities in the US that are even qualified to deal with a ‘Level-IV” virus.
According to the CDC  “Ebola virus is detected in blood only after the onset of symptoms, usually fever. It may take up to 3 days after  symptoms appear for the virus to reach detectable levels. Virus is generally detectable by real-time RT-PCR from 3-10 days after symptoms appear.

Specimens ideally should be taken when a symptomatic patient reports to a healthcare facility and is suspected of having an Ebola exposure. However, if the onset of symptoms is <3 days, a later specimen may be needed to completely rule-out Ebola virus, if the first specimen tests negative.”

For additional information on Collection, Storage and Handling of Lab Specimens: Printable factsheet: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Patients with Suspected Infection with Ebola Virus Disease

Diagnostic Timeline for Ebola

Unfortunately, according to the information that I’ve been able to find, there is no rapid test nor can you diagnose ebola via lab tests prior to the patient being symptomatic.  The recommendations state that testing should be done on the first sign of symptoms but further states that an initial negative should be re-tested.

(graph below obtained from WHO)

Timeline of Infection Diagnostic tests available
Within a few days after symptoms begin
  • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
  • IgM ELISA
  • Polymerase chain reaction (PCR)
  • Virus isolation
Later in disease course or after recovery
  • IgM and IgG antibodies
Retrospectively in deceased patients
  • Immunohistochemistry testing
  • PCR
  • Virus isolation

What is a ‘Level-IV’ virus

According to Wikipedia: Biosafety level 4

This level is required for work with dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, agents which cause severe to fatal disease in humans for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers,Marburg virusEbola virusLassa virusCrimean-Congo hemorrhagic fever, and various other hemorrhagic diseases. This level is also used for work with agents such as smallpox that are considered dangerous enough to require the additional safety measures, regardless of vaccination availability. When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors from opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.

ACCORDING To The CDC: BSL-4

Pyramid showing the four BSLs with the highest risk level, BSL-4, highlighted at the top. Levels 1-3 are grey.BSL-4 builds upon the containment requirements of BSL-3 and is the highest level of biological safety. There are a small number of BSL-4 labs in the United States and around the world. The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked with in a BSL-4 laboratory include Ebola and Marburg viruses.

US

Centers for Disease Control and Prevention United StatesGeorgia,Atlanta Currently operates in two buildings. One of two facilities in the world that officially hold smallpox.
Georgia State University United StatesGeorgia,Atlanta Is an older design “glovebox” facility.
National Bio and Agro-Defense Facility (NBAF),Kansas State University United StatesKansas,Manhattan Under construction. Facility to be operated by the Department of Homeland Security, and replace the Plum Island Animal Disease Center (which is not a BSL-4 facility). Planned to be operational by 2015, but likely delayed.
National Institutes of Health (NIH) United StatesMaryland,Bethesda Located on the NIH Campus, it currently only operates with BSL-3 agents.
Integrated Research Facility United StatesMaryland,Fort Detrick Under construction. This facility will be operated by National Institute of Allergy and Infectious Diseases(NIAID), it is planned to begin operating at 2009 at the earliest.[needs update]
National Biodefense Analysis and Countermeasures Center (NBACC) United StatesMaryland,Fort Detrick Under construction, it will be operated for the Department of Homeland Security.
US Army Medical Research Institute of Infectious Diseases (USAMRIID) United StatesMaryland,Fort Detrick 1969 Old building
US Army Medical Research Institute of Infectious Diseases (USAMRIID) United StatesMaryland,Fort Detrick 2017? New building, currently under construction
National Emerging Infectious Diseases Laboratory(NEIDL), Boston University United States,MassachusettsBoston Under construction by Boston University, building and staff training complete, waiting for regulatory approval.
NIAID Rocky Mountain Laboratories United StatesMontana,Hamilton National Institute of Allergy and Infectious Diseases
Kent State University, Kent Campus United StatesOhioKent Operates as a clean lab at level 3 for training purposes. Scheduled for conversion to a hot level 4 lab in response to a bioterrorism event in the USA.
Galveston National Laboratory, National Biocontainment Facility United StatesTexas,Galveston Opened in 2008, facility is operated by the University of Texas Medical Branch.[28]
Shope Laboratory United StatesTexas,Galveston Operated by the University of Texas Medical Branch (UTMB).
Texas Biomedical Research Institute United StatesTexasSan Antonio The only privately owned BSL-4 lab in the US.

 The U.S. Centers for Disease Control and Prevention (CDC) now maintains 20 quarantine stations in the United States, which can detain and examine people — and animals — believed to be carrying dangerous infectious diseases.

 

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