Chapter 3 : Symptoms and Case Definitions
Topics covered in this snack-sized chapter:
Incubation period 2 to 21 days (3-12)
Sudden onset of fever, weakness, muscle pain, headache and sore throat, conjunctivitis, hiccups, dysphagia
Followed by vomiting, diarrhea, rash
Internal and external bleeding, often absent or minimal
Confusion and irritability
Seizures
Easy bleeding;
Rash e.g. ecchymosis, petechiae, purpura
Bleeding from the gums,
Conjunctival hemorrhage
Oozing from puncture sites
Epistaxis
Hematemesis
Hemoptysis
Melena
Unexplained vaginal bleeding in women
Hematuria
Fever may be absent in late stages
Shock (compounded by dehydration)
Suspected (clinical) case:
Any person ill or deceased with fever and hemorrhage. Documented prior contact with an EHF case is not required.
Probable case (with or without bleeding )
Any person (living or dead) with contact with a clinical case of EHF and a history of acute fever
Any person (living or dead) with a history of acute fever and three or more of the following-
Headache /vomiting/nausea/ loss of appetite/ diarrhea/ intense fatigue/ abdominal pain/ general muscular or articular pain/ difficulty in swallowing/ difficulty in breathing/ hiccoughs
Any unexplained death.
The distinction between a suspected case and a probable case in practice relatively unimportant as far as outbreak control is concerned.
