Ebola hemorrhagic fever, identified by ICD-10 diagnostic code A98.4 has taken toll of around 1,000 people. It needs to be effectively managed to avoid an outbreak of epidemic proportions.
Some Facts about Ebola Virus – Symptoms, Diagnosis and Treatment
Ebola is a severe, often fatal, viral hemorrhagic fever. The Ebola virus first appeared in 1976 during two outbreaks in Africa. Countries across the world have taken measures against this infectious disease by issuing health and travel advisories. The World Health Organization has also declared this viral outbreak as an international public health emergency.
According to WHO, EVD outbreaks have a case fatality rate of up to 90%. At least 932 deaths and 1,711 cases have been reported throughout Guinea, Liberia, Sierra Leone and, most recently, Nigeria. According to the World Health Organization Chief Margaret Chan, “the current Ebola outbreak in West Africa is the largest, most severe, and most complex outbreak in the nearly 4-decade history of this disease. [It’s] moving faster than we can control it.” These outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
Causes and Symptoms
This virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Other ways to contract Ebola include touching contaminated needles or surfaces.
Strong safety measures are in place for people who have Ebola and are brought to the U.S. for treatment.
Symptoms appear 2 to 21 days after infection and usually include high fever, headache, joint and muscle aches, sore throat, weakness, stomach pain and lack of appetite. This is followed by vomiting, diarrhea, rash, and impaired kidney and liver function.
Ebola infected patients have to be isolated from the public immediately to prevent the spread. Severely ill patients require intensive supportive care.
Diagnosis
Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests: antibody-capture enzyme-linked immunosorbent assay (ELISA), antigen detection tests, serum neutralization test, reverse transcriptase polymerase chain reaction (RT-PCR) assay, electron microscopy and virus isolation by cell culture.
The US Food and Drug Administration has approved the use of a polymerase chain reaction (PCR) based test for the diagnosis of the Ebola Zaire virus. The FDA-approved PCA test offers hope for early detection of this deadly Ebola virus.
Management of Ebola Infection
Patients benefit from supportive therapy focusing on intravascular volume, nutrition, electrolytes and comfort care. Whatever therapy is administered, it must be done with great care and attention ensuring isolation of the patient to prevent the spread of the disease. Since the virus is transmitted through body fluids, these should be handled with extreme care. However, no single therapy is available that can efficiently treat Ebola hemorrhagic fever, and there are no vaccines available for Ebola.
The standard management option for Ebola HF is treating the symptoms as they appear and providing supportive care that includes:
- Maintaining the patient’s oxygen status and blood pressure
- Balancing their fluids and electrolytes
- Treating them for any complicating infections
To prevent Ebola from breaking out into an epidemic, patients must be carefully monitored and the spread of the disease tracked carefully utilizing the data available.
More Specific Reporting of Ebola Hemorrhagic Fever with ICD-10
ICD-10 codes are distinguished by their capability for capturing greater specificity. Diagnostic coding data is helpful with regard to disease surveillance and management, especially in the case of infectious diseases such as SARS (Severe Acute Respiratory Syndrome), West Nile Virus and Ebola. The data obtained is carefully interpreted and reported to many governmental/non-governmental agencies so that effective treatment protocols can be developed and the spread of the disease controlled.
ICD-10-has a specific code for “Ebola virus disease” — A 98.4. In the Alphabetic Index, it is listed under the main term Ebola virus disease, or Disease, Ebola (virus). The ICD-9 code for Ebola is not very specific, and here it is indexed under Infection, Virus, Ebola – code 065.8, other specified arthropod-borne hemorrhagic fever. Lack of specificity makes it highly challenging to identify patients really having Ebola HF. Specific coding capability that distinguishes ICD-10 makes it easy to monitor patients having a particular disease such as Ebola and track the disease, which is vital from the point of view of public health. It also facilitates research, helps in evaluating treatment efficacy and outcomes, and enables healthcare providers to control the spread of epidemics.
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