Ebola Virus

Disease, MERS
COV
April Love Rivera-Oja, RN, MAN
Ebola Virus Dsease
Emerging Diseases
 Ebola Virus Disease
Ebola virus disease (EVD), formerly
known as Ebola haemorrhagic fever, is a
severe, often fatal illness affecting
humans and other primates. The
average EVD case fatality rate is around
50%. Case fatality rates have varied
from 25% to 90% in past outbreaks.

The first EVD outbreaks occurred in remote villages in Central

Africa, near tropical rainforests. The 2014–2016 outbreak in
West Africa was the largest and most complex Ebola outbreak
since the virus was first discovered in 1976. There were more
cases and deaths in this outbreak than all others combined. It
also spread between countries, starting in Guinea then
moving across land borders to Sierra Leone and Liberia.
 Ebola Virus Disease

Ebola Virus Disease (EVD) is a

rare and deadly disease in people
and nonhuman primates. The
viruses that cause EVD are located
mainly in sub-Saharan Africa.

People can get EVD

through animal (bat or
nonhuman primate) or a
sick or dead person
infected with Ebola virus.
 Prevention: Contact Precaution
When living in or traveling to a region where Ebola virus is present, there
are a number of ways to protect yourself and prevent the spread of EVD

Contact with blood and Items that may have come

Contact with semen from a
body fluids (such as urine, in contact with an infected
man who has recovered
feces, saliva, sweat, vomit, person’s blood or body
from EVD, until testing
breast milk, semen, and fluids (such as clothes,
verifies the virus is gone
vaginal fluids) of persons bedding, needles, and
from the semen.
who are ill. medical equipment).

Contact with bats and

Funeral or burial rituals that
nonhuman primates’ blood,
require handling the body Contact with the raw meat
fluids, or raw meat
of someone who died from of an unknown source.
prepared from these
EVD.
animals (bushmeat).
 Pathophysiology

● EBOV is an enveloped, negative-stranded RNA virus characterized by a

virion of ≈80 nm of diameter and a length ranging from hundreds of
nanometers to micrometers

● The genus ebola virus from the filoviradae family includes fives species
Pathophysiology
 Target Cells of Ebola Virus

Monocytes macrophages dendritic cells endothelial

cells

fibroblasts hepatocytes adrenal

cortical cells
Clinical Manifestations

Initial clinical • high fever, muscle aches, and fatigue.

manifestations

third and fifth • severe diarrhea, abdominal pain, and vomiting.

symptomatic • neurologic symptoms: confusion, agitation,
delirium, or encephalitis
day

Indicates poor •hemorrhage

prognosis
 Vaccine

The rVSV-ZEBOV vaccine

is a single dose vaccine
regimen that has been
found to be safe and
protective against only the
Zaire ebolavirus species of
ebolavirus.
Diagnosis
Polymerase chain
reaction (PCR)
• able to detect low levels of
Ebola virus.

Antibody tests

• can then be used to confirm a

patient’s exposure and infection
by Ebola virus.
 Medical Management
Providing fluids and electrolytes (body salts) through
infusion into the vein (intravenously).

Offering oxygen therapy to maintain oxygen status.

Using medication to support blood pressure, reduce

vomiting and diarrhea and to manage fever and pain.

It is likely that the patient who is infected will need ventilator

and dialysis support during the acute phase of illness

Treating other infections, if they occur.

Nursing Management

Infection Contol
Patient Placement

Personal Protective Equipment

Patient Care Equipment

Monitoring and Management of Potentially

Exposed Personnel
 Middle East
Respiratory Syndrome
Emerging Diseases
 MERS
• Middle East respiratory syndrome (MERS) is a viral
respiratory disease caused by a novel coronavirus
(Middle East respiratory syndrome coronavirus, or
MERS‐CoV) that was first identified in Saudi Arabia in
2012.
• Coronaviruses are a large family of viruses that can
cause diseases ranging from the common cold to
Severe Acute Respiratory Syndrome (SARs)
• Approximately 35% of reported patients with MERS-
CoV infection have died.
Diagnosis

Real-time reverse-
transcription • detects viral RNA in clinical
polymerase chain samples , diagnoses active
reaction (rRT-PCR) infection
assays

Antibody tests • Diagnoses a previous infection

Clinical Manifestations
 Other Laboratory Findings

Leukopenia,
lymphopenia, Decreased Elevated
elevated platelet count Amylase
neutrophils,

PT and PTT;
Elevated AST Proteinuria
prolonged
People Who May Be at Increased Risk for MERS
Recent Travelers from the Arabian Peninsula

Close Contacts of an Ill Traveler from the

Arabian Peninsula

Close Contacts of a Confirmed Case of MERS

Healthcare Personnel Not Using Recommended

Infection-Control Precautions

People with Exposure to Camels

Transmission

Close contact

inhalation of respiratory droplet

Medical Management

There is no specific antiviral treatment

recommended for MERS-CoV infection.
Individuals with MERS often receive
medical care to help relieve symptoms.
For severe cases, current treatment
includes care to support vital organ
functions.
Nursing Management
Minimize Chance for
Exposures

Ensure Adherence to
Standard, Contact and
Airborne Precautions

Hand Hygiene

Personal Protective
Equipment (Gloves,
Gowns, Mask)
Nursing Management
Eye protection

Airborne Infection Isolation Room

(AIIR)

Use Caution When Performing

Aerosol-Generating Procedures

Manage Visitor Access and

Movement Within the Facility

Implement Environmental
Infection Control