Ebola Virus Disease (EVD)

Alvin Almazan 11/26/12 Microbiology Section 5 Yiming Guo

What is EVD?

Ebola is a viral hemorrhagic fever caused by 4 of 5 identified Ebola Viruses. Zaire Ebola-virus (ZEBOV) Deadliest; mortality rate = 90% Sudan Ebola-virus (SEBOV) Bundibugyo Ebola-virus (BEBOV) New species; recently active in 2008, 116 cases, 39 deaths (mortality rate = 34%) Cote dIvoire or Tai Forest Ebola-virus (TAFV) All strains have genomic overlap and are share high mortality rates, with all except for Zaire and Bundibugyo hovering around the 50-60%. Share certain genetic traits Name is derived from the place where it was found: Ebola River in Zaire, Africa

What is EVD? (cont.)

All of these strains are endemic in their respective origin areas. Ex. Sudan virus = endemic in Sudan. Under a colored TEM (Transmission Electron Microscope) slide, Ebola has a characteristically shepherds crook shape. Filamentous virus with a single strand of RNA Uses host cell to replicate; makes it extremely

What is Ebola? (cont.)

Reservoirs for Ebola Virus include:

Chimpanzees (B Fruit bats Pigs Infected humans

How is it spread/transmitted?

Any of the Ebola virus strains are spread through a myriad of ways:

Contact with any bodily fluid (ex. blood, mucus) that is infected

Contact with organs of infected animals.

As a result, unfortunately, this means that healthcare workers in places where Ebola is endemic are at extreme risk of contracting Ebola.

How does it affect the body?

Ebola, being a hemorrhagic disease, mainly targets:

Endothelial cells Mononuclear phagocytes Hepatocytes

Overwhelms the host immune system by producing a glycoprotein that neutralizes the hosts neutrophils. Presence of damaged cells/virus particles initiates inflammatory response, leads to hemorrhaging.

Identification

Unfortunately, Ebola Hemorrhagic Fever shares various early symptoms with various diseases, such as plague, trypanosomiasis, and smallpox. The only tell-tale sign of Ebola infection is if the victim has recently visited an area where it is endemic. Picture is of Mayinga NSeka, the first diagnosed case of Ebola Zaire; she died a few days later of severe internal bleeding and hemorrhaging.

Symptoms

After an incubation period of a minimum of 12.7 days (max. 25), the symptoms begin with a sudden onset of flu-like symptoms. Cough Fever w/chills Chest pain Headaches Agitiation Fatigue In extreme cases: Seizures Coma

Symptoms (cont.)

At later stages, hemorrhagic rash occurs, due to the breakdown of tissues due to the inflammation of most of the soft tissues of the body. As pictured, hemorrhagic rash (above); petechiae caused by EHF. Hematomas may occur around injection sites; bruises (actually pools of blood collecting underneath the skin) appear

Symptoms (cont.)

At the extreme later stages, hemorrhaging is severe, mostly occurring internally, causing Multiple Organ Dysfunction Syndrome (MODS) due to fluid redistribution, hypotension, disseminated intravascular coagulation and focal tissue necroses. Results in blood filled internal cavities of the body. Bleeding occurs from mucous membranes, such as the eyes, nose, gums, vagina, GI tract, etc. Late stage symptoms cause extreme pain.

Prognosis and Treatment

Almost impossible to diagnose Shares many symptoms with influenza virus. Often misdiagnosed as flu due to the flue like symptoms. Victims usually fail to get medical attention early enough due to misdiagnosis. Treatment No known treatment Early care focuses on providing electrolytes/fluid balance and painkillers, generally making the patient comfortable. Late care focuses on reduction of hemorrhaging in order to protect those involved in care; high doses of painkillers and supplementary oxygen is needed. In endemic areas, treatment of this kind is usually difficult/impossible to receive.

Survivors

Unknown how some cases survive: German lab worker accidentally stabbed herself with a needle contaminated with ZEBOV Showed preliminary symptoms and minor petechiae; symptoms receded. Should a person survive: Blindness Choroteinitis (floating black spots/retinal damage) Joint Pain In some cases, Ebola virus strains ZEBOV and SEBOV can survive in the sperm. Can be spread through sexual intercourse.

Prevention

In order to prevent infection with Ebola Viruses:

Avoid endemic areas Limit exposure to infected organisms/patients Carefully handle infected fluids/secretions, observing safe handling practices.

References

http://www.who.int/mediacentre/factsheets/fs103/en/ http://emedicine.medscape.com/article/216288-clinical#a0217 http://www.cbc.ca/news/health/story/2007/09/12/ebola-outbreak.html http://atlantablackstar.com/wp-content/uploads/2012/11/ebola-patient.jpg http://1.bp.blogspot.com/CbLdA0quBSc/Tn7aDHQNYiI/AAAAAAAABLg/hctvIfcCnmg/s400/ebola+ virus+patients.jpg http://2.bp.blogspot.com/0BnUO7QSSNE/Tq9xXNqjY3I/AAAAAAAAAHg/J06wBL4YIGQ/s1600/eb olz.jpeg http://66.197.58.78/pics/Ebola_Hemorrhagic_Fever_2.jpg http://www.worldwideconspiracy.co.uk/wp-content/uploads/ebolasympton-2.jpg http://wuster338spring2012.files.wordpress.com/2012/05/hemorrhagicfever-ebola-dengue.jpg

THE END