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What is Ebola? 10/12/2014. What is Ebola? Filoviridae Ebolavirus – 5 viruses/species – Ebola (Zaire) – Sudan – Bundibugyo – Tai Forest – Reston Marburgvirus.

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Presentation on theme: "What is Ebola? 10/12/2014. What is Ebola? Filoviridae Ebolavirus – 5 viruses/species – Ebola (Zaire) – Sudan – Bundibugyo – Tai Forest – Reston Marburgvirus."— Presentation transcript:

1 What is Ebola? 10/12/2014

2 What is Ebola? Filoviridae Ebolavirus – 5 viruses/species – Ebola (Zaire) – Sudan – Bundibugyo – Tai Forest – Reston Marburgvirus (single species) Cuevavirus 2

3 3 Where Does it Come From? Not entirely clear, but likely fruit bats are natural Ebola virus hosts

4 4 Where Does it Come From? Bats may infect other animals

5 5 Where Does it Come From? Any of these can infect humans

6 6 Where Does it Come From? Once a human is infected, human-to-human transmission occurs

7 How are humans infected - 1? Infected fruit bats – Bats have high titres in faeces – Used as food Infected animals e.g. monkeys – Handling uncooked bush meat 7 Bat soup: Bush meat: bola/ /Ebola-crisis-why-is-there-bush- meat-in-the-UK.html bola/ /Ebola-crisis-why-is-there-bush- meat-in-the-UK.html

8 How are humans infected - 2? Human-to-human transmission – Direct contact with blood or secretions of infected people, including urine, faeces, vomit, spit, sweat, semen and breast milk – Exposure to objects or environment contaminated with infected secretions – Burial ceremonies through direct contact with the body Access through mucosal surface / breaks in skin / parenteral (needlestick injury) Healthcare workers must practice strict infection prevention and control precautions 8

9 Signs and Symptoms Signs generally begin 2-21 days after contact with a person who is sick with Ebola – Most commonly 1-2 weeks, average 11.4 days People infected with Ebola but who do not show signs of disease cannot spread the virus

10 10 Signs and Symptoms General: (0-3 days) – Fever, headache, sore throat, chills, weakness, tiredness Gastrointestinal symptoms: (3-10 days) – Vomiting, diarrhoea, abdominal pain, Hiccups Severe symptoms (7-12 days) – Severe diarrhoea and vomiting, bleeding

11 11 Other signs of Ebola Virus Disease Redness in the whites of the eyes Rash on the trunk Bleeding in 45% of cases (historically) – Mild: nose bleed, bruising – Severe: gastrointestinal bleeding, shock

12 12 Timeline for how a person with Ebola becomes more infectious over time Source: Public Health England

13 13 Ebola and infectivity Ebola virus is spread among people through: – Touching body fluids of a person who is sick with or has died from Ebola – Touching or using objects contaminated with Ebola People infected with Ebola can only spread the virus to others once they have developed symptoms People with no or very mild symptoms (low-grade fever), level of virus is low and unlikely to pose a risk to others Once a person is unwell, all body fluids are infectious, with blood, vomit and diarrhoea being the most infectious Semen can remain infectious for up to three months after recovery

14 14 Clinical illness in first 106 patients with EVD, Sierra Leone, May-June 2014 (n=106) Schieffelin et al, NEJM, 29 Oct 2014

15 15 What is the natural history of EVD in humans? Non-fatal cases – Fever for 5-9 days and then improve – Coincident with humoral antibody response – Complete recovery can take weeks Weakness/ arthralgias/ headaches/ hair loss Deaths – Mortality: 30-90% – Current outbreak: Case fatality rate: 70% 1 Among hospitalised cases, deaths occur on average 4.2 days after admission 1 1 WHO Ebola Response Team. Ebola Virus Disease in West Africa – the first 9 months of the epidemic and forward projections. N Eng J Med 2014; 371:

16 16 Ebola shares symptoms with many diseases! Malaria Typhoid fever Cholera Other viral hemorrhagic fevers (e.g., Lassa) Most people sick with fever, vomiting, and diarrhea do not have Ebola

17 17 Management of patients Treatment and Vaccines Isolation Ill patients require intensive supportive care Fluids: oral rehydration if possible No licensed vaccine available (several being tested) No specific treatment available New drug therapies being evaluated

18 18 Control in the population

19 19 Acknowledgements Adapted from materials produced by: – World Health Organisation (WHO) – Centers for Disease Control and Prevention (CDC) – Nigerian Centre for Disease Control and Prevention – Public Health England – Dr Todd F Hatchette, Nova Scotia, Canada

20 20 More Information Health Protection Surveillance Centre CDC WHO HSE


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