Ebola Hemorrhagic Fever Jessie Nipp, Kristen Rhodin, Frank Toms

What is Ebola Hemorrhagic Fever? severe, often fatal disease that occurs in humans and nonhuman primates recognized in 1976 discovered in Africa Caused by the infection of Ebola Virus

Ebola Virus Member of family Filoviridae Negative, single- stranded RNA Helical capsid Pantropic and able to infect a large variety of cells

Different Strains of Ebola Virus There are five subtypes of Ebola Virus, each named for the location of their discovery Ebola-Zaire Ebola-Sudan Ebola-Ivory Coast Ebola-Bundibugyo Ebola-Reston Has only caused infection in nonhuman primates Isolated in the Philippines

Mystery of Ebola Virus Natural Reservoir is currently unknown Hypothesized that an animal host native to Africa serves as the reservoir No consistent animal vector for the virus

Transmission Mode of Transmission: the infection caused by the Ebola Virus is transmitted by direct contact with infected fluids (blood, secretions, organs, or semen of those infected) many health care workers are infected while attending to patients it is also hypothesized that close contact with infected animals can prompt transmission (scientists working with infected monkey tissue)

Diagnosis Lab tests in biohazard facilities: ELISA - identifies viruses or antibodies to the virus in infected blood PCR - detects Ebola virus genetic information Indirect Immunofluorescent assay - detects antigens in infected blood products Serology (study of blood serum): involves the detection of immunoglobulin M (IgM) antibody, which appears as the viremia fades Can be performed with an immunofluorescence assay, Western blot, radioimmunoprecipitation, or enzyme-linked immunosorbent assay (ELISA) which is most recommended

Progression of Disease Ebola Virus targets macrophages and dendritic cells Virus is carried to the lymph nodes where is it able to spread into the bloodstream and throughout the body Infection causes severe disease due to: rapid viral replication host immune suppression induced by the virus vascular dysfunction

Onset of Illness Symptoms vary between survivors and nonsurvivors Large difference in the viral load of patients who die versus patients who survive Incubation period of 2-21 days

Symptoms Ebola Hemorrhagic Fever does manifest immediately after infection Day 6-9 sudden onset of fever severe headache malaise myalgia

Symptoms Day 8-11 deterioration severe nausea and vomiting abdominal pain diarrhea pharyngitis bleeding in gastrointestinal tract and mucous membranes

Symptoms Day 13-15 Rash appears and spreads throughout extremities shock and pulmonary insufficiency development of respiratory distress syndrome death is most likely at this stage

Treatment No specific treatment available The development of an inactivated filovirus vaccine has yet to create adequate results The most effective way to prevent and stop spread of the infection is with barrier isolation and precautions in exchange of bodily fluids.

Past Outbreaks Initial Outbreaks 1976 Other Serious Outbreaks: Yambuku, Dem. Rep. of Congo; 318 cases and 280 deaths Nzara, Sudan; 284 cases and 151 deaths Other Serious Outbreaks: 1995- Kikwit, Dem. Rep. of Congo; 315 cases and 250 deaths 2000- Gulu, Uganda; 425 cases and 224 deaths 2002- Mbomo, Rep. of Congo; 143 cases and 128 deaths 2007- Two Outbreaks Luebo, Dem. Rep. of Congo; 264 cases and 187 deaths Bundibugyo, Uganda; 149 cases and 37 deaths

Map of Distribution of Ebola Hemorrhagic http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/ebolamap.htm

Prevention Efforts Containment: isolation of patients with suspected cases strict barrier nursing techniques hospital staff is supplied with individual gowns, gloves, masks, etc (which are not reused unless disinfected) Prompt burial: patients that die from the fever are quickly buried or cremated

Prevention Continued Reduction of casual contacts Surveillance of suspected cases Contact tracing: due to person-to person transmission, anyone who has close physical contact with someone that is ill should be monitored Body temps checked twice a day Immediate hospitalization if a fever reaches more than 101 F

Works Cited Anderson, Rodney P. (2006). Reference material for multisystem zoonoses and vector-borne diseases and pathogens. In, Outbreak: Cases in Real-World Microbiology (pp. 205 - 206). Washington, DC: American Society for Microbiology Press. Hartman, A. (2010-01-01). Ebola and Marburg Hemorrhagic Fever. Clinics in laboratory medicine, 30(1), 161-177. US Department of Health and Human Services, Division of High-Consequence Pathogens and Pathology. (2010). Ebola hemorrhagic fever information packet. Retrieved from Centers for Disease Control website: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Ebola_Fact_Booklet.pdf Weir, Michael R., & Weir, Tracey E. (2002). Marburg and ebola hemorrhagic fevers. In Stephen K. Tyring (Ed.), Mucocutaneous manifestations of viral diseases (pp. 421-426). Tyring, Stephen K. (2002). New York, NY: Marcel Dekker, Inc.