DISASTER • A total of 2,615 Ebola infections and 1,427 deaths • highest case fatality rates of any human virus, 88% ETYMOLOGY • First recorded outbreak at,Yambuku in democratic

republic of congo (EBOLA RIVER)

VIRUS ( Latin virulentus) • Viruses do not contain enzymes for energy

production or protein synthesis. • small infectious agent that replicates only inside the

living cells of other organisms

STROKES YEAR REGIONS AFFECTED

DISCRIPTION

FIRST 1976 Democratic republic of congo (ZAIRE) & sudan

First outbreak of Ebola. Hemorrhagic fever

SECOND 1989 Reston ,Virginia mysterious outbreak. (initially diagnosed as Simian hemorrhagic fever virus (SHFV)) among a shipment of crab-eating macaque monkeys imported from the Philippines. named Reston ebolavirus (REBOV)

THIRD 2014 WEST AFRICA -affecting Guinea, Sierra Leone, Liberia and Nigeria.

largest outbreak to the date

Sudan (SUDV)

Group : Group V (-)sense RNA

Order : Mononegavirales

Family : Filoviridae

Genus : Ebolavirus

Bundibugyo (BDBV)

Tai forest (TAFV)

Formerly Cote d-Ivoire

Species

Zaire ebola (EBOV)

The most

dangerous

Reston (RESTV)

Non-humans

Ebola Taxonomy

STRUCTURE

– Single-stranded, linear, non-segmented

– Filamentous - shape of “U” or “6”

– Coiled, toroid, or branched

– 19 kb length,60-80 nm in diameter

– Negative-sense enveloped RNA (3’ to 5’ direction)

– “Spikes” appearance

– 8 sub-genomic mRNA proteins: 7 structural and 1 nonstructural

Ebola Pathogenesis

ebola Attach to

walls

Leakage of blood and serum into

surrounding tissue

Wbcs’ attack

Wbcs’ dissolve

Chemical released

Pro-inflammatory

cytokines Pro coagulants Also released

Blood vessels more

damaged

Permanent bleeding

Entire body leaks

and dissolves

https://www.youtube.com/watch?v=sRv19gkZ4E0

• Viral cores

– stack up in cell

– migrate to the cell surface

– Produce trans-membrane proteins

– Push through cell surface

– Become enveloped by cel membrane

• ssRNA- Genome Mutations

– Capable of rapid mutation

– very adaptable to evade host defenses and environmental change

• Enters Bloodstream

– skin, membranes,open wounds

• Cell Level

– docks with cell membrane

• Viral RN

– released into cytoplasm

– production new viral proteins

• New viral genomes

– rapidly coated in protein

– create cores

Transmission

Environment to Human :

Fruit bats-natural reservoir

Gorilla, chimpanzee, monkey, porcupine, duiker

Human to human :

1. Direct contact

2. Contaminated medical equipment

3. Traditional burial rituals

4. Medical workers

5. Survivors(via semen for 2 months)

SIGNS AND SYMPTOMS 1 Early symptoms : Influenza(fatigue,fever,headache,joint & abdominal pain)

Vomiting,diarrhea

Loss of appetite

Sore throat,chest pain,hiccups,shortness of breath, trouble swallowing

Weakness

Maculopular rash(50% cases)

Myalgia(muscular pain or tenderness),back pain

Mucosal redness of the oral cavity

SIGNS AND SYMPTOMS 2 Acute symptoms : Bleeding from puncture sites and mucous

membrane(eg.nose,gums and gastrointestinal tract)

Internal and subcutaneous bleeding

anuria(absence of urine formation)

raddening of eyes,bloody vomit

Impaired blood clotting

Multiple organ dysfunction syndrome which leads to death

THE PATIENTS WILL HAVE DIARRHEA PHARYNGITIS.

THE INFLAMMATION OF THE THROAT AND EYE.

CAUSES SEVERE DAMAGE TO THE SKIN.

ATTACKS EVERY TISSUE AND ORGAN OF THE BODY EXCEPT THE

SKELETAL MUSCLES AND BONES.

CAN ATTACK THE CONNECTIVE TISSUES THAT ARE RAPIDLY

MULTIPLYING IN COLLAGEN.

CAUSES SMALL BLOOD CLOTS TO FORM IN THE BLOODSTREAM

OF THE PATIENT AND FORMS RED SPOT ON THE SKIN

SPONTANEOUS BLEEDING THEN OCCURS FROM BODY ORIFICES

AND GAPS IN THE SKIN

EFFECT OF EBOLA

EHF & EVD

EHF ( EBOLA HEMORRHAGIC FEVER ) :

Internal and External Bleeding occurs

Genital swelling

Increased feeling of pain in the skin

Rash over the entire body that often

contains blood

Roof of mouth looks red

EVD ( EBOLA VIRUS

DISEASE ) :

Bleeding does not occur

EBOLA IN NON-HUMAN PRIMATES

• NON-HUMAN PRIMATES HAVE BEEN A SOURCE OF INFECTION

FOR HUMANS

• EBOLA OUTBREAKS FROM THE EBOV AND TAFV SPECIES

HAVE BEEN OBSERVED IN CHIMPANZEES AND GORILLAS.

• RESTV HAS CAUSED SEVERE EVD OUTBREAKS IN MACAQUE

MONKEYS (MACACA FASCICULARIS).

• RESTV VIRUSES HAVE BEEN DETECTED DURING SEVERAL

OUTBREAKS OF A DEADLY DISEASE IN PIGS IN PEOPLE’S

REPUBLIC OF CHINA AND PHILIPPINES.

COUNTRY

YEAR

EBOLAV

IRUS

SPEICE

S

CAS

ES

DEATH

CASE

FATALI

TY

DRC,

UGANDA

2012 BUNDIBU

GYO,SUD

AN

88 50 56.81%

DRC,

UGANDA

2007 BUNDIBU

GYO,ZAI

RE

413 224 54.23%

UGANDA 2000 SUDAN 425 224 53%

DRC 1995 ZAIRE 315 254 81%

COTE

D`LOVIRE,

GOBANA

1994 TAI

FOREST,

ZAIRE

53 31 58.50%

SUDAN 1979 SUDAN 34 22 65%

CHRONOLOGY OF EBOLA VIRUS

DISEASE OUTBREAKS

: DRC- DEMOCRATIC REPUBLIC OF

CONGO

TABLE EBOLA OUTBREAKS,2014 (BY WHO)

1. DRC

2. GUINEA

3. LIBERIA

4. NIGERIA

5. SIERRA LEONE

• 24 CASES,13 DEATHS.

• 607 CASES,406

DEATHS.

• 1082 CASES,624

DEATHS.

• 16 CASES, 5 DEATHS.

• 910 CASES, 392

DEATHS. DRC= democratic republic

of congo

Anti-Fluenza:Avigan

• ZMapp (JAPAN) • combination of antibodies (inactivate ebola virus)

• is effective in primates, studies in humans yet to be done(effectively treat 43% of animals challenged with the Ebola virus)

• WHO has given an ethical green light to the use of these experimental therapies (testing on 2nd august)

• would provide a medical tool to discourage the use of Ebola virus as an agent of bioterrorism

PREVENTION OF EBOLA

Avoid contact with other infected humans, animals or objects

Raising awareness by IEC &BCC

Reducing human to human transmission by use of PPE

Safe disposal of the dead

Active surveillance – Contact tracing & monitoring – Reporting /Notification

PRECAUTIONS

Use Standard Precautions

Routine Hand washing

Handle and Dispose of Instruments Safely

Cook meat thoroughly

Environment Cleaning

FIVE TYPES OF HAND HYGEINE

Gather Recommended Supplies Bed and mattress, Plastic sheeting, One thermometer,

Covered container , Screens or other barriers

Plan Disinfection for VHF-Contaminated items using

1)Ordinary Household Bleach 2)Soap and Clean Water 3)Sterilization

Set Up Changing Rooms for patient-care staff

Place Security Barrier Around Isolation Area

TREATMENT No specific treatment available but

experimental ones are

Frequent dehydration and oral rehydration with solutions containing electrolytes or intravenous fluids.

Maintaining oxygen status and blood pressure

Replacing lost blood

Treating other infections if they occur

Timely treatment of ebola is difficult due to difficult diagnosis

VACCINES

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Obtain to obtain samples and study the disease

in remote areas where outbreaks occur.

A high degree of biohazard containment is required for laboratory studies and clinical analysis.

Difficulty in making vaccines

BIOTERRORISM

NATURAL OUTBREAKS OF EBOLA HEMORRHAGIC FEVER IN AFRICA ALARMED

GLOBAL HEALTH EXPERTS.

RAISES QUESTIONS ABOUT HUMAN ACCESSIBILITY TO THE VIRUS AND

HUMAN USAGES OF THE VIRUS FOR HARMFUL PURPOSES.

THEN TERRORIST GROUPS COULD USE THE RECENT OUTBREAK OF EBOLA

IN AFRICA TO THEIR ADVANTAGE. BY USING THE EBOLA VIRUS AS A

BIOLOGICAL WEAPON.

THIS PROSPECT IS WORTHY OF CONSIDERATION :

1.DUE TO THE HISTORY OF TERRORIST ATTACKS BY DIFFERENT GROUPS IN

THE AREA.

2.THE POTENTIAL FOR THESE GROUPS TO OBTAIN EBOLA IN THE FIELD

3.THE LACK OF POLITICAL CAPACITY IN THE REGION AND GLOBAL WILL TO

DEVELOP A VACCINE.

4.THE PATHOGEN’S NATURAL OCCURRENCE IN THE REGION.

ALTHOUGH DEADLY, EBOLA IS NOTORIOUSLY UNSTABLE WHEN REMOVED

FROM A HUMAN OR ANIMAL HOST, MAKING WEAPONIZATION OF THE VIRUS

UNLIKELY.

BIOTERRORISM

THE POSSIBILITY OF A DELIBERATE OUTBREAK IN EAST AFRICA IS

A GLOBAL HEALTH AND SECURITY ISSUE

“TERRORISTS COULD HARNESS THE VIRUS AS A POWDER, LOAD

IT INTO A BOMB, AND THEN EXPLODE THE BOMB IN A HIGHLY

POPULATED AREA. IT COULD CAUSE A LARGE NUMBER OF

HORRIFIC DEATHS.“ - PETER WALSH

"THE THING ABOUT EBOLA IS THAT IT'S NOT EASY TO WORK

WITH, IT WOULD BE DIFFICULT TO WEAPONIZE.“ - DR. ROBERT

LEGGIADRO

CREDIT

• HTTP://WWW.WHO.INT/MEDIACENTRE/FACTSHEETS/FS103/

EN/

• HTTP://WWW.CDC.GOV/VHF/EBOLA/

• HTTP://WWW.DOCTORSWITHOUTBORDERS.ORG/OUR-

WORK/MEDICAL-ISSUES/EBOLA