Ebola Virus Hemorrhagic Fever

Outbreaks1976- First Major Outbreak (ZEBOV)1976- Sudan (SEBOV)Occur Sporadicallywww.cdc.gov for more information

Where does Ebola hide?2002- Fruit BatsAntibodies against EbolaEbola Gene sequences in liver and spleenFruit bats do not show any symptomsBest candidate to be the reservoirMore research needs to be done

GeographyThe link between human infection by the Ebola virus and their proximity to primates is clear. -Outbreaks occurred in countries that house 80 percent of the worlds remaining wild gorilla and chimpanzee populations. - The outbreaks coincided with the outbreaks in wild animals. - The same distinct viral strains were isolated in animal carcasses and in the bodies of those who handled those carcasses. - These outbreaks were preceded by an abnormally large death in wild Gorilla populations.

Clinical Observations Incubation period: 2-21 days

Stage I (unspecific): -Extreme asthenia (body weakness) -diarrhea, nausea and vomiting, anorexia abdominal pain - headaches - arthralgia (neuralgic pain in joints) - myalgia (muscular pain or tenderness), back pain - mucosal redness of the oral cavity, dysphagia (difficulty in swallowing) - conjunctivitis. - rash all over body except in face

** If the patients dont recover gradually at this point, there is a high probability that the disease will progress to the second phase, resulting in complications which eventually lead to death (Mupapa et al., 1999).

Stage II (Specific): - Hemorrhage - neuropsychiatric abnormalities - anuria (the absence of urine formation) - hiccups - tachypnea (rapid breathing).

** Patients who progressed to phase two EHF almost always die. (Ndambi et al., 1999)

Late Complications: -Arthralgia - ocular diseases (ocular pain, photophobia and hyperlacrimation) - hearing loss - unilateral orchitis( inflammation of one or both of the testes) ** These conditions are usually relieved with the treatment of 1% atropine and steroids

Epidemiology

Ebola Hemorrhagic Fever was first found in 1976 It struck two countries within that yeara.Sudan in a town called Nzarab.Zaire, now known as the Democratic Republic of Congo In these two instances the mortality rate was between 50 90%Following those epidemics, Ebola hit Africa in many other instances the worst yet being in the year 2000 when it struck Uganda infecting more than 400 people.

Transmissioncontracted through contact of any infected individuals body fluids Ebola HF prevention poster used in Kikwit outbreak.

Controlling the spread of Ebola a. Hospitals must follow precautionary methods, such as: 1. wearing gloves 2. isolating infected individuals 3. practicing nurse barrier techniques 4. proper sterilization and disposal of all equipmentb. Burials must be done correctly 1. no washing or touching carcass 2. put into body bags and bury outside cityc. Report any questionable illness to officials

Ebola SubtypesEbola-Zaire (ZEBOV)Ebola-Sudan (SEBOV)Ebola Ivory-Coast (ICEBOV)Ebola-Reston (REBOV)

MOLECULAR STRUCTURECharacterization of the virusOrder: MononegaviralesFamily: FiloviridaeGenus: EbolavirusSpecies: Ebola-Zaire, Ebola-Sudan, Ebola-Cote d-Ivoire, Ebola-Reston

Morphology under electron microscopefilamentous, enveloped RNA virusapprox. 19 kb in length (1 kb = 1000 RNA bases/nucleotides) or 60-80 nm in diametersingle-stranded, linear, non-segmentednegative-sense RNA (encoded in a 3 to 5 direction)appears to have spikes due to glycoprotein on outside membrane

Structure of Ebola genome and proteinsTranscribed into 8 sub-genomic mRNA proteins: 7 structural and 1 nonstructural7 structural proteins:nucleoprotein (NP)4 viral/virion proteins (VP35, VP40, VP30, VP24)glycoprotein (GP)RNA-dependent RNA polymerase (L protein)NP, VP35, VP30, L protein: required for transcription & replicationVP40, GP, VP24: associated with the membrane

Proteins

EthicsBiogeograophical Ethics is defined as motivation based on ideas of right and wrong when dealing with the geographical distribution of animals and plants. This concept of can be used to explain the worlds shockingly small response to the Ebola Virus. Because there was little travel to that region by people of more developed countries, there was not much economic drive for a vaccine, treatment, and aid in prevention.

BioterrorismSince the September 11 bombings in the United States, the locality of this virus has become less isolated as the threat of bioterrorism looms large. The Ebola virus is now on the A list for hopeful vaccination development.Experiments have even been formed to show how Ebola can be used as a bioterror agent.