Mariano Marcos State UniversityBatac City, Ilocos Norte

College of Health SciencesDepartment of Nursing

A

REPORT

ON

EBOLA VIRUS

Submitted by:

John Lester Fernandez Charlimagne Gonzales

BSN II-B

Submitted to:

Prof. Rosemarie Asuncion

September 2015

The Ebola Virus

The Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a

severe, often fatal illness in humans.

It causes an acute, serious illness which is often fatal if untreated.

Researchers named the disease after the Ebola River.

Ebola appeared in Africa only.

The average EVD case fatality rate is around 50%. Case fatality rates have varied from

25% to 90% in past outbreaks.

The first EVD outbreaks occurred in remote villages in Central Africa, near tropical

rainforests, but the most recent outbreak in West Africa has involved major urban as well

as rural areas.

Community engagement is key to successfully controlling outbreaks.

Good outbreak control relies on applying a package of interventions, namely case

management, surveillance and contact tracing, a good laboratory service, safe burials and

social mobilization.

Early supportive care with rehydration, symptomatic treatment improves survival.

There is as yet no licensed treatment proven to neutralize the virus but a range of blood,

immunological and drug therapies are under development. There are currently no

licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.

Causative Agent

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. 

There are five identified Ebola virus species, four of which are known to cause disease in

humans:

Ebola virus (Zaire ebolavirus);

Sudan virus (Sudan ebolavirus);

Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus);

and Bundibugyo virus (Bundibugyo ebolavirus).

The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates,

but not in humans.

The Zaire virus, since it was first recognized in 1976, has caused multiple large outbreaks

in Central Africa, with mortality rates ranging from 55 to 88 percent. It is the causative

agent of the West African epidemic.

The Sudan virus has been associated with a case-fatality rate of approximately 50 percent

in four epidemics: two in Sudan in the 1970s, one in Uganda in 2000, and another in

Sudan in 2004.

The Ivory Coast virus has only been identified as the cause of illness in one person, and

that individual survived. The exposure occurred when an ethnologist performed a

necropsy on a chimpanzee found dead in the Tai Forest, where marked reductions in the

great ape population had been observed.

The Bundibugyo virus emerged in Uganda in 2007, causing an outbreak of Ebola virus

disease with a lower case-fatality rate (approximately 30 percent) than is typical for the

Zaire and Sudan viruses. Sequencing has shown that the agent is most closely related to

the Ivory Coast species.

The fifth Ebola species, the Reston virus, differs markedly from the others, because it is

apparently maintained in an animal reservoir in the Philippines and has not been found in

Africa.

The Ebola Reston virus was discovered when it caused an outbreak of lethal infection in

macaques imported into the United States in 1989. Three more outbreaks occurred among

nonhuman primates in quarantine facilities in the United States and Europe before the

Philippine animal supplier ceased operations. None of the personnel who were exposed to

sick animals without protective equipment became ill, but several animal caretakers

showed evidence of seroconversion.

2008 nothing further was heard of the Reston virus, when the investigation of an outbreak

of disease in pigs in the Philippines unexpectedly revealed that some of the sick animals

were infected both by an arterivirus (porcine reproductive and respiratory disease virus)

and by Ebola Reston virus.

Characteristics of the virus

Ebola virus belongs to the order Mononegavirales and the family Filoviridae

a taxonomic group of non-segmented, enveloped and negative-strand RNA viruses.

Particles of these viruses have a characteristic filamentous appearance that gives the

virus family its name.

Their diameter is uniform at 80 nm, but particle length can be quite variable and up to

14 000 nm.

The genome of the virus consists of seven genes that code for nucleoprotein,

glycoprotein, virion protein (VP) 24, VP30, VP35, VP40 and RNA-dependent RNA

polymerase.

With the exception of the glycoprotein gene, all aforementioned genes are

monocistronic, which means that they encode for only one structural protein.

Production of a soluble glycoprotein (i.e. protein that contains covalently attached

sugar residues) is an important distinction of Ebola virus from other viruses in the

order. This major pathogenicity factor gets secreted from infected cells in large

quantities, facilitating further viral entry by binding to the receptor present on the host

cells.

Portal of Exit

Ebola leaves its reservoir by contact with body

fluids of an infected animal, often by bush meat

hunters.

Portal of Entry

Ebola enters the human body through breaks in the skin, including micro-abrasions and

splashes on mucus membranes.

Personal protective equipment (PPE)

includes full body coverage including

hood, mask or face shield, a tight

fitting respirator, boots or shoe

coverings, and double gloving.

Removing PPE is a point of frequent

contamination and should be done

with help from another robed person.

Source of Infection and Mode of Transmission

Unlike other types of viruses, Ebola

can’t be transmitted through the air or

by touch alone.

You must have direct contact with the bodily fluids of someone who has it.

The virus may be transmitted through: blood, diarrhea, breast milk, feces, saliva,

semen, sweat, urine, and vomit.These bodily fluids can all carry the Ebola virus.

Transmission can occur via the eyes, nose, mouth, broken skin, or sexual contact.

Healthcare workers are especially at risk for contracting Ebola because they often

deal with blood and bodily fluids.

Other risk factors include: exposure to infected objects, such as needles, interactions

with infected animals, attending burial ceremonies of someone who has died from

Ebola, and traveling to areas where a recent outbreak has occurred.

Incubation Period

The incubation period --the period between contact with the virus and the

appearance of symptoms -- ranges from 2 to 21 days.

Pathognomonic

Pathognomonic sign is a sign or symptom specific to a certain disease. Since

Ebola does NOT have this, lab tests such as the enzyme-linked imunosorbent

assay are the best way to confirm if a person has Ebola.

Susceptible host

susceptible host refers to an individual not possessing sufficient immunity against

a particular infectious agent to prevent contracting an infection when exposed to

an infectious agent.

A susceptible host must be exposed to an infectious agent/infected source in a

manner that will enable the acquisition of an infection.

There is a new and strongly implicates that bats as the reservoir host for

ebolavirus.

It is thought that fruit bats of the Pteropodidae

family are natural Ebola virus hosts.

The virus came from the bats are transfer to other

animal like chimpanzees, forest antelopes, gorillas,

monkeys, porcupines, rats and deer.

The virus is known as a zoonotic virus because

it’s transmitted to humans from animals.

Since people may handle these infected animals,

the virus can be transmitted via the animal’s blood

and body fluids.

Humans can also transfer the virus to each other.

Health workers have a high risk of getting infected with Ebolavirus if they are not

wearing correct personal protective equipment or are not applying infection

prevention and control measures when caring for patients.

Family members or others in close contact with infected people have a high risk

of acquiring this disease same thru with mourners who have direct contact with

bodies during burial rituals because the virus is in the body even the patient was

dead already it is capable of spreading the microorganism if you contact with the

body fluids and discharges of the patient.

Ebolavirus reservoir and susceptible host

Signs and Symptoms

After two to 21 days of

incubation symptoms may

appear, on average symptoms

appear within 8 to 10 days.

Take note that humans are not

infectious until they develop

symptoms.

The early symptoms of Ebola is common and non-specific it can be also present

in some diseases and this includes:

Abrupt fever

Headache

Weakness

Vomiting

Diarrhea

Stomach discomfort

Decrease appetite

Joint and muscle discomfort

As the disease progresses the

patient may develop other signs

and symptoms such as: 

rashes

Eye redness

Hiccups

Sore throat

Cough

Chest pain

Bleeding both inside and

outside the body (for example, mucosal surfaces, eyes)

Difficulty breathing and swallowing

Image of Ebola victims

Drug of choice

This illness is very lethal to the condition of every person in the world.

Take note there is no FDA-approved vaccine or medicine is available for Ebola.

Experimental vaccines and treatments for Ebola are under development, but they have

not yet been fully tested for safety or effectiveness.

But although there is no drugs and any form of vaccine that can defend us against this

virus early treatment to avoid further complication.

People who recover from Ebola infection develop antibodies that last for at least 10

years, possibly longer.

The body produces Ebola-fighting antibodies in response to the virus. So the idea is to

purify the blood, extract the antibodies and give those to sick patients.

Nursing Care 

There is no cure for Ebola but if early treatment and interventions are given to the victims

there is a chance of surviving this fatal disease.

Nurses play vital role in direct care for patients with Ebola, shaping health policy, and

raising awareness about the deadly virus.

Providing intravenous hydration and oral nutrition, managing diarrhea and nausea,

cleaning and feeding patients, and monitoring their overall status.

Recommended care includes:

volume repletion,

maintenance of blood pressure (with vasopressors if needed),

maintenance of oxygenation,

pain control,

nutritional support,

and treatment of secondary bacterial infections and pre-existing comorbidities.

Among patients medically evacuated from West Africa with EVD, large volumes

of intravenous fluids often have been required to correct dehydration due to

diarrhea and vomiting.

Protect all areas of petechiae and echymoses for further injury.

Watch for any changes in the patient’s respiration rate and pattern.

Closely monitor the patient’s fluid and electrolyte imbalance.

Monitor intake and output.

Check the results of complete blood count and coagulation studies for signs of

blood loss and coagulopathy.

Test stools, urine and vomitus for occult blood; watch for frank bleeding.

Teach the patient’s family about ebola virus infection.

Monitor the patient’s family and other close contacts for fever and other signs of

infections.

Explain the importance of reporting any signs of bleeding.

Explain the purpose of any diagnostic tests and procedures that the patient may

undergo.

Nursing Problem

Social isolation related to to altered state of wellness

Imbalance nutrition less than body requirement related to diarrhea and vomiting.

Impaired mobility related muscle and joint pain

Impaired breathing related to  involuntary contractions of the diaphragm muscle