SOURAV PANDA | Roll
No - 40 |
BIOLOGY
INVESTIGATORY
PROJECT
ON RECENT DISEASES - EBOLA
Ebola Proteins
Initial symptoms are nonspecific - may
include fever, chills, myalgias, and
Symptoms of Ebola
malaise.
Patients can progress to develop
gastrointestinal symptoms:
severe watery diarrhea, nausea,
vomiting, abdominal pain
Other symptoms:
chest pain, shortness of breath,
headache or confusion, conjunctival
injection, hiccups, seizures, and
cerebral edema
Bleeding not universally present but
can manifest later as petechiae,
ecchymosis/ bruising, or oozing. Frank
hemorrhage less common.
Some develop diffuse erythematous
maculopapular rash that can
desquamate.
Source: Centers for Disease Control and Prevention.
http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html
Accessed Oct. 14, 2014
Diagonosis Of Ebola
Diagnosing Ebola can be difficult at first
since early symptoms, such as fever, are
nonspecific to Ebola infection.
However, if a person has the early
symptoms and has had contact with Ebola
they should be isolated and public health
professionals notified.
Samples from the patient can then be
collected and tested to confirm infection.
Treatment of Ebola
There are no approved treatments available for
EVD.
Clinical management focus - supportive care of
complications:
Hypovolemia , electrolyte abnormalities,
hematologic abnormalities, refractory
shock, hypoxia, hemorrhage, septic shock,
multi-organ failure, and DIC.
Recommended care includes:
volume repletion
maintenance of blood pressure (with
vasopressors if needed)
maintenance of oxygenation
pain control
nutritional support
treating secondary bacterial infections and
pre-existing comorbidities
Among patients from West Africa, large
volumes of intravenous fluids have often been
required to correct dehydration due to diarrhea
and vomiting.
Several investigational therapeutics for Ebola
virus disease are in development. There are no
approved vaccines available for EVD. Several
Source: Centers for Disease Control and Prevention.
investigational Ebola vaccines are in
http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html
Accessed Oct. 14, 2014
Index
Ebola: Upcoming Future Epidemic
Epidemiology
Ebola Subtypes
Molecular Structure And Characteristic Features
Transmission Of Ebola
Symptoms Of Ebola
Diagnosis Of Ebola
Treatment Of Ebola
Checklist For Infected Ebola Virus Disease(EVD)
Sequence Of Putting On Personal Protective
Equipment(PPE)
Ebola: Upcoming
Future Epidemic
The Ebola virus is a lipid
enveloped virus in the family
Filoviridae. Members of this
family also include Marburg,
Lassa, and other viruses that
cause hemorrhagic fever, a
group of illnesses that damage
the vascular system and in
severe cases, lead to bleeding
under the skin, in internal
organs or from body orifices
(e.g. mouth, eyes and ears)1.
Infection with the Ebola virus is
now referred to as: Ebola virus
disease (EVD)2. There is a
diagnostic test to determine if
the patient has EVD. There is no
current FDA approved effective
medication or treatment for
those who become infected with
Ebola other than supportive
hydration, electrolyte balancing
and oxygen. The death rate of
those infected is between 50-
90%. There is no vaccine or
preventative treatment.
TRANSMISSION OF
EBOLA
Person-to-person transmission occurs by very
close personal contact with an infected
individual or with their body fluids during the
late stages of infection or after their death 3,4.
During the care of an infected individual,
spread of the virus can occur through
contact with infected body fluids on the
patient, on their clothes or bedding, on
surfaces such as bedrails, side tables, the
floor, or on reused unsterilized syringes,
needles, thermometers or other virus-
contaminated medical equipment. Humans
may also be infected by handling sick or dead
non-human primates and are also at risk
when handling the bodies of deceased
humans in preparation for funerals 5,6.
Virus containing body fluids from individuals
infected with the Ebola virus:
Blood
Breast milk
Organs and tissues
Saliva
Semen
Stool
Sweat
Urine
Vaginal secretions
Vomit
Amniotic fluid (possibly)
Note: Ebola virus has been isolated from
semen 61 days after the initial symptoms of
infection appear. Transmission through
semen has occurred 7 weeks after clinical
recovery
Incubation period: It requires 2 to 21 days
(more often 4-9 days) before symptoms of
infection occur. The infected individual is not
contagious until symptoms appear.
Hemorrhage begins to present 4-5 days after
general symptom onset
Survival outside the body: The virus can
survive and remain infective in liquid or dried
material at room temperature for a number of
days 10 or at 39F (4C) for several days, and is
indefinitely stable at -70C. Infectivity can be
preserved by lyophilization (freeze-drying)
How Ebola enters the body: Intact skin is a
barrier, but scratches, cuts (large or tiny),
rashes, and abrasions, ruin the barrier
integrity and become routes for viral entry.
Additionally, Ebola virus can enter the body
through mucosal tissues after being
deposited by contaminated fluids through
physical contact, splashes, splatters, sprays,
or possibly aerosols. Mucosal tissues include
the eyes, mouth, throat, lungs inside of nose,
vaginal tissues, intestines, and urinary tract
Most common symptoms reported
during current outbreak:
fever (87%)
fatigue (76%)
vomiting (68%)
diarrhea (66%)
loss of appetite (65%)
Patients with fatal disease develop
more severe clinical signs early
during infection and die between
days 6 - 16 of complications (mean
of 7.5 days).
In non-fatal cases, patients may
have fever for several days and
improve, around day 6.
The case fatality proportion in West
Africa is about 71%
Ebola Subtypes
Ebola-Zaire
Ebola-Zaire
(ZEBOV) (ZEBOV)
Ebola- Ebola-Sudan
Sudan (SEBOV)
Ebola Ivory-
(SEBOV)
Coast (ICEBOV)
Ebola Ebola-Reston
Ivory-Coast (REBOV)
(ICEBOV)
Ebola-Reston
(REBOV)
MOLECULAR STRUCTURE
Characterization of the
virus
Order: Mononegavirales
Family: Filoviridae
Genus: Ebolavirus
Species: Ebola-Zaire, Ebola-Sudan,
Ebola-Cote d-Ivoire, Ebola-Reston
Morphology under
electron microscope
filamentous, enveloped RNA virus
approx. 19 kb in length (1 kb =
1000 RNA
bases/nucleotides) or 60-80 nm in
diameter
single-stranded, linear, non-
segmented
negative-sense RNA (encoded in a
3 to 5 direction)
appears to have spikes due to
glycoprotein on outside membrane
Structure of Ebola
genome and proteins
Transcribed into 8 sub-genomic
mRNA proteins: 7 structural and 1
nonstructural
7 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 &
replication
VP40, GP, VP24: associated
with the membrane
Epidemiol
ogy
First Known Case Of
Ebola
August 26, 1976 in Yambuku, a town in the
north of Zare.
A 44-year-old school teacher returned from a
small hike. His went to the doctor and because
of his high fever they gave him a quinine shot
which is good against malaria.
A week later, he had uncontrolled vomiting,
bloody diarrhea, trouble breathing and then
bleeding from his nose, mouth, and anus.
--It struck two countries within that year
--a. Sudan in a town called Nzara
b. 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
