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PRESENTED BY
S.SHIVA SHIVANI
08DQ1R0045
JBRPC
CONTENTS
 INTRODUCTION
 EPIDEMIOLOGY
 CLASSIFICATION OF THE VIRUS
 MORPHOLOGY UNDER ELECTRON MICROSCOPE
 PATHOPHYSIOLOGY
 SYMPTOMS
 MODE OF TRANSMISSION
 RISK FACTOR
 DIAGNOSIS AND IDENTIFICATION
 PREVENTION AND CONTROL
 PROGNOSIS
 TRATMENT
INTRODUCTION
WHAT IS EBOLA?
 Ebola is the most lethal virus known to man.
 Ebola hemorrhagic fever is a very contagious illness that is often fatal in
humans and nonhuman primates (monkeys, gorillas, and
chimpanzees).
 It kills 50 to 90 percent of the infected personnel, compared to Anthrax’s
25 percent.
 Outbreaks occurred all over central Africa.
 Believed to be primate deadly. Monkeys have infected many doctors,
scientists, and monkey care handlers.
EPIDEMIOLOGY
 Ebola Hemorrhagic Fever was first found in 1976
 It struck two countries within that year
 Sudan – in a town called N’zara
 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.
CLASSIFICATION OF THE VIRUS
 Order: Mononegavirales
 Family: Filoviridae
 Genus: Ebolavirus
 Ebola virus is one of two members of a family of RNA viruses called the
Filoviridae. There are four identified subtypes of Ebola virus. Three of
the four have caused disease in humans:
 Four types of strains they are:
• Ebola-zaire
• Ebola-sudan
• Ebola-cote ‘d-Ivoire
• Ebola-reston
MORPHOLOGY UNDER ELECTRON
MICROSCOPE
 Single stranded , linear, non-segmented
Negative-sense RNA (encoded in a 3’-5’ direction)
Coiled RNA in spike-covered envelope from host cell
Therefore ,spreads rapidly.
 appears to have “spikes” due to glycoprotein on
outside membrane
PATHOPHYSIOLOGY
 Endothelial cells, mononuclear phagocytes, and hepatocytes are the
main targets of infection.
 The GP forms a trimeric complex, which binds the virus to the
endothelial cells lining the interior surface of blood vessels. The sGP
forms a dimeric proteins which interferes with the signaling of white
blood cell.
 These white blood cells also serve as carriers to transport the virus
throughout the entire body to places such as the lymph nodes, liver,
lungs, and spleen.
SYMPTOMS
 Incubation period: 2-21 day
 Sudden onset of fever
 Intense weakness
 Muscle pain
 Headache and sore throat
 Impaired kidney and liver function
MODE OF TRANSMISSION
 Transmission:
• Unsterilized needles
• Suboptimal hospital condition
• Personal contact
• Transmitted through body fluids, secretions
• Ebola-Reston has shown to be air borne.
RISK FACTORS
 Antibodies against Ebola
 Ebola Gene sequences in liver and spleen
 Fruit bats do not show any symptoms
 Best candidate to be the reservoir
 More research needs to be done.
DIAGNOSIS AND IDENTIFICATION
 Clinical diagnosis:-
• Difficult because early symptoms
(red eye,skin rash) are nonspecific to virus
• Takes a combination of many symptoms characteristic of Ebola.
 Laboratory testing/Diagnosis:-
• Antigen-capture enzyme-linked immunosorbent assay(ELISA)
IgM ELISA test
• polymerase chain reaction (PCR)-a DNA test to match the DNA from
the sample to known Ebola DNA
• All done with in a few days of onset of symptoms.
DIAGNOSIS AND IDENTIFICATION
 Advance testing :
• Test for IgM and IgG antibodies.
 Immunohisto chemisty testing
• Virus Isolation
• PCR
 Immunofluorescence assays are used to confirm Ebolavirus presence
in cell cultures.
PREVENTION AND CONTROL
 Hospitals must follow precautionary method such as:
• Wearing gloves
• Isolating infected individuals
• Practicing nurse barrier technique
• Proper sterilization and disposal of all equipment
• Burials must be done correctly
• No washing or touching carcass
• Put into body bags and bury outside city.
PREVENTION AND CONTROL
• Due to the extreme biohazard, doctors must wear Level 4 containment
suits. They are the equivalence of a spacesuit.
• Some poor African towns put the diseased in a straw hut, and then
burn it down when they’re dead. Simple yet effective.
PROGNOSIS
 As the Ebola virus is of the most deadly illnesses known to humankind,
ebola virus patients have little chance of surviving. The definitive
prognosis of the Ebola virus is death, and as many as 90% of people
afflicted with the disease die from the shock that it causes to the body.
 Morbidity and mortality rates are very high, and they vary with the
strain of Ebola. The most highly lethal Ebola subtype is EBO-Z, which
has been reported to have a mortality rate as high as 88%.TheEBO-
S subtype has a reported mortality rate of 50%.
TREATMENT
 THERE IS NO CURE FOR EBOLA HF
• Care of Infected Person.
• Oxygen and devices that help with breathing
• Antibiotics to prevent secondary infections from bacteria
• Medications to control fever, help the blood clot, and maintain blood pressure
Intravenous (IV) fluids to maintain fluids and electrolytes (sodium,potassium,
and chloride)
• Good nursing care, Bleeding problems may require transfusions of platelets or fresh
blood.
 EXPERIMENTAL TREATMENT:
In the Kikwit outbreak in DRC, doctors transmitted blood from survivors
to sufferers, hoping to transmit whatever antibodies helped them survive.
FUTURE OUT LOOKS
A study released in December of 2003 showed that researchers studying
infected monkeys have found a way to increase survival rates
100% of infected monkeys had been dying
These were injected with rNAPc2, a factor known to inhibit blood
coagulation, a characteristic of Ebola HF
33% of these monkeys survived and regained health. All untreated monkeys
died.
rNAPc2 is known to be relatively safe in humans – this method is being
studied further
REFERENCES
 www.wikipidea.com
 ^ a b c d e f Kuhn, Jens H.; Becker, Stephan; Ebihara , Hideki; Geisbert, Thomas W.;
Johnson, Karl M.; Kawaoka , Yoshihiro; Lipkin, W. Ian; Negredo, Ana I et al.
(2010). "Proposal for a revised taxonomy of the family Filoviridae: Classification, names
of taxa and viruses, and virus abbreviations". Archives of Virology 155 (12): 2083–
103. doi:10.1007/s00705-010-0814-x. PMC 3074192. PMID 21046175.
 ^ Netesov, S. V.; Feldmann, H.; Jahrling, P. B.; Klenk, H. D.; Sanchez, A. (2000), "Family
Filoviridae", in van Regenmortel, M. H. V.; Fauquet, C. M.; Bishop, D. H. L. et al., Virus
Taxonomy—Seventh Report of the International Committee on Taxonomy of Viruses, San
Diego, USA: Academic Press, pp. 539-48, ISBN 0123702003
 ^ Pringle, C. R. (1998). "Virus taxonomy-San Diego 1998". Archives of Virology 143 (7):
1449–59. PMID 9742051.
 ^ Feldmann, H.; Geisbert, T. W.; Jahrling, P. B.; Klenk, H.-D.; Netesov, S. V.; Peters, C. J.;
Sanchez, A.; Swanepoel, R. et al. (2005), "Family Filoviridae", in Fauquet, C. M.; Mayo, M.
A.; Maniloff, J. et al., Virus Taxonomy—Eighth Report of the International Committee on
Taxonomy of Viruses, San Diego, USA: Elsevier/Academic Press, pp. 645-
653, ISBN 0123702003
 ^ Mayo, M. A. (2002). "ICTV at the Paris ICV: results of the plenary session and the
binomial ballot". Archives of Virology 147 (11): 2254–60.
Ebola virus (Ebola Hemorrhagic Fever) by S Shivani Shastrulagari
Ebola virus (Ebola Hemorrhagic Fever) by S Shivani Shastrulagari

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Ebola virus (Ebola Hemorrhagic Fever) by S Shivani Shastrulagari

  • 1.
  • 3. CONTENTS  INTRODUCTION  EPIDEMIOLOGY  CLASSIFICATION OF THE VIRUS  MORPHOLOGY UNDER ELECTRON MICROSCOPE  PATHOPHYSIOLOGY  SYMPTOMS  MODE OF TRANSMISSION  RISK FACTOR  DIAGNOSIS AND IDENTIFICATION  PREVENTION AND CONTROL  PROGNOSIS  TRATMENT
  • 4. INTRODUCTION WHAT IS EBOLA?  Ebola is the most lethal virus known to man.  Ebola hemorrhagic fever is a very contagious illness that is often fatal in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).  It kills 50 to 90 percent of the infected personnel, compared to Anthrax’s 25 percent.  Outbreaks occurred all over central Africa.  Believed to be primate deadly. Monkeys have infected many doctors, scientists, and monkey care handlers.
  • 5. EPIDEMIOLOGY  Ebola Hemorrhagic Fever was first found in 1976  It struck two countries within that year  Sudan – in a town called N’zara  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.
  • 6. CLASSIFICATION OF THE VIRUS  Order: Mononegavirales  Family: Filoviridae  Genus: Ebolavirus  Ebola virus is one of two members of a family of RNA viruses called the Filoviridae. There are four identified subtypes of Ebola virus. Three of the four have caused disease in humans:  Four types of strains they are: • Ebola-zaire • Ebola-sudan • Ebola-cote ‘d-Ivoire • Ebola-reston
  • 7. MORPHOLOGY UNDER ELECTRON MICROSCOPE  Single stranded , linear, non-segmented Negative-sense RNA (encoded in a 3’-5’ direction) Coiled RNA in spike-covered envelope from host cell Therefore ,spreads rapidly.  appears to have “spikes” due to glycoprotein on outside membrane
  • 8. PATHOPHYSIOLOGY  Endothelial cells, mononuclear phagocytes, and hepatocytes are the main targets of infection.  The GP forms a trimeric complex, which binds the virus to the endothelial cells lining the interior surface of blood vessels. The sGP forms a dimeric proteins which interferes with the signaling of white blood cell.  These white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.
  • 9.
  • 10. SYMPTOMS  Incubation period: 2-21 day  Sudden onset of fever  Intense weakness  Muscle pain  Headache and sore throat  Impaired kidney and liver function
  • 11. MODE OF TRANSMISSION  Transmission: • Unsterilized needles • Suboptimal hospital condition • Personal contact • Transmitted through body fluids, secretions • Ebola-Reston has shown to be air borne.
  • 12. RISK FACTORS  Antibodies against Ebola  Ebola Gene sequences in liver and spleen  Fruit bats do not show any symptoms  Best candidate to be the reservoir  More research needs to be done.
  • 13. DIAGNOSIS AND IDENTIFICATION  Clinical diagnosis:- • Difficult because early symptoms (red eye,skin rash) are nonspecific to virus • Takes a combination of many symptoms characteristic of Ebola.  Laboratory testing/Diagnosis:- • Antigen-capture enzyme-linked immunosorbent assay(ELISA) IgM ELISA test • polymerase chain reaction (PCR)-a DNA test to match the DNA from the sample to known Ebola DNA • All done with in a few days of onset of symptoms.
  • 14. DIAGNOSIS AND IDENTIFICATION  Advance testing : • Test for IgM and IgG antibodies.  Immunohisto chemisty testing • Virus Isolation • PCR  Immunofluorescence assays are used to confirm Ebolavirus presence in cell cultures.
  • 15. PREVENTION AND CONTROL  Hospitals must follow precautionary method such as: • Wearing gloves • Isolating infected individuals • Practicing nurse barrier technique • Proper sterilization and disposal of all equipment • Burials must be done correctly • No washing or touching carcass • Put into body bags and bury outside city.
  • 16. PREVENTION AND CONTROL • Due to the extreme biohazard, doctors must wear Level 4 containment suits. They are the equivalence of a spacesuit. • Some poor African towns put the diseased in a straw hut, and then burn it down when they’re dead. Simple yet effective.
  • 17. PROGNOSIS  As the Ebola virus is of the most deadly illnesses known to humankind, ebola virus patients have little chance of surviving. The definitive prognosis of the Ebola virus is death, and as many as 90% of people afflicted with the disease die from the shock that it causes to the body.  Morbidity and mortality rates are very high, and they vary with the strain of Ebola. The most highly lethal Ebola subtype is EBO-Z, which has been reported to have a mortality rate as high as 88%.TheEBO- S subtype has a reported mortality rate of 50%.
  • 18. TREATMENT  THERE IS NO CURE FOR EBOLA HF • Care of Infected Person. • Oxygen and devices that help with breathing • Antibiotics to prevent secondary infections from bacteria • Medications to control fever, help the blood clot, and maintain blood pressure Intravenous (IV) fluids to maintain fluids and electrolytes (sodium,potassium, and chloride) • Good nursing care, Bleeding problems may require transfusions of platelets or fresh blood.  EXPERIMENTAL TREATMENT: In the Kikwit outbreak in DRC, doctors transmitted blood from survivors to sufferers, hoping to transmit whatever antibodies helped them survive.
  • 19. FUTURE OUT LOOKS A study released in December of 2003 showed that researchers studying infected monkeys have found a way to increase survival rates 100% of infected monkeys had been dying These were injected with rNAPc2, a factor known to inhibit blood coagulation, a characteristic of Ebola HF 33% of these monkeys survived and regained health. All untreated monkeys died. rNAPc2 is known to be relatively safe in humans – this method is being studied further
  • 20. REFERENCES  www.wikipidea.com  ^ a b c d e f Kuhn, Jens H.; Becker, Stephan; Ebihara , Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka , Yoshihiro; Lipkin, W. Ian; Negredo, Ana I et al. (2010). "Proposal for a revised taxonomy of the family Filoviridae: Classification, names of taxa and viruses, and virus abbreviations". Archives of Virology 155 (12): 2083– 103. doi:10.1007/s00705-010-0814-x. PMC 3074192. PMID 21046175.  ^ Netesov, S. V.; Feldmann, H.; Jahrling, P. B.; Klenk, H. D.; Sanchez, A. (2000), "Family Filoviridae", in van Regenmortel, M. H. V.; Fauquet, C. M.; Bishop, D. H. L. et al., Virus Taxonomy—Seventh Report of the International Committee on Taxonomy of Viruses, San Diego, USA: Academic Press, pp. 539-48, ISBN 0123702003  ^ Pringle, C. R. (1998). "Virus taxonomy-San Diego 1998". Archives of Virology 143 (7): 1449–59. PMID 9742051.  ^ Feldmann, H.; Geisbert, T. W.; Jahrling, P. B.; Klenk, H.-D.; Netesov, S. V.; Peters, C. J.; Sanchez, A.; Swanepoel, R. et al. (2005), "Family Filoviridae", in Fauquet, C. M.; Mayo, M. A.; Maniloff, J. et al., Virus Taxonomy—Eighth Report of the International Committee on Taxonomy of Viruses, San Diego, USA: Elsevier/Academic Press, pp. 645- 653, ISBN 0123702003  ^ Mayo, M. A. (2002). "ICTV at the Paris ICV: results of the plenary session and the binomial ballot". Archives of Virology 147 (11): 2254–60.