This document discusses Ebola hemorrhagic fever (EHF), a severe and often fatal viral disease in humans. It is caused by Ebola virus, which belongs to the filovirus family. The virus is transmitted through direct contact with body fluids of infected humans or animals. Symptoms include fever and internal and external bleeding. There is currently no approved vaccine or treatment, though isolation and supportive care are used. Outbreaks have occurred in several African countries, with person-to-person transmission driving spread. Protective equipment and strict isolation protocols are necessary to prevent further transmission in healthcare settings. More research is still needed to understand disease ecology and develop medical countermeasures.

1. EBOLA Haemorrhagic Fever
DR.SATTI MOHAMMED SALEH
MEEQAT HOSPITAL MEDICAL DIRECOR
INFECTION CONTROL DIRECTOR
CBAHI SIT MEMBER

3. What are viral hemorrhagic fevers?
(VHFs) refer to a group of illnesses that are
caused by several distinct families of viruses.
In general, the term "viral hemorrhagic
fever" is used to describe a severe
multisystem syndrome (multisystem in that
multiple organ systems in the body are
affected). Characteristically, the overall
vascular system is damaged, and the body's
ability to regulate itself is impaired

4. CLASSIFICATION OF VIRAL HEMORRHAGIC FEVER ACCORDING TO MODES OF
TRANSMISSION
ETIOLOGICAL VIRUSDISEASESMODE OF
TRANSMISSION
Yellow fever
Dengue types 1-4
Chikunguny a rift
valley fever
Yellow fever
Dengue fever
Chikunguny a
hemorrhagic fever
Mosquito borne
Congo-Crimean
hemorrhagic fever
kyasanur forest
disease Omsik
hemorrhagic fever
Crimean hemorrhagic
fever kyasanur forest
disease a Omsk
hemorrhagic disease
Tick borne
Junin
Machupo
Lassa
Argentine hemorrhagic fever
Bolivian hemorrhagic
fever- Lassa fever
Zoonotic
Hanta an
Marburg
Ebola
Korean hemorrhagic
fever
Marburg virus disease
Ebola virus disease
Unknown

5. Filoviridae
(Ebola, Marburg)
Arenaviridae
(Lassa, Junin, Machupo, Guanarito)
Bunyaviridae
(CCHF, RVF,
Hantaviruses)
Viral Haemorrhagic Fevers
Flaviviridae
(dengue, yellow fever,
TBE encephalitides)
Enveloped
RNA viruses

6. • Ebola hemorrhagic fever (Ebola HF)
is one of numerous Viral
Hemorrhagic Fevers. It is a severe,
often fatal disease in humans and
nonhuman primates (such as
monkeys, gorillas, and chimpanzees).

7. Ebola Virus
(Filoviridae Family)
3Genere
1- Ebola Virus
2- Marburgvirus
3- Cuevasirus ( NEW

8. Ebola Virus Genus Consists of
5 species
• 1- Zaire
• 2- Sudan
• 3- Reston
• 4- Taiforest
• 5- Bundibugyo( New)

9. reservoir
•The natural host of ebola viruses, and the
manner in which transmission of the virus to
humans occurs, remain unknown. This makes
risk assessment in endemic areas difficult.
With the exception of several laboratory
contamination cases (one in England and two
in Russia), all cases of human illness or death
have occurred in Africa; no case has been
reported in the United States.

11. All filoviruses are classified as :
• All filoviruses are classified as :
• Category A select agent pathogens in USA
• 1- Easily transmitted between Humans
• 2- Cause High Mortality ( 40-90%)
• 3- Potential for Major Public Health Impact
• 4- High public panic and disruption
• 5- Concern for use as Bioterror weapon

12. Need BSL for LAB to provide highest
level of protection for both lab
workers and environment

13. Epidemiology :
• MURBURG HF ( first filovirus ) In
Germany and Yugoslavia 1967
• From primates imported from Uganda
31 cases, 23% mortality
• Largest outbreak of MURBURG in
Angola 2005, 250 cases 90% mortality

14. large outbreak
• Ebola HF first 2 large outbreak
simultaneously 1976
• Democratic Republic of Congo
• Southern Sudan
• Caused by 2 separate species ;
• Zaire ( EBOV) and Sudan ( SUDV)

15. Other 3 species of EBOLA : ( TAI,
RESTON, BUNDIBUGYO
• )
• Occurred less frequently
• TAI only single non fatal infection )
• (AUTOPSY OF DEAD CHIMPANZEES)

16. • A host of similar species is probably associated
with Reston virus, which was isolated from
infected cynomolgous monkeys imported to
the United States and Italy from the
Philippines. Several workers in the Philippines
and in US holding facility outbreaks became
infected with the virus, but did not become ill.

17. Transmission and Pathogenesis and
Pathology
• Spread by close contact with sick patients
• Virus containing bodily fluids Includes
• *Blood * Semen
• * Vomitus *Breast milk
• *Saliva *Tears
• *Stool

18. Transmission Requires
• Close contact with blood, body fluid and
mucous Membranes Exposure
• No true Aerosol transmission
• No transmission in asymptomatic
patients during incubation Period

19. Severe Diseases Attributed to
• :
• 1- Rapid Viral Replication
• 2- Host immune suppression
• 3- Vascular Dysfunction

20. Incubation period
• 2-21 days.
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22. Case definition-WHO/CDC
Anyone presenting with fever and signs of bleeding such as:
• • Bleeding of the gums
• • Bleeding from the nose
• • Red eyes
• • Bleeding into the skin (purple coloured patches in the skin)
• • Bloody or dark stools
• • Vomiting blood
• • Other unexplained signs of bleeding
• Whether or not there is a history of contact with a suspected
case of EHF.
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23. OR Anyone living or deceased with:
• Contact with a suspected case of EHF AND
• A history of fever, with or without signs of bleeding.
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24. • OR
• Any unexplained death in an area with suspected cases of
EHF.
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25. Lab findings
• Leucopenia.
• Thropocytopenia.
• Elevated liver enzymes.
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26. Lab diagnosis
• Specific antigen detection.
• Viral gene detection.
• Antibodies detection (IgM for recent infection).
• Viral isolation (BSL-4 Lab.).
• Non-invasive methods of detection (saliva and urine sample).
• Postmortem by immunohistochemical exam. Of skin or
autopsy specimen.
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27. Therapy
• No specific ttt
• No vaccine
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28. Containment
• Isolate suspected cases from other patients.
• Tracing and follow up people exposed to Ebola cases.
• Health staff Orientation and using PPE.
• Health staff Precaution for invasive technique and body
secretions.
• Inform public about disease nature and burial of deceased.
• Strict surveillance of contacts.
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29. Patient Placement
•Single patient room (containing a private
bathroom) with the door closed
•Facilities should maintain a log of all persons
entering the patient's room
•Consider posting personnel at the patient’s
door to ensure appropriate and consistent use
of PPE by all persons entering the patient
room

30. Personal Protective Equipment (PPE)
•All persons entering the patient room should wear at least:
–Gloves
–Gown (fluid resistant or impermeable)
–Eye protection (goggles or face shield)
–Facemask
•Additional PPE might be required in certain situations (e.g.,
copious amounts of blood, other body fluids, vomit, or
feces present in the environment), including but not limited
to:
–Double gloving
–Disposable shoe covers
–Leg coverings

31. Challenges
• Additional diagnostic tools.
• Ecological investigations and possible reservoirs.
• Monitor suspected cases to determine disease incidence.
• Natural reservoirs and how virus spread.
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33. THANK YOU
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