EBOLA Haemorrhagic Fever
DR.SATTI MOHAMMED SALEH
MEEQAT HOSPITAL MEDICAL DIRECOR
INFECTION CONTROL DIRECTOR
CBAHI SIT MEMB...
What are viral hemorrhagic fevers?
(VHFs) refer to a group of illnesses that are
caused by several distinct families of vi...
CLASSIFICATION OF VIRAL HEMORRHAGIC FEVER ACCORDING TO MODES OF
TRANSMISSION
ETIOLOGICAL VIRUSDISEASESMODE OF
TRANSMISSION...
Filoviridae
(Ebola, Marburg)
Arenaviridae
(Lassa, Junin, Machupo, Guanarito)
Bunyaviridae
(CCHF, RVF,
Hantaviruses)
Viral ...
• Ebola hemorrhagic fever (Ebola HF)
is one of numerous Viral
Hemorrhagic Fevers. It is a severe,
often fatal disease in h...
Ebola Virus
(Filoviridae Family)
3Genere
1- Ebola Virus
2- Marburgvirus
3- Cuevasirus ( NEW
Ebola Virus Genus Consists of
5 species
• 1- Zaire
• 2- Sudan
• 3- Reston
• 4- Taiforest
• 5- Bundibugyo( New)
reservoir
•The natural host of ebola viruses, and the
manner in which transmission of the virus to
humans occurs, remain u...
All filoviruses are classified as :
• All filoviruses are classified as :
• Category A select agent pathogens in USA
• 1- ...
Need BSL for LAB to provide highest
level of protection for both lab
workers and environment
Epidemiology :
• MURBURG HF ( first filovirus ) In
Germany and Yugoslavia 1967
• From primates imported from Uganda
31 cas...
large outbreak
• Ebola HF first 2 large outbreak
simultaneously 1976
• Democratic Republic of Congo
• Southern Sudan
• Cau...
Other 3 species of EBOLA : ( TAI,
RESTON, BUNDIBUGYO
• )
• Occurred less frequently
• TAI only single non fatal infection ...
• A host of similar species is probably associated
with Reston virus, which was isolated from
infected cynomolgous monkeys...
Transmission and Pathogenesis and
Pathology
• Spread by close contact with sick patients
• Virus containing bodily fluids ...
Transmission Requires
• Close contact with blood, body fluid and
mucous Membranes Exposure
• No true Aerosol transmission
...
Severe Diseases Attributed to
• :
• 1- Rapid Viral Replication
• 2- Host immune suppression
• 3- Vascular Dysfunction
Incubation period
• 2-21 days.
20
Case definition-WHO/CDC
Anyone presenting with fever and signs of bleeding such as:
• • Bleeding of the gums
• • Bleeding ...
OR Anyone living or deceased with:
• Contact with a suspected case of EHF AND
• A history of fever, with or without signs ...
• OR
• Any unexplained death in an area with suspected cases of
EHF.
24
Lab findings
• Leucopenia.
• Thropocytopenia.
• Elevated liver enzymes.
25
Lab diagnosis
• Specific antigen detection.
• Viral gene detection.
• Antibodies detection (IgM for recent infection).
• V...
Therapy
• No specific ttt
• No vaccine
27
Containment
• Isolate suspected cases from other patients.
• Tracing and follow up people exposed to Ebola cases.
• Health...
Patient Placement
•Single patient room (containing a private
bathroom) with the door closed
•Facilities should maintain a ...
Personal Protective Equipment (PPE)
•All persons entering the patient room should wear at least:
–Gloves
–Gown (fluid resi...
Challenges
• Additional diagnostic tools.
• Ecological investigations and possible reservoirs.
• Monitor suspected cases t...
THANK YOU
33
DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever
DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever
DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever
DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever
Upcoming SlideShare
Loading in …5
×

DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever

996 views

Published on

DR.SATTI MOHAMMED SALEH
MEEQAT HOSPITAL MEDICAL DIRECOR
INFECTION CONTROL DIRECTOR
CBAHI SIT MEMBER

Published in: Education
0 Comments
5 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
996
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
28
Comments
0
Likes
5
Embeds 0
No embeds

No notes for slide

DR.SATTI MOHAMMED SALEHEbola hemorrhagic fever

  1. 1. EBOLA Haemorrhagic Fever DR.SATTI MOHAMMED SALEH MEEQAT HOSPITAL MEDICAL DIRECOR INFECTION CONTROL DIRECTOR CBAHI SIT MEMBER
  2. 2. 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
  3. 3. 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
  4. 4. Filoviridae (Ebola, Marburg) Arenaviridae (Lassa, Junin, Machupo, Guanarito) Bunyaviridae (CCHF, RVF, Hantaviruses) Viral Haemorrhagic Fevers Flaviviridae (dengue, yellow fever, TBE encephalitides) Enveloped RNA viruses
  5. 5. • 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).
  6. 6. Ebola Virus (Filoviridae Family) 3Genere 1- Ebola Virus 2- Marburgvirus 3- Cuevasirus ( NEW
  7. 7. Ebola Virus Genus Consists of 5 species • 1- Zaire • 2- Sudan • 3- Reston • 4- Taiforest • 5- Bundibugyo( New)
  8. 8. 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.
  9. 9. 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
  10. 10. Need BSL for LAB to provide highest level of protection for both lab workers and environment
  11. 11. 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
  12. 12. 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)
  13. 13. Other 3 species of EBOLA : ( TAI, RESTON, BUNDIBUGYO • ) • Occurred less frequently • TAI only single non fatal infection ) • (AUTOPSY OF DEAD CHIMPANZEES)
  14. 14. • 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.
  15. 15. 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
  16. 16. Transmission Requires • Close contact with blood, body fluid and mucous Membranes Exposure • No true Aerosol transmission • No transmission in asymptomatic patients during incubation Period
  17. 17. Severe Diseases Attributed to • : • 1- Rapid Viral Replication • 2- Host immune suppression • 3- Vascular Dysfunction
  18. 18. Incubation period • 2-21 days. 20
  19. 19. 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. 22
  20. 20. OR Anyone living or deceased with: • Contact with a suspected case of EHF AND • A history of fever, with or without signs of bleeding. 23
  21. 21. • OR • Any unexplained death in an area with suspected cases of EHF. 24
  22. 22. Lab findings • Leucopenia. • Thropocytopenia. • Elevated liver enzymes. 25
  23. 23. 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. 26
  24. 24. Therapy • No specific ttt • No vaccine 27
  25. 25. 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. 28
  26. 26. 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
  27. 27. 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
  28. 28. Challenges • Additional diagnostic tools. • Ecological investigations and possible reservoirs. • Monitor suspected cases to determine disease incidence. • Natural reservoirs and how virus spread. 31
  29. 29. THANK YOU 33

×