EBOLA Haemorrhagic Fever
DR.SATTI MOHAMMED SALEH
MEEQAT HOSPITAL MEDICAL DIRECOR
INFECTION CONTROL DIRECTOR
CBAHI SIT MEMBER
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
CLASSIFICATION OF VIRAL HEMORRHAGIC FEVER ACCORDING TO MODES OF
ETIOLOGICAL VIRUSDISEASESMODE OF
Dengue types 1-4
Chikunguny a rift
fever kyasanur forest
disease a Omsk
Argentine hemorrhagic fever
fever- Lassa fever
Marburg virus disease
Ebola virus disease
Ebola Virus Genus Consists of
• 1- Zaire
• 2- Sudan
• 3- Reston
• 4- Taiforest
• 5- Bundibugyo( New)
•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.
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
Need BSL for LAB to provide highest
level of protection for both lab
workers and environment
• 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
• Ebola HF first 2 large outbreak
• Democratic Republic of Congo
• Southern Sudan
• Caused by 2 separate species ;
• Zaire ( EBOV) and Sudan ( SUDV)
Other 3 species of EBOLA : ( TAI,
• Occurred less frequently
• TAI only single non fatal infection )
• (AUTOPSY OF DEAD CHIMPANZEES)
• 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.
Transmission and Pathogenesis and
• Spread by close contact with sick patients
• Virus containing bodily fluids Includes
• *Blood * Semen
• * Vomitus *Breast milk
• *Saliva *Tears
• Close contact with blood, body fluid and
mucous Membranes Exposure
• No true Aerosol transmission
• No transmission in asymptomatic
patients during incubation Period
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.
OR Anyone living or deceased with:
• Contact with a suspected case of EHF AND
• A history of fever, with or without signs of bleeding.
• Any unexplained death in an area with suspected cases of
• 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
• Inform public about disease nature and burial of deceased.
• Strict surveillance of contacts.
•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
Personal Protective Equipment (PPE)
•All persons entering the patient room should wear at least:
–Gown (fluid resistant or impermeable)
–Eye protection (goggles or face shield)
•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
–Disposable shoe covers
• Additional diagnostic tools.
• Ecological investigations and possible reservoirs.
• Monitor suspected cases to determine disease incidence.
• Natural reservoirs and how virus spread.