Ebola And Marburg


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Ebola And Marburg

  1. 1. EBOLA and MARBURG Viral Infections Dr.T.V.Rao MD
  2. 2. Viral Hemorrhagic fevers <ul><li>The term viral hemorrhagic fever refers to a clinical syndrome characterized by acute onset of fever accompanied by nonspecific findings of malaise, prostration, diarrhea,and headache. Patients frequently show signs of increased vascular permeability, and many develop bleeding diatheses. The hemorrhagic fever viruses represent potential agents for biologic warfare because of capability of aerosol transmission, high morbidity,and mortality associated with infection, and ability to replicate in cell culture in high concentrations., The important infecting agents are Ebola and Marburg </li></ul>
  3. 3. Ebola and Marburg Virus <ul><li>Ebola and Marburg viruses are highly virulent in humans and non human primates, ends in death. </li></ul><ul><li>Both the viruses are identified to cause African hemorrhagic fevers </li></ul>
  4. 4. Filovirus Filo is Latin for Thread <ul><li>Marburg and Ebola are members of the Filoviridae </li></ul><ul><li>Appear as long threads, </li></ul><ul><li>Can be U shaped, </li></ul><ul><li>Genome 19 kb long </li></ul><ul><li>Enveloped viruses. </li></ul><ul><li>A single stranded, unregimented, -Helical, –ve sense RNA genome </li></ul><ul><li>80 nm Diameter </li></ul>
  5. 5. Events on Ebola <ul><li>Ebola virus were discovered in 1976 with occurance of two severe epidemics of hemorrhagic fever in Sudan and Zaire. </li></ul><ul><li>The Epidemic invloved > 500 persons and killed > 400 infected individual. </li></ul><ul><li>The importance of epidemic lies with in each outbreak hospital staff become infected through close contact with patients, their blood and excreta. </li></ul><ul><li>The mean time of death from onset to symptoms is 7 – 8 days. </li></ul>
  6. 6. Events on Marburg <ul><li>Marburg Viruses were discovered in 1967 </li></ul><ul><li>First identified in Laboratory workers exposed to tissues of African green Monkeys imported to Germany and Yugoslavia. </li></ul><ul><li>Transmission from patients to Medical personal occurred with highly mortality. </li></ul><ul><li>Marburg virus can infect Guinea pigs, Mice, Hamsters, Monkeys </li></ul>
  7. 8. Epidemic Outbreaks of Marburg <ul><li>Out breaks occured in Kenya, South Africa, Democratic Republic of Congo. </li></ul><ul><li>Recent outbreak in Angola in 2005 </li></ul>
  8. 9. Ebola Patient
  9. 10. Reservoir Hosts <ul><li>Reservoirs can be a Rodent or Bat </li></ul><ul><li>Humans infected accidentally </li></ul><ul><li>Monkeys are not proved as reservoirs as die with infection early </li></ul><ul><li>Infected humans are rich source of infections to others. </li></ul><ul><li>By direct contact with blood and body fluids of infected persons can spread the disease </li></ul>
  10. 11. Spread of Infections <ul><li>Transmission appears to be associated with contamination of Blood, Blood stained body fluids or tissues. </li></ul><ul><li>Nosocomial spread is common mode of spread, Doctors and Nurses at risk when attending the patients. </li></ul><ul><li>Transmission by sexual intercourse has been on record from a case of man infecting his wife 83 days after initial infection. </li></ul>
  11. 12. Viral Replication <ul><li>The viruses are grown in variety of cell lines including </li></ul><ul><li>Vero </li></ul><ul><li>M A 104 </li></ul><ul><li>S W 13 cells </li></ul><ul><li>Filoviruses replicates in the cytoplasam </li></ul>
  12. 13. Pathology and Pathogenesis <ul><li>The viruses belong to group of Filoviruses </li></ul><ul><li>The viruses have tropism for </li></ul><ul><li>Cells of macrophage system </li></ul><ul><li>Dendritic cells </li></ul><ul><li>Interstitial fibroblasts </li></ul><ul><li>Endothelial cells </li></ul>
  13. 14. Mode of Spread
  14. 15. Virus infect several Organs <ul><li>High titer of viruses are found in </li></ul><ul><li>Liver </li></ul><ul><li>Spleen, </li></ul><ul><li>Lungs </li></ul><ul><li>Kidneys </li></ul><ul><li>Blood </li></ul><ul><li>Other Body fluids </li></ul>
  15. 16. How the Illness is Presented in Marburg and Ebola <ul><li>Fever </li></ul><ul><li>Head ache </li></ul><ul><li>Sore throat </li></ul><ul><li>Muscle pain </li></ul><ul><li>Abdominal pain, </li></ul><ul><li>Vomitting </li></ul><ul><li>Diarrhea </li></ul><ul><li>Incubation period 3 -9 days in Marburg </li></ul><ul><li>In Ebola 2 – 21 days. </li></ul>
  16. 17. Serious manifestation of Ebola and Marburg <ul><li>Internal and External bleeding, </li></ul><ul><li>Shock, </li></ul><ul><li>Death </li></ul>
  17. 18. Diagnosis <ul><li>Viruses are isolated from Blood by cell culture on Vero cells ( Vero –E 6 ) </li></ul><ul><li>ELISA for antigen detection </li></ul><ul><li>ELISA for IgM </li></ul><ul><li>RT - PCR </li></ul>
  18. 19. Control of Infection <ul><li>Isolation facilities within the Hospital remain the most important effective measure. </li></ul><ul><li>Barrier nursing remain the basic need in control of infection spread </li></ul>
  19. 20. The health care workers should <ul><li>Avoid </li></ul><ul><li>Infected Blood, </li></ul><ul><li>secretions, </li></ul><ul><li>Tissues, </li></ul><ul><li>Wastes </li></ul>
  20. 21. Treatment of Ebola and Marburg <ul><li>Antiviral drugs are not available </li></ul><ul><li>Interferons are not effective </li></ul><ul><li>To date no Vaccine </li></ul><ul><li>Electrolyte corrections </li></ul><ul><li>Dealing with hemorrhagic complications . </li></ul>
  21. 22. Barrier Nursing remains the only best option in Prevention
  22. 23. Created for Health awarness on Filoviruses Dr.T.V.Rao MD Email [email_address]