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Ebola Hemorrhagic Fever 
Deadly African Virus 
Dr. Hythum Salah H. Mohamed NGHA -KAMC-Riyadh 6th August 2014
Historical Background 
 Ebola first appeared in 1976 in 2 simultaneous outbreaks, first in Nzara which is small town 
in ...
Ebola Outbreaks 
 24 outbreaks reported by WHO from 1976 till 2012 . 
 first outbreak occurred in Sudan( Newly south of ...
Ebola 2014 Outbreak 
 August 1, 2014, the Guinea Ministry of Health announced a total of 485 
suspect and confirmed cases...
 August 1, 2014, the Ministry of Health and Social Welfare of Liberia and WHO 
have reported 468 suspect and confirmed EH...
Geographical Map of 2014 Outbreak
Genus of Ebola Virus 
 Genus Ebolavirus is 1 of 3 members of the 
Filoviridae family (filovirus), along with 
genus Marbu...
 Bundibugyo , Zaire and Sudan Ebola virus species are associated with have 
with large Ebola virus disease outbreaks in A...
Transmission of EVD . 
 Ebola is introduced into the human population through close contact with the 
blood, secretions, ...
 Burial ceremonies in which mourners have direct contact with the body of the 
deceased person can also play a role in th...
Natural host of Ebola virus 
 In Africa, fruit bats, particularly 
species of the genera Hypsignathus 
monstrosus, Epomop...
Signs and Symptoms of Ebola Haemorrhagic Fever 
 Fever (90%-100%) 
 Headache (40%-90%) 
 Chills 
 Myalgia/arthralgia (...
 Blood fails to clot (71%-78%) 
 Abdominal pain (60-80%) 
 Dry and sore throat (63%) 
 Chest pain (83%) 
 Hemorrhagic...
 CNS involvement (infrequently) 
 Terminal shock 
 Lymphopenia 
 Severe thrombocytopenia 
 Transaminase elevation 
 ...
Diagnosis 
 Ebola virus infections can be diagnosed definitively in a laboratory through 
several types of tests: 
1-anti...
Treatment 
 No specific treatment is available . 
 Standard treatment for Ebola HF is still limited to supportive therap...
 During the 1995 Ebola Zaire outbreak in Kikwit, whole blood from 
convalescent patients was administered to eight patien...
Post exposure prophylaxis 
 At this time, there are no FDA-approved forms of post exposure prophylaxis 
for Ebola HF. 
 ...
Infection Control 
Controlling infection in health-care settings 
 it is important that health-care workers 
apply standa...
 face shields or surgical masks and eye 
protection (e.g., goggles or eyeglasses 
with side shields) should be worn by 
p...
 Laboratory workers are also at 
risk. 
 Samples taken from suspected 
human and animal Ebola cases for 
diagnosis shoul...
Reducing the risk of Ebola infection in people 
 raising awareness of the risk factors for 
Ebola infection and the prote...
 Reducing the risk of human-to-human 
transmission in the 
community arising from direct or 
close contact with infected ...
Ebola Reported 
Outside Africa 
 Ebola in Saudi Arabia 
 Ebola in Saudi Arabia 
 Ebola in Saudi Arabia 
 Ebola in Saud...
Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
Ebola Hemorrhagic Fever          Deadly African Virus
Ebola Hemorrhagic Fever          Deadly African Virus
Ebola Hemorrhagic Fever          Deadly African Virus
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Ebola Hemorrhagic Fever Deadly African Virus

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Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
EVD outbreaks have a case fatality rate of up to 90%.
EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.
Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.

Published in: Health & Medicine
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Ebola Hemorrhagic Fever Deadly African Virus

  1. 1. Ebola Hemorrhagic Fever Deadly African Virus Dr. Hythum Salah H. Mohamed NGHA -KAMC-Riyadh 6th August 2014
  2. 2. Historical Background  Ebola first appeared in 1976 in 2 simultaneous outbreaks, first in Nzara which is small town in south of Sudan which infected over 284 people, with a mortality rate of 53%.  After view month another out break occurred in Yambuku in Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name  In Congo outbreak 318 people infected with highest mortality rate of 88% . www.who.int WWW.web.stanford.edu Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  3. 3. Ebola Outbreaks  24 outbreaks reported by WHO from 1976 till 2012 .  first outbreak occurred in Sudan( Newly south of Sudan ) and Democratic Republic of Congo with mortality rate of 53% and 88% respectively .  Countries involved in outbreaks was , Sudan , Congo , Uganda ,Gabon , South Africa ( one case in 1996 ) and Cote d'Ivoire ( one case in 1994).  No case reported out of Africa till 2012 .  The maximum No of infected patients was 425 in Uganda outbreak 2000 . www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  4. 4. Ebola 2014 Outbreak  August 1, 2014, the Guinea Ministry of Health announced a total of 485 suspect and confirmed cases of Ebola virus disease (EVD), including 358 fatal cases.  340 cases across Guinea have been confirmed by laboratory testing to be positive for Ebola virus infection.  August 1, 2014, the Ministry of Health and Sanitation of Sierra Leone and WHO reported a cumulative total of 646 suspect and confirmed cases, including 540 laboratory confirmations and 273 reported fatal cases. www.cdc.gov update 4th August 2014 Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  5. 5.  August 1, 2014, the Ministry of Health and Social Welfare of Liberia and WHO have reported 468 suspect and confirmed EHF cases (including 129 laboratory confirmations) and 255 reported fatalities.  August 1, 2014, the Nigerian Ministry of Health and WHO reported 4 suspect and probable cases and 1 fatal probable case.  Nigerian Suspected and Confirmed Case Count are 4 . www.cdc.gov update 4th August 2014
  6. 6. Geographical Map of 2014 Outbreak
  7. 7. Genus of Ebola Virus  Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus.  Genus Ebolavirus comprises 5 distinct species: 1-Bundibugyo ebolavirus (BDBV) 2-Zaire ebolavirus (EBOV) 3-Reston ebolavirus (RESTV) 4-Sudan ebolavirus (SUDV) 5-Taï Forest ebolavirus (TAFV). www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  8. 8.  Bundibugyo , Zaire and Sudan Ebola virus species are associated with have with large Ebola virus disease outbreaks in Africa .  Reston ebolavirus (RESTV) and Taï Forest ebolavirus (TAFV) have not associated with EVD in Africa .  The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  9. 9. Transmission of EVD .  Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals.  In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.  Ebola spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  10. 10.  Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.  Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.  Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD.  However, the only available evidence available comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  11. 11. Natural host of Ebola virus  In Africa, fruit bats, particularly species of the genera Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are considered possible natural hosts for Ebola virus. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  12. 12. Signs and Symptoms of Ebola Haemorrhagic Fever  Fever (90%-100%)  Headache (40%-90%)  Chills  Myalgia/arthralgia (40%-80%)  Malaise (75%-85%)  Pharyngitis (20%-40%)  Loss of appetite  Vomiting (59%)  Hematemesis (10%-40%)  Non-bloody diarrhea (81%) http://web.stanford.edu/group/virus/filo/humandiseases.htm l Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  13. 13.  Blood fails to clot (71%-78%)  Abdominal pain (60-80%)  Dry and sore throat (63%)  Chest pain (83%)  Hemorrhagic diathesis (71%-78%)  Maculopapular rash (5%-20%)  Hiccups (15 %)  Hepatic damage  Renal failure http://web.stanford.edu/group/virus/filo/humandiseases.html Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  14. 14.  CNS involvement (infrequently)  Terminal shock  Lymphopenia  Severe thrombocytopenia  Transaminase elevation  Hyperamylasemia  During the convalescent stage: 1-Loss of memory 2-Central nervous system disorders 3-Loss of hair http://web.stanford.edu/group/virus/filo/humandiseases.html Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  15. 15. Diagnosis  Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests: 1-antibody-capture enzyme-linked immunosorbent assay (ELISA) 2-antigen detection tests 3-serum neutralization test 4-reverse transcriptase polymerase chain reaction (RT-PCR) assay 5-electron microscopy 6-virus isolation by cell culture. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  16. 16. Treatment  No specific treatment is available .  Standard treatment for Ebola HF is still limited to supportive therapy. This consists of: 1-balancing the patient’s fluids and electrolytes 2-maintaining their oxygen status and blood pressure 3-treating them for any complicating infections . www.cdc.gov Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  17. 17.  During the 1995 Ebola Zaire outbreak in Kikwit, whole blood from convalescent patients was administered to eight patients late in their clinical course . Only one patient died, suggesting that even small amounts of transfused blood had a beneficial effect. However, a subsequent analysis demonstrated that, due to good prognostic factors, these patients would have likely survived without any intervention .  convalescent serum , interferon-alpha , Ribavirin , immune globulin and plasma exchange are tried but not provided evidence of therapeutic efficacy . www.uptodate.com Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  18. 18. Post exposure prophylaxis  At this time, there are no FDA-approved forms of post exposure prophylaxis for Ebola HF.  In Animal experiments Interferon-alpha showed effectiveness .  In a very promising approach to postexposure prophylaxis, an experimental live-virus vaccine has been developed using recombinant vesicular stomatitis virus (VSV) encoding the Marburg or Ebola surface glycoproteins. A single injection is completely protective as a standard preexposure vaccine www.uptodate.com Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  19. 19. Infection Control Controlling infection in health-care settings  it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times .  These include basic hand hygiene, respiratory hygiene, the use of personal protective equipment and safe injection practices and safe burial practices.  When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures). www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  20. 20.  face shields or surgical masks and eye protection (e.g., goggles or eyeglasses with side shields) should be worn by persons coming within approximately 3 feet of the patient.  Patients who are hospitalized or treated in an outpatient healthcare setting should be placed in a private room and Standard, Contact, and Droplet Precautions should be initiated .  Nonessential staff and visitors should be restricted from entering the room of patients with suspected VHF. www.cdc.gov/vhf/abroad/pdf/vhf-interim- guidance.pdf-2005. Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  21. 21.  Laboratory workers are also at risk.  Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  22. 22. Reducing the risk of Ebola infection in people  raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.  Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat  handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption. www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  23. 23.  Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Ebola patients should be avoided.  Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home and burial of the dead . www.who.int Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  24. 24. Ebola Reported Outside Africa  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia  Ebola in Saudi Arabia Ebola in Saudi Arabia Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014
  25. 25. Dr. Hythum Salah H. Mohamed -- NGHA -KAMC-Riyadh 6th August 2014

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