SlideShare a Scribd company logo
• Veronica M.B.
  Ebo
• monamoursansf
  in@yahoo.com
• 09333161116
Content
1.   Definition
                    9. Treatment
2.   History
3.   Distribution   10. Recomendation
4.   Epidemiology
5.   Life cycle
6.   Symptomology
7.   Diagnosis
8.   Prognosis
What is Ebola Virus?
• A notoriously deadly virus that
  causes fearsome symptoms
  –High Fever
  –Internal Bleeding
• kills as many as 90% of the
  people it infects
• EBOV is a Select Agent, World
  Health Organization Risk Group 4
  Pathogen
  – use of a positive pressure
   personnel suit, with a
   segregated air supply, is
   mandatory
• capable of
  causing hemorrhagic (bloody)
  fever
• belongs to the Filoviridae family
  (filovirus)
5 species of ebolavirus
1. Bundibugyo (Uganda)
2. Zaire ( Democratic Republic of
   Congo)
3. Sudan
4. Côte d’Ivoire
5. Reston
• Zaïre, Sudan and Bundibugyo species
  have been associated with large Ebola
  haemorrhagic fever (EHF) outbreaks in
  Africa with high case fatality ratio (25–
  90%)
• Côte d’Ivoire and Reston have not
• Reston can infect humans but no serious
  illness or death in humans have been
  reported to date.
• Ebola Reston subtype, found in
  the Western Pacific, has only
  caused asymptomatic illness,
  meaning that those who contract
  the disease do not experience
  clinical illness.
Medical
personnel
 aiding in
  ZAIRE
History
• The Ebola virus was first identified in
  the western equatorial province of
  Sudan and in a nearby region of Zaire
  in 1976 after significant epidemics in
  Nzara, southern Sudan and Yambuku,
  northern Zaire.
• Named after a river in Zaire
•  morphologically identical to
  Marburg Virus; the cause of deadly
  outbreaks of hemorrhagic fever in
  Germany and Yugoslavia in 1967,
  but serologically distinct.
• The estimated case-fatality rate
  was over 50% in Sudan, and more
  than 80% in Zaire
MARBURG VIRUS
• The first case at Kikwit General
Hospital was admitted on 9 April. He
   had previously been admitted to
   another hospital in Kikwit with a
differential diagnosis of typhoid fever
     with intestinal perforation. A
 laparotomy was performed on the
patient at Kikwit General Hospital on
10 April. Three days later, on 14 April,
            the patient died.
• Medical personnel who had taken care
  of this patient, either in the operating
     theatre or in the hospital wards,
  became ill with fever starting 14 April.
   About three-quarters of the first 70
   patients in the epidemic appear to
   have been health workers, and the
  case fatality-rate was very high in the
                    group
KIKWIT
• In this outbreak, at least four
  generations of cases can be
  distinguished
• 1st - spouses, other relatives and
  close friends of those infected at
  the hospital, infected either during
  patient care or preparation of
  bodies for burial
• 2nd&3rd-other relatives and
  friends of the first generation
  who were infected in a similar
  manner
•4  th-those who tended the second

  and third generation cases
Distribution
• Epidemics of Ebola virus have
  occurred mainly in African countries:
  Zaire (Democratic Republic of
  Congo), Gabon, Uganda, Côte
  d’Ivoire, and Sudan
• Ebola virus is a hazard to laboratory
  workers and, for that matter, anyone
  who is exposed to it.
Cases of Ebola Hemorrhagic Fever in
                  Africa, 1976 - 2008
Country     Town         Cases    Deaths   Species       Year
Dem. Rep.
            Yambuku         318      280   Ezaire           1976
of Congo
Sudan       Nzara           284      151   Esudan           1976
Dem. Rep.
            Tandala          1        1    Ezaire           1977
of Congo
Sudan       Nzara            34       22   Esudan           1979
Gabon       Mekouka          52       31   Ezaire           1994

Ivory Coast Tai Forest       1        0    EIvoryCoast      1994

Dem. Rep.
          Kikwit            315      250   Ezaire           1995
of Congo
Gabon     Mayibout           37       21   Ezaire           1996
Gabon         Booue        60    45    Ezaire   1996
South         Johannesbu
                           2     1     Ezaire   1996
Africa        rg
Uganda        Gulu         425   224   Esudan   2000
Gabon         Libreville    65    53   Ezaire   2001
Republic of   Not
                           57    43    Ezaire   2001
Congo         specified
Republic of
              Mbomo        143   128   Ezaire   2002
Congo
Republic of
              Mbomo        35    29    Ezaire   2003
Congo
Sudan         Yambio       17    7     Esudan   2004
Dem. Rep.
          Luebo            264   187   Ezaire   2007
of Congo

Uganda        Bundibugyo   149   37    Ebundi   2007
VICTIM OF EBOLA
     ZAIRE
• The origin in nature and the
  natural history of Ebola virus
  remain a mystery
• It appears that the viruses are
  zoonotic.
   – that they are transmitted to
     humans from discrete life
     cycles in animals or insects
• The infection of human cases with Ebola
  virus through the handling of infected
  chimpanzees, gorillas, and forest
  antelopes – both dead and alive – has
  been documented in Côte d'Ivoire, the
  Republic of Congo and Gabon.
• The transmission of the Ebola Reston
  strain through the handling of
  cynomolgus monkeys has also been
  reported.
• person-to-person transmission is
  the means by which outbreaks
  and epidemics progress
   –direct contact with infected
    blood, secretions, organs or
    semen
s
• Hospital-acquired infections have been
  frequent, and many health care workers
  have been infected while attending
  patients
   – In the 1976 Zairian Ebola epidemic,
    many cases could be linked to the use
    of contaminated syringes and needles
• Transmission also occurs through
  preparation of the dead for burials
• lysogenic life cycle. This mean
 that the cycle does not
 immediately kill the infected host
 cells
  –    The virus just invade the cells and
      replicates or make more copies of it
      self and spread to other cells and
      destroy the host DNA
• Ebola virus docks with cell
  membrane
• Viral RNA is released into the
  cytoplasm where it directs the
  production of new viral proteins
  and genetic material
• New viral genomes are rapidly
  coated in protein to create cores.
  –These viral cores stack up in the cell
   and migrate to the cell surface
• Transmembrane proteins are
  produced which are ferried to the
  cell surface.
• Cores push their way through the
  cell membrane becoming enveloped
  in cell membrane and collecting
  their transmembrane proteins as
  they do so
• The Ebola incubation period is the
  period of time between infection
  with the Ebola virus and the
  appearance of symptoms
  associated with the disease.
• incubation period can be as short as
  2 days or as long as 21 days.
• After four to six days on average,
  symptoms of Ebola can begin
• Sudden onset of
  fever
• Intense weakness
• Muscle pain
• Headache
• Sore throat
Then followed by:
• Vomiting, diarrhoea, rash, impaired
  kidney and liver function, and in some
  cases, both internal and external
  bleeding
• Laboratory findings show low counts of
  white blood cells and platelets as well
  as elevated liver enzymes.
EBOLA VICTIM
• CBC
• ELECTROLYTES
• Tests of how well the blood
  clots (coagulation studies)
• Tests to show whether
  someone has been exposed to
  the Ebola virus
• a high fatality rate for this
  disorder (80% to 90%)
• mortality from Ebola has ranged
  from 25% to 90% and recovery is
  slow in those who survive.
  – Morbidity and mortality rates are
    very high, and they vary with the
    strain of Ebola
•




•
• There is no known cure for the disorder
  at this time
• For people with Ebola, treatment
  involves providing relief of Ebola
  symptoms while the body fights the
  infection.
   –Supportive Care
   –intravenous fluids, antibiotics, and
    oxygen. Treatment may also include
    the use of medications to control
    fever, help the blood clot, and
    maintain blood pressure
• DNA vaccines, adenovirus-
  based vaccines, and VSIV-
  based vaccines have entered
  clinical trials
• avoiding direct contact with
  the body fluid of infected
  people. Also, it's important to
  avoid direct contact with the
  body of an Ebola victim who
  has died
• For healthcare workers in Africa,
 who are most likely to encounter
 cases of Ebola, prevention focuses
 on being able to recognize cases of
 the disease when they appear, as
 well as using barrier isolation
 techniques to avoid direct contact
 with infected people.
Recommendations
• Containment
  – Those who are infected should be
    isolated in order to prevent further
    infection
• Make sure staff member should be
  informed about the nature of the
  disease in order to take proper
  precautions
  – Wear proper clothing to prevent
    contamination
Proper
Clothing
• Make sure linens or any material
  used by an Ebola patient should by
  cleaned thoroughly
• Ebola victims should be properly
  buried in order to prevent further
  infection

• Make sure the community and
  neighbouring communities are
  aware of the epidemic and inform
  them on safety precautions.
• Ban eating/hunting of animals that are
  most likely carriers of the virus such as
  gorillas.
• If you plan on travelling to uganda, DRC,
  Cote d’Ivoir and sudan check with the
  Center for Disease Control and
  Prevention before travelling to these
  places to make sure that there hasn't
  been an outbreak.
THE END?
• http://www.medterms.com/script/main/art.asp?
  articlekey=6490
• http://www.cdc.gov/ncidod/dvrd/spb/mnpages/
  dispages/ebola/ebolamap.htm
• http://www.psmid.org.ph/vol25/vol25num1topic
  9.pdf
• http://www.dailygalaxy.com/my_weblog/2009/0
  7/a-hot-zone-sequel-a-new-ebola-virus-detected-
  in-pigs.html
• http://www.rkm.com.au/virus/ebola/
• http://www.virtualmedicalcentre.com/diseases.a
  sp?did=321#Prognosis
• http://www.scienceagogo.com/news/201004
  31010042data_trunc_sys.shtml
• http://health.nytimes.com/health/guides/dise
  ase/ebola-hemorrhagic-fever/overview.html

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Ebola virus

  • 1.
  • 2. • Veronica M.B. Ebo • monamoursansf in@yahoo.com • 09333161116
  • 3. Content 1. Definition 9. Treatment 2. History 3. Distribution 10. Recomendation 4. Epidemiology 5. Life cycle 6. Symptomology 7. Diagnosis 8. Prognosis
  • 4. What is Ebola Virus? • A notoriously deadly virus that causes fearsome symptoms –High Fever –Internal Bleeding • kills as many as 90% of the people it infects
  • 5. • EBOV is a Select Agent, World Health Organization Risk Group 4 Pathogen – use of a positive pressure personnel suit, with a segregated air supply, is mandatory
  • 6.
  • 7. • capable of causing hemorrhagic (bloody) fever • belongs to the Filoviridae family (filovirus)
  • 8.
  • 9. 5 species of ebolavirus 1. Bundibugyo (Uganda) 2. Zaire ( Democratic Republic of Congo) 3. Sudan 4. Côte d’Ivoire 5. Reston
  • 10.
  • 11. • Zaïre, Sudan and Bundibugyo species have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa with high case fatality ratio (25– 90%) • Côte d’Ivoire and Reston have not • Reston can infect humans but no serious illness or death in humans have been reported to date.
  • 12. • Ebola Reston subtype, found in the Western Pacific, has only caused asymptomatic illness, meaning that those who contract the disease do not experience clinical illness.
  • 13.
  • 14.
  • 16. History • The Ebola virus was first identified in the western equatorial province of Sudan and in a nearby region of Zaire in 1976 after significant epidemics in Nzara, southern Sudan and Yambuku, northern Zaire. • Named after a river in Zaire
  • 17. • morphologically identical to Marburg Virus; the cause of deadly outbreaks of hemorrhagic fever in Germany and Yugoslavia in 1967, but serologically distinct. • The estimated case-fatality rate was over 50% in Sudan, and more than 80% in Zaire
  • 19. • The first case at Kikwit General Hospital was admitted on 9 April. He had previously been admitted to another hospital in Kikwit with a differential diagnosis of typhoid fever with intestinal perforation. A laparotomy was performed on the patient at Kikwit General Hospital on 10 April. Three days later, on 14 April, the patient died.
  • 20. • Medical personnel who had taken care of this patient, either in the operating theatre or in the hospital wards, became ill with fever starting 14 April. About three-quarters of the first 70 patients in the epidemic appear to have been health workers, and the case fatality-rate was very high in the group
  • 22.
  • 23. • In this outbreak, at least four generations of cases can be distinguished • 1st - spouses, other relatives and close friends of those infected at the hospital, infected either during patient care or preparation of bodies for burial
  • 24. • 2nd&3rd-other relatives and friends of the first generation who were infected in a similar manner •4 th-those who tended the second and third generation cases
  • 25. Distribution • Epidemics of Ebola virus have occurred mainly in African countries: Zaire (Democratic Republic of Congo), Gabon, Uganda, Côte d’Ivoire, and Sudan • Ebola virus is a hazard to laboratory workers and, for that matter, anyone who is exposed to it.
  • 26.
  • 27. Cases of Ebola Hemorrhagic Fever in Africa, 1976 - 2008 Country Town Cases Deaths Species Year Dem. Rep. Yambuku 318 280 Ezaire 1976 of Congo Sudan Nzara 284 151 Esudan 1976 Dem. Rep. Tandala 1 1 Ezaire 1977 of Congo Sudan Nzara 34 22 Esudan 1979 Gabon Mekouka 52 31 Ezaire 1994 Ivory Coast Tai Forest 1 0 EIvoryCoast 1994 Dem. Rep. Kikwit 315 250 Ezaire 1995 of Congo Gabon Mayibout 37 21 Ezaire 1996
  • 28. Gabon Booue 60 45 Ezaire 1996 South Johannesbu 2 1 Ezaire 1996 Africa rg Uganda Gulu 425 224 Esudan 2000 Gabon Libreville 65 53 Ezaire 2001 Republic of Not 57 43 Ezaire 2001 Congo specified Republic of Mbomo 143 128 Ezaire 2002 Congo Republic of Mbomo 35 29 Ezaire 2003 Congo Sudan Yambio 17 7 Esudan 2004 Dem. Rep. Luebo 264 187 Ezaire 2007 of Congo Uganda Bundibugyo 149 37 Ebundi 2007
  • 29.
  • 30.
  • 32. • The origin in nature and the natural history of Ebola virus remain a mystery • It appears that the viruses are zoonotic. – that they are transmitted to humans from discrete life cycles in animals or insects
  • 33.
  • 34. • The infection of human cases with Ebola virus through the handling of infected chimpanzees, gorillas, and forest antelopes – both dead and alive – has been documented in Côte d'Ivoire, the Republic of Congo and Gabon. • The transmission of the Ebola Reston strain through the handling of cynomolgus monkeys has also been reported.
  • 35.
  • 36. • person-to-person transmission is the means by which outbreaks and epidemics progress –direct contact with infected blood, secretions, organs or semen
  • 37. s
  • 38. • Hospital-acquired infections have been frequent, and many health care workers have been infected while attending patients – In the 1976 Zairian Ebola epidemic, many cases could be linked to the use of contaminated syringes and needles • Transmission also occurs through preparation of the dead for burials
  • 39. • lysogenic life cycle. This mean that the cycle does not immediately kill the infected host cells – The virus just invade the cells and replicates or make more copies of it self and spread to other cells and destroy the host DNA
  • 40. • Ebola virus docks with cell membrane • Viral RNA is released into the cytoplasm where it directs the production of new viral proteins and genetic material • New viral genomes are rapidly coated in protein to create cores. –These viral cores stack up in the cell and migrate to the cell surface
  • 41. • Transmembrane proteins are produced which are ferried to the cell surface. • Cores push their way through the cell membrane becoming enveloped in cell membrane and collecting their transmembrane proteins as they do so
  • 42.
  • 43. • The Ebola incubation period is the period of time between infection with the Ebola virus and the appearance of symptoms associated with the disease. • incubation period can be as short as 2 days or as long as 21 days. • After four to six days on average, symptoms of Ebola can begin
  • 44. • Sudden onset of fever • Intense weakness • Muscle pain • Headache • Sore throat
  • 45. Then followed by: • Vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding • Laboratory findings show low counts of white blood cells and platelets as well as elevated liver enzymes.
  • 46.
  • 47.
  • 49.
  • 50. • CBC • ELECTROLYTES • Tests of how well the blood clots (coagulation studies) • Tests to show whether someone has been exposed to the Ebola virus
  • 51.
  • 52. • a high fatality rate for this disorder (80% to 90%) • mortality from Ebola has ranged from 25% to 90% and recovery is slow in those who survive. – Morbidity and mortality rates are very high, and they vary with the strain of Ebola
  • 54.
  • 55.
  • 56. • There is no known cure for the disorder at this time • For people with Ebola, treatment involves providing relief of Ebola symptoms while the body fights the infection. –Supportive Care –intravenous fluids, antibiotics, and oxygen. Treatment may also include the use of medications to control fever, help the blood clot, and maintain blood pressure
  • 57. • DNA vaccines, adenovirus- based vaccines, and VSIV- based vaccines have entered clinical trials
  • 58.
  • 59.
  • 60. • avoiding direct contact with the body fluid of infected people. Also, it's important to avoid direct contact with the body of an Ebola victim who has died
  • 61. • For healthcare workers in Africa, who are most likely to encounter cases of Ebola, prevention focuses on being able to recognize cases of the disease when they appear, as well as using barrier isolation techniques to avoid direct contact with infected people.
  • 62. Recommendations • Containment – Those who are infected should be isolated in order to prevent further infection • Make sure staff member should be informed about the nature of the disease in order to take proper precautions – Wear proper clothing to prevent contamination
  • 64.
  • 65. • Make sure linens or any material used by an Ebola patient should by cleaned thoroughly • Ebola victims should be properly buried in order to prevent further infection • Make sure the community and neighbouring communities are aware of the epidemic and inform them on safety precautions.
  • 66.
  • 67. • Ban eating/hunting of animals that are most likely carriers of the virus such as gorillas. • If you plan on travelling to uganda, DRC, Cote d’Ivoir and sudan check with the Center for Disease Control and Prevention before travelling to these places to make sure that there hasn't been an outbreak.
  • 68.
  • 69.
  • 70.
  • 71.
  • 72.
  • 74. • http://www.medterms.com/script/main/art.asp? articlekey=6490 • http://www.cdc.gov/ncidod/dvrd/spb/mnpages/ dispages/ebola/ebolamap.htm • http://www.psmid.org.ph/vol25/vol25num1topic 9.pdf • http://www.dailygalaxy.com/my_weblog/2009/0 7/a-hot-zone-sequel-a-new-ebola-virus-detected- in-pigs.html • http://www.rkm.com.au/virus/ebola/ • http://www.virtualmedicalcentre.com/diseases.a sp?did=321#Prognosis
  • 75. • http://www.scienceagogo.com/news/201004 31010042data_trunc_sys.shtml • http://health.nytimes.com/health/guides/dise ase/ebola-hemorrhagic-fever/overview.html