The document provides information on Ebola virus, including its history, outbreaks, transmission, symptoms, diagnosis and potential treatments. It discusses how Ebola was first identified in 1976 near the Ebola River in Africa. It causes severe hemorrhagic fever in humans with high mortality. While fruit bats are suspected to be the natural reservoir, transmission occurs between humans via contact with bodily fluids. Current efforts are focused on supportive care and experimental therapies like monoclonal antibodies, antivirals and immunomodulators until a vaccine is developed.
The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in west Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the Democratic Republic of Congo.
The virus family Filoviridae includes 3 genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are 5 species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first 3, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 west African outbreak belongs to the Zaire species.
The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in west Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the Democratic Republic of Congo.
The virus family Filoviridae includes 3 genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are 5 species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first 3, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 west African outbreak belongs to the Zaire species.
This is a PowerPoint on the Marburg virus, which is a disease similar to Ebola. I very briefly talk about what the disease is, some of the key facts about the structure and death rate, some outbreak history, prevention and treatment and the social-economical impacts that have been caused.
Description about recent outbreak of Ebola virus in West African countries with history, pathogenesis, clinical signs and prevention measures of Filoviruses are presented in comprehensive manner.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
Ebola virus disease (EVD; also Ebola hemorrhagic fever, or EHF), or simply Ebola, is a disease of humans and other primates caused by ebolaviruses. Ebola virus disease is a serious illness that originated in Africa, where there is currently an outbreak
Video presentation - https://www.youtube.com/watch?v=45CjKnJaIC0
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This is a PowerPoint on the Marburg virus, which is a disease similar to Ebola. I very briefly talk about what the disease is, some of the key facts about the structure and death rate, some outbreak history, prevention and treatment and the social-economical impacts that have been caused.
Description about recent outbreak of Ebola virus in West African countries with history, pathogenesis, clinical signs and prevention measures of Filoviruses are presented in comprehensive manner.
Monkeypox is a zoonotic disease endemic in the Democratic Republic of Congo (DRC) but prevalent also in other countries of Central and Western Africa. The clinical presentation of monkeypox closely resembles the one of smallpox. The mortality rate is officially about 11% however rates as high as 17% have been observed. The disease has been considered rare and not much attention is paid to it. Nonetheless, the incidence of monkeypox increased 20-fold from 1981-1986 to 2005-2007 (two active surveillance programs). More research, surveillance and effective interventions are needed to ensure it would not gain the potential to become the next global pandemic.
Ebola virus disease (EVD; also Ebola hemorrhagic fever, or EHF), or simply Ebola, is a disease of humans and other primates caused by ebolaviruses. Ebola virus disease is a serious illness that originated in Africa, where there is currently an outbreak
Video presentation - https://www.youtube.com/watch?v=45CjKnJaIC0
Learn Community Medicine along with me : https://t.me/drvkspm
Be my friend by connecting with me through:
Instagram : https://www.instagram.com/drvenkateshkarthikeyan/
Facebook : https://www.facebook.com/drvenkateshkarthikeyan/
Twitter : https://twitter.com/dr_venkatesh_k
Website : www.drvenkateshkarthikeyan.com
LinkedIn : https://in.linkedin.com/in/dr-venkatesh-karthikeyan-8b1234ab
Learn Community Medicine along with me : https://t.me/drvkspm
Current updates of swine mycoplasma vaccinesMamta Singh
Current measures do not provide sustainable control of the disease, although they are beneficial from an economic point of view,efforts to develop a more effective vaccine against swine mycoplasma have been proposed and vaccines developed using recombinant DNA technology represents a viable alternative
Presented my Guest Lecture on the topic, "Infections in SICU and ICU" at MAHAMICROCON 2016 - XXII Maharashtra State Conference of Indian Association of Medical Microbiologists on 25th September in Dr. Vaishampayan Memorial Government Medical College, Solapur.
My Guest Lecture at "TROPACON 2011", 5th National Conference of Indian Academy of Tropical Parasitology, 11th-13th November, 2011 at Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
In light of the of the Ebola outbreak in West Africa the Yale-Tulane ESF-8 Planning and Response Program has produced this special report.
Since most of our student are not back yet from summer break I reached out to past alumni and members of Team Rubicon to assist in putting this report together.
The report was compiled entirely from open source materials. Please feel free to forward the report to anyone who might be interested.
Any students, past alumni, or volunteers who would like to work on future slides let me know. Assistance is always welcome.
Ebola Virus Disease: An Emerging Global Public Health Concernpaperpublications3
Abstract: Ebola virus disease (EVD) formerly known as, Ebola haemorrhagic fever (EHF) is one of the most severe viral HFs often characterized by the sudden onset of fever, intense weakness, muscle pain, headache, sore throat, vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa affecting multiple countries in West Africa e.g. Guinea, Liberia, and Sierra Leone. The current outbreak threatens to spread more and cross the boundaries of West Africa to establish itself in realms of different continents. India is also vulnerable due to its susceptible ecosystem and unprepared health system. Our healthcare systems as well as communities are clearly not sensitised to the extent of the danger this possess, it’s time to take action before it is far too late.
Keyword: Ebola Virus Disease, Outbreak, West Africa, Laboratory Diagnosis, Vaccine, Prevention.
Ebola Virus Disease: An Emerging Global Public Health Concernpaperpublications3
Abstract: Ebola virus disease (EVD) formerly known as, Ebola haemorrhagic fever (EHF) is one of the most severe viral HFs often characterized by the sudden onset of fever, intense weakness, muscle pain, headache, sore throat, vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa affecting multiple countries in West Africa e.g. Guinea, Liberia, and Sierra Leone. The current outbreak threatens to spread more and cross the boundaries of West Africa to establish itself in realms of different continents. India is also vulnerable due to its susceptible ecosystem and unprepared health system. Our healthcare systems as well as communities are clearly not sensitised to the extent of the danger this possess, it’s time to take action before it is far too late.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Professional air quality monitoring systems provide immediate, on-site data for analysis, compliance, and decision-making.
Monitor common gases, weather parameters, particulates.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
Deep Behavioral Phenotyping in Systems Neuroscience for Functional Atlasing a...Ana Luísa Pinho
Functional Magnetic Resonance Imaging (fMRI) provides means to characterize brain activations in response to behavior. However, cognitive neuroscience has been limited to group-level effects referring to the performance of specific tasks. To obtain the functional profile of elementary cognitive mechanisms, the combination of brain responses to many tasks is required. Yet, to date, both structural atlases and parcellation-based activations do not fully account for cognitive function and still present several limitations. Further, they do not adapt overall to individual characteristics. In this talk, I will give an account of deep-behavioral phenotyping strategies, namely data-driven methods in large task-fMRI datasets, to optimize functional brain-data collection and improve inference of effects-of-interest related to mental processes. Key to this approach is the employment of fast multi-functional paradigms rich on features that can be well parametrized and, consequently, facilitate the creation of psycho-physiological constructs to be modelled with imaging data. Particular emphasis will be given to music stimuli when studying high-order cognitive mechanisms, due to their ecological nature and quality to enable complex behavior compounded by discrete entities. I will also discuss how deep-behavioral phenotyping and individualized models applied to neuroimaging data can better account for the subject-specific organization of domain-general cognitive systems in the human brain. Finally, the accumulation of functional brain signatures brings the possibility to clarify relationships among tasks and create a univocal link between brain systems and mental functions through: (1) the development of ontologies proposing an organization of cognitive processes; and (2) brain-network taxonomies describing functional specialization. To this end, tools to improve commensurability in cognitive science are necessary, such as public repositories, ontology-based platforms and automated meta-analysis tools. I will thus discuss some brain-atlasing resources currently under development, and their applicability in cognitive as well as clinical neuroscience.
3. INTRODUCTION
• Ebola viruses cause a severe illness known as Ebola hemorrhagic
fever that can be lethal to humans.
• Although hemorrhagic fever can be brought on by several types of
viruses, Ebola produces one of the most deadly forms of viral
hemorrhagic fevers.
• Mortality rates for Ebola hemorrhagic fever are high, ranging from
50 percent to 90 percent, with death usually occurring from shock
rather than blood loss.
4. HISTORY
The virus takes its name from the Ebola River in the northern Congo
basin of central Africa, where it first emerged in 1976.
Prevention is through isolation of the infected person/s so it does
not spread.
In Hot Zone in Africa a cave called Kitum cave is found which links
two separate single-incidence occurrences of Ebola. Scientists went to
the cave and took blood samples from everything they can find. They
found nothing at all and the results were never formally published.
Kitum cave was stuffed with bats; so the fruit bat find could explain
how two people died of Ebola in separate incidents after visiting Kitum
cave.
5. Past outbreaks
EVD first appeared in in 1976 in 2 simultaneous outbreaks – Zaire,
Sudan and Yambuku, DRC.
The latter occurred in a village near Ebola(origin of name).
Year Country
Ebolavirs
species Cases Deaths Case fatality
2012
Democratic
Republic of Congo Bundibugyo 57 29 51%
2012 Uganda Sudan 7 4 57%
2012 Uganda Sudan 24 17 71%
2011 Uganda Sudan 1 1 100%
2008
Democratic
Republic of Congo Zaire 32 14 44%
2007 Uganda Bundibugyo 149 37 25%
2007
Democratic
Republic of Congo Zaire 264 187 71%
7. Year Country Ebola
species
Cases Deaths Case fatality
1995
Democratic
Republic of Congo Zaire 315 254 81%
1994 Cote d'Ivoire Taï Forest 1 0 0%
1994 Gabon Zaire 52 31 60%
1979 Sudan Sudan 34 22 65%
1977
Democratic
Republic of Congo Zaire 1 1 100%
1976 Sudan Sudan 284 151 53%
1976
Democratic
Republic of Congo Zaire 318 280 88%
8. PRESENT OUTBREAK
The recent outbreak (2014) in West Africa is the largest and
complex outbreak since the Ebola virus was first discovered in 1976.
It has spread between countries starting in Guinea then spreading
across land borders to Sierra leone and Liberia, by air(1 traveller
only) and by land(1 traveller) to Senegal.
These are the most severly affected countries due to weak health
systems.
The index case was a pregnant woman who prepared bushmeat
from an animal.
On Aug 8, 2014 WHO declared it as “Public Health Emergency of
international Concern”.
Zaire species is involved in the present outbreak of Ebola.
9. IMPORTANT TIMELINE OF EBOLA OUTBREAK
• March 22: Guinea confirms a previously unidentified hemorrhagic fever, which
killed over 50 people in its south eastern Forest Region, is Ebola. One study traces
the suspected original source to a 2-year-old boy in the town of Gueckedou. Cases
are also reported in the capital, Conakry.
• March 30: Liberia reports two Ebola cases; suspected cases reported in Sierra
Leone.
• May 26: WHO confirms first Ebola deaths in Sierra Leone.
• June 23: With deaths above 350, making the West African outbreak the worst
Ebola epidemic on record, MSF says it is "out of control" and calls for massive
resources.
• July 25: Nigeria, Africa's biggest economy, confirms its first Ebola case, a man who
died in Lagos after traveling from Monrovia.
• Aug. 2: A U.S. missionary physician infected with Ebola in Liberia is flown to Atlanta
in the United States for treatment.
• Aug. 5: A second U.S. missionary infected with Ebola is flown from Liberia to
Atlanta for treatment.
• Aug. 8: WHO declares Ebola "international public health emergency," stops short
of urging ban on trade and travel.
• Aug. 12: WHO says death toll has topped 1,000, approves use of unproven drugs
or vaccines.
• A Spanish priest with Ebola dies in a Madrid hospital.
10. • Aug. 24: Democratic Republic of Congo declares Ebola outbreak in a
northern province, apparently separate from larger outbreak.
• An infected British medical worker is flown home from Sierra Leone for
treatment.
• Aug. 29: Senegal reports first confirmed Ebola case
• Sept. 3: Epidemic's pace accelerates; deaths top 1,900. Officials say there
were close to 400 deaths in the past week.
• A third U.S. missionary doctor infected with Ebola is flown out of Liberia for
treatment in Omaha, Nebraska.
• Sept. 26 - New WHO tally: 3,091 dead out of 6,574 probable, suspected and
confirmed cases
• Sept. 30 - CDC confirms the first diagnosis in the United States of a patient
infected with Ebola. The patient, being treated at a hospital in Dallas, had
travelled to West Africa
• Oct. 17 –WHO declares Senegal free of Ebola.
• Oct. 20-WHO declares Nigeria free of Ebola.
11.
12. EPIDEMIOLOGICAL STATUS
• Ebola first emerged in Sudan and Zaire in the year 1976.
• The first outbreak of Ebola (Ebola-Sudan) infected over 284 people,
with a mortality rate of 53%.
• A few months later, the second Ebola virus emerged from Yambuku,
Zaire, (Ebola-Zaire); it had the highest mortality rate of any of the
Ebola viruses (88%), infected 318 people.
• On the basis of available evidence and the nature of similar viruses,
researchers believe that the virus is animal-borne and is normally
maintained in an animal host that is native to the African continent.
• The virus is not known to be native to any other continents,
though.
13.
14. TYPES OF EBOLA
There are five subtypes of Ebola viruses:
1. Bundibugyo virus (BDBV).
2. Sudan virus (SUDV).
3. Taï Forest virus (TAFV).
4. Zaire Ebola virus (EBOV).
5. Reston virus.
Each of these viruses were named after the location in which the
disease had its first out break.
15. WHERE CAN THE VIRUS BE FOUND?
• Originates in primates including gorillas, chimpanzees, and humans
and some domestic pigs, also elephants in central Africa
• Host cell: Ebola interacts specifically with liver cells and cells of the
reticulo-endothelial system. The lining of blood capillaries are
attacked. The capillaries start to leak fluids and plasma proteins.
Some patients experience intravascular coagulation, and loss of
normal clotting capability.
16. The virus kills gorillas and
chimpanzees and other monkeys.
Because it kills apes in such high
percentage – they are not likely
to be its natural host.
18. HOW IS IT TRANSMITTED?
• Ebola is transmitted by blood, bodily fluids, and tissue of infected
people.
• Ebola can be transmitted in the simplest of ways. If you are walking
in the bush and an elephant has the virus and the elephant sneezes,
the virus can be transmitted by entering your mouth or even
touching an open cut.
19.
20.
21. LIFE CYCLE
• First in the non-human animal.
• Gets transmitted to the human by direct contact with their faeces
and bodily fluids. Animal can sneeze and the virus can make direct
contact with a human mouth or even a cut.
• Gets into the host cell (liver cell).
• The virus multiplies in the cell.
• Then is transferred by the human to another animal or human
through the same way the virus was transferred him/her.
22.
23. THE WEAK LINK
• The transmission and spread can be cut off near the end of stage 4
by isolating the human thus he/she can’t contaminate anyone or
anything else.
• As the man’s body fluids and tissue is not in contact with any other
possible hosts the virus continues to multiply within the person till
death.
24. WHERE DOES EBOLA HIDE?
• Fruit Bats
• Ebola in liver and spleen
cells.
• Fruit bats do not show any
symptoms.
• More research needs to be
done.
25. SYMPTOMS OF DISEASE
Time Frame Symptoms that
occur in most
Ebola patients:
Symptoms that
occur in some
Ebola patients:
Within a few days
of becoming
infected with the
virus:
high fever, head
ache, muscle aches,
stomach pain,
fatigue, diarrhea
Sore throat,
hiccups, rash, red
and itchy eyes,
vomiting blood,
bloody diarrhea
Within one week
of becoming
infected with the
virus:
Chest pain, shock,
and death
Blindness and
bleeding
26.
27. CONTROLLING EBOLA
To control Ebola and make sure it does not spread, one needs to
isolate the person in and enclosed area until he/she dies.
This affects some communities cultural aspects as this means none
of the persons family or friends can give the person a good bye hug,
hold, etc. since the virus is contagious.
This also means a funeral can’t be held and even if it is the best for
people on a global basis, their culture has been invaded and they
weren’t allowed to do what they might have been doing for
generations.
28. CONT…..
A successful virus does not kill its host and also does not seriously
harm it. When the traditional host of a virus is wiped out, the virus
will try to jump to other species, and it will mutate.
A virus that is benign to a moth may be a killer of humans.
Conserving the environment can keep these killers in harmless
hosts inside the rain forests and jungles of the world. Wipe out
their environments and the hosts will die, the viruses will mutate
and jump species, and we could be in serious trouble.
31. DIAGNOSIS OF EBOLA
• Diagnosing Ebola can be difficult at first since early symptoms, such as
fever, are nonspecific to Ebola infection.
• However, if a person has the early symptoms and has had contact with
Ebola they should be isolated and public health professionals notified.
• Samples from the patient can then be collected and tested to confirm
infection.
32. • The diagnosis is confirmed by isolating the virus, detecting its RNA or
proteins, or detecting antibodies against the virus in a person's blood.
• Isolating the virus by cell culture, detecting the viral RNA by polymerase
chain reaction (PCR) and detecting proteins by ELISA is effective early
and in those who have died from the disease.
• Virions can be seen and identified in cell culture by electron
microscopy due to their unique filamentous shapes, but electron
microscopy cannot tell the difference between the various filoviruses
despite there being some length differences.
• Detecting antibodies against the virus is effective late in the disease and
in those who recover.
SPECIFIC METHODS
33. Timeline of Infection Diagnostic tests available
Within a few days after symptoms begin
•Antigen-capture enzyme-linked
immunosorbent assay (ELISA) testing
•IgM ELISA
•Polymerase chain reaction (PCR)
•Virus isolation
Later in disease course or after recovery •IgM and IgG antibodies
Retrospectively in deceased patients
•Immunohistochemistry testing
•PCR
•Virus isolation
Source: Centers for Disease Control and Prevention http://www.cdc.gov/vhf/ebola/diagnosis/index.html
Accessed Oct. 14, 2014
EBOLA DIAGNOSTIC TECHNIQUES
35. EBOLA VIRUS DIAGNOSIS
• Real Time PCR (RT-PCR):
– Used to diagnose acute infection.
– More sensitive than antigen detection ELISA.
– Identification of specific viral genetic fragments.
– Performed in selected certified laboratories.
• RT-PCR sample collection:
– Volume: minimum volume of 4mL whole blood.
– Plastic collection tubes.
– Whole blood preserved with EDTA is preferred .
• Whole blood preserved with sodium polyanethol sulfonate
(SPS), citrate, or with clot activator is acceptable.
36. CONT…..
• Virus isolation
– Requires Biosafety Level 4 laboratory.
– Can take several days.
• Immunohistochemical staining and histopathology
– On collected tissue or dead wild animals; localizes viral antigen.
• Serologic testing for IgM and IgG antibodies (ELISA):
– Detection of viral antibodies in
specimens, such as blood, serum,
or tissue suspensions.
– Monitor the immune response
in confirmed EVD patients.
37. POTENTIAL EBOLA TREATMENTS
1. Antibody therapy
a. Convalescent whole blood and
plasma
b. Monoclonal antibodies (ZMapp)
2. Antiviral therapy
a. RNA-based drugs
b. Brincidofovir (CMX-001)
3. Immunomodulators
4. Coagulation modulators
38. MONOCLONAL ANTIBODIES - ZMapp
• Cocktail of 3 monoclonal antibodies:
– c13C6 and c2G4 and c4G7
• Manufactured in tobacco plants.
• Targets Ebola virus glycoprotein.
• Attaches to the virus and block its infective potential.
• Not yet tested in human trials.
• Small number of cases from current outbreak given drug on
compassionate basis with variable results.
• Current supplies of drug exhausted.
• Efforts being made to scale up production, task difficult due to its
complex production processes.
39. RNA-BASED DRUGS
• Interfere with translation of Ebola virus mRNA to protein.
• Prevent virus from replicating.
Favipiravir (T-705)
• Orally
• Approved for influenza treatment in Japan.
• Efficacy against Ebola in mice (Oestereich et al 2014).
AVI-7537
• Intravenously
• In early stage development for treatment of Ebola virus.
• It is an antisense phosphorodiamidate morpholino oligimers (PMO)
that inhibits VP24 protein of Ebola virus.
40. CONT…..
TKM-Ebola
• Intravenously.
• It is a small interfering RNA (siRNA), affecting 3 of Ebola’s 7
proteins.
• Limited safety and efficacy data are available.
• Clinical hold on phase 1 trials in early 2014, because of increased
cytokine levels in healthy individuals.
• FDA has approved the emergency use of TKM-Ebola during the
current outbreak.
• Risk versus benefit should be estimated when deciding whether to
use this agent.
41. BRINCIDOFOVIR (CMX-001)
• Orally
• Brincidofovir is a prodrug of cidofovir but fewer renal side-effects
than cidofovir.
• In vitro tests have shown its potential for treatment of EVD.
IMMUNOMODULATORS
Interferons
• Commercially available.
• Efficacy in rodents.
• Delayed time to death (Smith et al 2013).
42. COAGULATION MODULATORS
• Severe coagulation disorder occurs in EVD.
• Recombinant Activated Protein C
– Inhibits clotting factors.
– Levels of protein C low in EVD.
• Recombinant Nematode Anticoagulant Protein
– Inhibits clotting factors.
– Limited success with both in NHP studies.
(Hensley et al 2007; Geisbert et al 2003)
43. LINE OF TREATMENT
• There are no approved treatments available for EVD.
• Clinical management focus - supportive care of complications:
– hypovolemia, electrolyte abnormalities, haematologic
abnormalities, refractory shock, hypoxia, haemorrhage, septic
shock, multi-organ failure.
• Recommended care includes:
– volume repletion.
– maintenance of blood pressure (with vasopressors if needed)
– maintenance of oxygenation.
– pain control.
– nutritional support.
– treating secondary bacterial infections.
Source: Centers for Disease Control and Prevention. http://www.cdc.gov/vhf/ebola/hcp/clinician-information-
us-healthcare-settings.html Accessed Oct. 14, 2014
44. CONT….
• Among patients from West Africa, large volumes of intravenous
fluids have often been required to correct dehydration due to
diarrhea and vomiting.
• Several investigational therapeutics for Ebola virus disease are in
development.
• There are no approved vaccines available for EVD.
• Several investigational Ebola vaccines are in development, and
Phase I trials are underway for some vaccine candidates.
Source: Centers for Disease Control and Prevention. http://www.cdc.gov/vhf/ebola/hcp/clinician-information-
us-healthcare-settings.html Accessed Oct. 14, 2014
45. • DNA vaccines, adenovirus-based vaccines, and VSIV-based vaccines
have entered clinical trials.
• No licensed vaccine for EVD is available. Several vaccines are being
tested, but none are available for clinical use.
POSSIBILITY OF VACCINES?
46. EBOLA VACCINES - HISTORICALLY
• Debate about requirement for vaccine previously-
o Rarity of disease.
o Lack of interest from pharmaceutical industry
o Potential cost.
• View has changed in recent years-
o Increasing frequency of outbreaks with high
case fatality rates.
o Number of imported cases of viral
haemorrhagic fever and laboratory exposures.
o Potential misuse of EVD as bioterrorism agent.
47. WHO TO VACCINATE?
• Valuable for:
Medical personnel
First responder
Military personnel
Researchers
Ring vaccination in outbreak
48. WHAT’S IN THE PIPELINE?
• Several candidate vaccines being developed.
• Two identified as being at the most advanced stage of
development.
• Both are recombinant vector vaccines:
1. Chimpanzee adenovirus serotype 3 (cAd3-EBO)
2. Recombinant vesicular stomatitis virus (rVSV-EBO)
• Both are being fast-tracked but data on safety and efficacy are
limited.
49. 1. CHIMPANZEE ADENOVIRUS SEROTYPE 3
(cAd3-EBO)
• Based on recombinant adenovirus 3 (cAd3)
technology-
– a surface protein gene of Ebola virus is inserted into a modified
chimpanzee adenovirus
– resulting virus cannot replicate in humans, but is intended to
induce an immune response
• Pre-existing immunity in humans may be a problem, impairing
vaccine efficacy.
• However, cAd3 is a rare adenovirus serotype, with most humans not
having pre-existing immunity.
50. CONT…..
• cAd3-EBO tested in 16 NHPs and found to be 100% protective
(Stanley et al 2014).
• Phase 1 human trials began in September in US and Oxford.
• Being developed by GlaxoSmithKline and US National Institute of
Health.
51. 2. RECOMBINANT VESICULAR STOMATITIS
VIRUS VACCINE (rVSV-EBO)
• VSV causes mild flu-like illness in humans.
• Gene for surface glycoprotein of Ebola inserted into VSV - this
recombinant virus is then intended to induce an immune response
in humans to Ebola virus.
• Jones et al (2005)
– 100% protective against Zaire Ebola virus (ZEBOV) in NHPs after
a single vaccination.
• Feldmann et al (2007)
– demonstrated varying degrees of protection post-exposure in
NHPs if vaccine given up to 24 hours after exposure to a lethal
dose of Ebola virus.
52. CONT….
• Given to lab worker exposed to ZEBOV following needle stick injury
in Hamburg, 2009
– VSV viraemia but did not develop EVD.
– It’s not possible to know if treatment
was effective or if patient was never
infected.
• Phase 1 human trials has began.
• Being developed by Public Health Agency of Canada, NewLink
Genetics and others.
53.
54. To obtain samples and study the disease in remote areas where
outbreaks occur.
A high degree of biohazard containment is required for laboratory
studies and clinical analysis.
CD4+ T cells are important master‐regulators of the immune response
and other cellular compartments to produce more robust and long
lasting immunity.
Lack of CD4+ T cells in Ebola infection that is thought to underlie the
suboptimal antibody responses in infected subjects and the ultimate
inability to mount sufficient antibody responses to suppress the
infection.
Potent vaccination strategy against Ebola must include a robust CD4+ T
cell‐mediated response, likely critical in providing T cell help to the B
cell compartment.
DIFFICULTY IN MAKING VACCINES
55. CONCLUSION
Ebola is a threat not only to humans but also to our closest living
relatives - the great apes.
The western lowland gorilla populations have been reduced by Ebola
to such an extent that they are now considered "critically
endangered". About a third of the gorillas in protected areas have died
from Ebola in the past 15 years.
Scientists are concerned that their numbers may not be able to
recover and fear that they could become extinct in decade.
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