Brief General History of Ebola

In 1976, Ebola (named after the Ebola River in Zaire) first emerged in Sudan and Zaire. 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 (EBOZ). EBOZ, with the highest mortality rate of any of the Ebola viruses (88%), infected 318 people. Despite the tremendous effort of experienced and dedicated researchers, Ebola's natural reservoir was never identified. The third strain of Ebola, Ebola Reston (EBOR), was first identified in 1989 when infected monkeys were imported into Reston, Virginia, from Mindanao in the Philippines. Fortunately, the few people who were infected with EBOR (seroconverted) never developed Ebola hemorrhagic fever (EHF). The last known strain of Ebola, Ebola Cote d'Ivoire (EBO-CI) was discovered in 1994 when a female ethologist performing a necropsy on a dead chimpanzee from the Tai Forest, Cote d'Ivoire, accidentally infected herself during the necropsy¹.

Definition

An infectious and generally fatal disease marked by fever and severe internal bleeding, spread through contact with infected body fluids by a filovirus (Ebola virus), whose normal host species is unknown ².

Causes

EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one called simply, Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species, and the most dangerous of the known Ebola disease causing viruses, as well as being responsible for the largest number of outbreaks.^[15] The fifth virus, Reston virus (RESTV), is not thought to be disease-causing in humans. The five Ebola viruses are closely related to the Marburg viruses.¹

Incubation period

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days.

Transmission

Ebola is introduced into the human population through

· Close contact with the blood, secretions, organs or other bodily fluids of infected animals.

· The handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or

dead or in the rainforest.

· 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.

· 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. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

· Among workers in contact with monkeys or pigs infected with Reston ebolavirus, several infections have been documented in people who were clinically asymptomatic. Thus, RESTV appears less capable of causing disease in humans than other Ebola species.³

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 immune-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans³.

Symptoms of Ebola typically include

· Fever (greater than 38.6°C or 101.5°F)

· Severe headache

· Muscle pain

· Weakness

· Diarrhea

· Vomiting

· Abdominal (stomach) pain

· Lack of appetite

Some patients may experience

· Rash

· Red eyes

· Hiccups

· Cough

· Sore throat

· Chest pain

· Difficulty breathing

· Difficulty swallowing

· Unexplained bleeding inside and outside of the body

Symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus, although 8-10 days is most common. Some who become sick with Ebola are able to recover. We do not yet fully understand why. However, patients who die usually have not developed a significant immune response to the virus at the time of death⁴

Diagnosis

Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:

· Antibody-capture enzyme-linked immune-sorbent assay (ELISA)

· Antigen detection tests

· Serum neutralization test

· Reverse transcriptase polymerase chain reaction (RT-PCR) assay

· Electron microscopy

· Virus isolation by cell culture.

· Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

Vaccine and treatment

· No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

· Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids.

No specific treatment is available. New drug therapies are being evaluated. Prevention

When cases of the disease do appear, risk of transmission is increased within healthcare settings. Therefore, healthcare workers must be able to recognize a case of Ebola and be ready to use practical viral hemorrhagic fever isolation precautions or barrier nursing techniques. They should also have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.

Barrier nursing techniques include:

Ø Wearing of protective clothing (such as masks, gloves, gowns, and goggles)

Ø Using infection-control measures (such as complete equipment sterilization and routine use of disinfectant).

Ø Isolating patients with Ebola from contact with unprotected persons.

Past Ebola Outbreaks

Past Ebola outbreaks have occurred in the following countries:

• Democratic Republic of the Congo (DRC)

• Gabon

• South Sudan

• Ivory Coast

• Uganda

• Republic of the Congo (ROC)

• South Africa (imported)

Current Ebola Outbreak in West Africa

The current (2014) Ebola outbreak is occurring in the following West African countries:

· Guinea

· Liberia

· Sierra Leone

• Nigeria

Ten Interesting and Important facts about Ebola

1) Death is not absolutely certain:

2) Its only spread through bodily fluids:

3) Access to modern medicine matters:

4) Quarantine and travel restrictions are important:

5) There is no cure and no real treatment:

6) But new drugs are on the horizon:

7) Ebola has only been around for about 40 years:

8) The symptoms are awful:

9) It didn’t start with monkeys:

10) It’s named after a river⁵

TIPS ON HOW TO AVOID CONTRACTING THE EBOLA VIRUS

Ebola disease as of today has no cure here are some few tips that can help protect you and your family from the deadly virus,

1. Avoid bush meat or any meat you are not sure of its source.

2. Wash your hands frequently with detergent or soap using clean water.

3. Avoid trips to Ebola endemic countries

4. Get a hand sanitizer for people to use in your office and educate them on the importance of sanitizers, Get one for your kids to use in school frequently and if possible for their class.

5. Avoid buying Food stuffs, Clothing or other personal materials from Markets/Shops that share the same vicinity with live or roasted bush meat, dealer’s or sellers

6. Be careful with hands when using railings on the stairs, door knobs and other utilities used by the public.

7. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues

8. Watch out for people with flu-like symptoms and sudden fever

9. Avoid Pig farms, Pig farms in Africa play a role in the amplification of infection because of the presence of fruit bats on these farms.

10. Avoid bat meats and bat products⁶

REFERENCES:

1. https://web.stanford.edu/group/virus/filo/history.html

2. www.oxforddictionaries.com/definition/English/ebola-fever

3. www.who.int/mediacentre/factsheets/fs103/en/ Ebola virus disease

4. www.cdc.gov/vhf/ebola

5.www.fromquarkstoquasars.com/10-interesting-and-important-facts-about Ebola Top of Form

6.www.nairaland.com/1804363/tips-how-avoid-contracting-ebola virus

EBOLA Virus Disease

Mr. Mahesh M Rebinal

Assistant Professor, P.D. Bharatesh College of Nursing, Halaga, Belgaum. Karnataka