Download EBOLA VIRUS DISEASE

DR I.O.LAWAL
MBChB(Ife),FWACS(Urol)
EBOLA VIRUS DISEASE
 Introduction
 Epidemiology
 Transmission
 Signs & Symptoms
 Diagnosis
 Differentials
 Treatment/ Health Education
 Outbreaks/Conclusion
Introduction
 A severe, fatal illness in humans with case fatality of
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up to 90%.
A variety of viral Heamorrhagic fever
Seen mainly in central and West Africa
Highly Contagious, with highest risk to health workers
and relations of infected patients.
Current outbreak started in December, 2013, but not
detected until March, 2014.
Epidemiology
 Ist appeared in two simultaneous outbreaks in 1976: Nzara
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(Sudan) & Yambuku ( a village near Ebola river in DR
Congo).
Genus Ebola Virus is 1 of 3 members of filoviridae along
with genus Marburgvirus & genus Cuevirus.
Genus Ebola Virus has 5 Species: Bundibugyo virus, Zaire
Ebola virus, Sudan Ebola virus, Tai Ebola virus and Reston
Ebola virus.
The 1st 3 has been associated with large outbreaks.
Current outbreak due to Zaire Ebola virus.
Reston Species is found in Phillipines & China; can infect
humans, but no illness or human deaths has been reported
to death.
Transmission
 Natural host includes infected animals: Fruit bats,
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Monkeys, forest antelopes, Gorillas & Chimpanzees.
Transmitted to man by contact with any of the above.
Human-Human transmission occur rapidly by contact
with body secretions of infected person- blood, Saliva,
faeces, vomittus, sweats and semen.
Further spread during Burial ceremony
Recuperating man can infect partner up to 7 weeks
from coitus.
Incubation period is from 2-21 days.
Signs and Symptoms
 Fever
 Rashes
 Severe Headache
 Red eyes
 Muscle pains
 Hiccups
 Weakness
 Sore throat
 Diarrhoea
 Difficulty in breathing
 Vomitting
 Bleeding from mucous
 Abdominal pains
 Lack of apetite
membranes.
Diagnosis
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High index of Suspicion
History of Contact /History of Travel
Signs and Symptoms
Confirmatory test:
*Antigen-capture enzyme linked immuno-sorbent assay
(ELISA)
*IgM ELISA
*Polymerase Chain Reaction (PCR)
*Virus isolation
In deceased patients: Immuno-histochemistry, Virus
isolation and PCR.
Differentials
 Malaria fever.
 Typhoid fever
 Hepatitis infection
 Meningitis
 Other Viral Heamorrhagic fever like Lassa fever,
Dengue fever.
Treatment
 NO KNOWN TREATMENT AT PRESENT
 Present Treatment regime is supportive:
 * Fluids & Electrolyte therapy
 *Maitain Oxygen saturation
 * Nutritional support
 * Administration of anti-coagulants.
 *Treat other complications that may arise.
Health Education
 Barrier Nursing technique
 Wearing of protective clothing( mask, gloves, gowns, &
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goggles).
Routine use of disinfectants.
Isolating patients with Ebola virus from population.
Quarrantine infected patients.
Surveillance of contacts.
Present Outbreak
COUNTRY
CASES
DEATHS
Guinea
519
380
Liberia
786
413
Sierra Leone
810
348
Nigeria
12 (?10)
4
Outbreaks: Previous
YEAR
COUNTRY
SPECIES
CASES
DEATHS
FATALITY
2012
DR
CONGO
Bundibugy
o
57
29
51%
2012
UGANDA
Sudan
7
4
57%
2012
UGANDA
Sudan
24
17
71%
2011
UGANDA
Sudan
1
1
100%
2008
DR
CONGO
Zaire
32
14
44%
2007
UGANDA
Bundibugy
o
149
37
25%
2007
DR
CONGO
Zaire
264
187
71%
2005
DR
CONGO
Zaire
12
10
83%
Outbreaks: Previous
YEAR
COUNTRY
SPECIES
CASES
DEATHS
FATALITY
2001-2002
Gabon
Zaire
65
53
82%
2000
Uganda
Sudan
425
224
53%
1996
SA exGabon
zaire
1
1
100%
1996-Jul/De Gabon
Zaire
60
45
75%
1996Jan/Ap
Gabon
Zaire
31
21
68%
1995
DR
CONGO
Zaire
315
254
81%
1994
Cote
d’Ivoire
Tai Forest
1
0
0%
1994
Gabon
Zaire
52
31
60%
1979
Sudan
Sudan
34
22
65%
Conclusion- Take Home
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Ebola Virus has very high fatality , over 90%
No known cure at present
No known vaccines.
Approved experimental drug:-Z-mapp(on trial)
Same for Nano-Silver drug ??( in Nigeria only).
Bitter kola does not cure Ebola virus disease.
Salt water does not prevent or cure Ebola virus disease
PREVENTION IS STILL BETTER-PERSONAL
HYGIENE, AVOID CONTACT,
CULTURAL/RELIGIOUS PRACTICES.