Ebola
Transcript of Ebola
EBOLA VIRUS DISEASEEVD
DR.SATTI MOHAMMED SALEH
MEEQAT HOSPITAL MEDICAL DIRECOR
INFECTION CONTROL DIRECTOR
CBAHI SIT MEMBER
CHANGING PATTERN OF INFECTIOUS DISEASES EPIDIMIOLOGY
Spread to new groupRe emerging of some diseases
Resurgent epidemicsDisappearance of same diseases
Appearance of new infectious disease
Determination of change
Changes in susceptibility to infectious disease
Increase opportunities for infection
Rapid adaptation of microbial world
What are viral hemorrhagic fevers?
(VHFs )refer to a group of illnesses that are caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the body are affected). Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired
CLASSIFICATION OF VIRAL HEMORRHAGIC FEVER ACCORDING TO MODES OF TRANSMISSION
ETIOLOGICAL VIRUS DISEASES MODE OF TRANSMISSIONYellow feverDengue types 1-4Chikunguny a rift valley fever
Yellow feverDengue feverChikunguny a hemorrhagic fever
Mosquito borne
Congo-Crimean hemorrhagic fever kyasanur forest disease Omsik hemorrhagic fever
Crimean hemorrhagic fever kyasanur forest disease a Omsk hemorrhagic disease
Tick borne
Junin MachupoLassa
Argentine hemorrhagic fever Bolivian hemorrhagic fever- Lassa fever
Zoonotic
Hanta anMarburgEbola
Korean hemorrhagic feverMarburg virus diseaseEbola virus disease
Unknown
Filoviridae(Ebola, Marburg)
Arenaviridae(Lassa, Junin, Machupo, Guanarito)
Bunyaviridae(CCHF, RVF,
Hantaviruses)
Viral Haemorrhagic Fevers
Flaviviridae(dengue, yellow fever,
TBE encephalitides)
EnvelopedRNA viruses
Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
Ebola Virus Genus Consists of 5 species
1- Zaire 2- Sudan 3- Reston 4- Taiforest 5- Bundibugyo( New)
reservoir The natural host of ebola viruses, and the
manner in which transmission of the virus to humans occurs, remain unknown. This makes risk assessment in endemic areas difficult. With the exception of several laboratory contamination cases (one in England and two in Russia), all cases of human illness or death have occurred in Africa; no case has been reported in the United States.
All filoviruses are classified as : All filoviruses are classified as : Category A select agent pathogens in
USA 1- Easily transmitted between Humans 2- Cause High Mortality ( 40-90%) 3- Potential for Major Public Health
Impact 4- High public panic and disruption 5- Concern for use as Bioterror weapon
Epidemiology :
MURBURG HF ( first filovirus ) In Germany and Yugoslavia 1967
From primates imported from Uganda 31 cases, 23% mortality
Largest outbreak of MURBURG in Angola 2005, 250 cases 90% mortality
large outbreak
Ebola HF first 2 large outbreak simultaneously 1976
Democratic Republic of Congo
Southern Sudan Caused by 2 separate
species ; Zaire ( EBOV) and Sudan ( SUDV)
Other 3 species of EBOLA : ( TAI, RESTON, BUNDIBUGYO
) Occurred less frequently TAI only single non fatal infection ) (AUTOPSY OF DEAD CHIMPANZEES)
A host of similar species is probably associated with Reston virus, which was isolated from infected cynomolgous monkeys imported to the United States and Italy from the Philippines. Several workers in the Philippines and in US holding facility outbreaks became infected with the virus, but did not become ill.
Transmission and Pathogenesis and Pathology
Spread by close contact with sick patients
Virus containing bodily fluids Includes
*Blood * Semen * Vomitus *Breast milk *Saliva *Tears *Stool
Transmission Requires
Close contact with blood, body fluid and mucous Membranes Exposure
No true Aerosol transmission No transmission in
asymptomatic patients during incubation Period
Severe Diseases Attributed to
:
1- Rapid Viral Replication 2- Host immune
suppression 3- Vascular Dysfunction
Case definition-WHO/CDC
Anyone presenting with fever and signs of bleeding such as: • Bleeding of the gums • Bleeding from the nose • Red eyes • Bleeding into the skin (purple coloured patches in the
skin) • Bloody or dark stools • Vomiting blood • Other unexplained signs of bleeding Whether or not there is a history of contact with a
suspected case of EHF.26
OR Anyone living or deceased with: Contact with a suspected case of EHF AND A history of fever, with or without signs of bleeding.
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Lab diagnosis Specific antigen detection. Viral gene detection. Antibodies detection (IgM for recent infection). Viral isolation (BSL-4 Lab.). Non-invasive methods of detection (saliva and urine
sample).
Postmortem by immunohistochemical exam. Of skin or autopsy specimen.
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Treatment : Supportive
Fluid managementBlood products and management of DIC
Oxygenation and ventilationNutrition
No anti viral availableFuture management
Containment
Isolate suspected cases from other patients. Tracing and follow up people exposed to Ebola
cases. Health staff Orientation and using PPE. Health staff Precaution for invasive technique and
body secretions. Inform public about disease nature and burial of
deceased. Strict surveillance of contacts.
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Patient Placement
Single patient room (containing a private bathroom) with the door closed
Facilities should maintain a log of all persons entering the patient's room
Consider posting personnel at the patient’s door to ensure appropriate and consistent use of PPE by all persons entering the patient room
Personal Protective Equipment (PPE)
All persons entering the patient room should wear at least:
GlovesGown (fluid resistant or impermeable)Eye protection (goggles or face shield)
FacemaskAdditional PPE might be required in certain situations
(e.g., copious amounts of blood, other body fluids, vomit, or feces present in the environment), including but not limited to:
Double glovingDisposable shoe covers
Leg coverings
Challenges
Additional diagnostic tools. Ecological investigations and possible reservoirs. Monitor suspected cases to determine disease
incidence. Natural reservoirs and how virus spread.
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1/6//2015 27055 All countries TOTAL NUMBER
L
1/6/2015 11147 All countries DEATHS
14981 CONFIRMED
Number of casescumulative