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Ebola Virus Facts and Information

CDC Ebola Virus

Ebola Virus:

The current 2014 Ebola Hemorrhagic Fever outbreak is the worst in history, and largest outbreak to have ever occurred. With 909* (*Laboratory confirmed cases) and 1323 clinical cases with 729 deaths recorded as of July 27, 2014.

Numerous healthcare workers including a doctor and two others from the U.S. have become infected with the virus. At least one of the patients, the doctor has been quarantined and flown to a treatment center here in the United States.

This step has caused some controversy, and even some conspiracy theories to evolve. This is unfortunate, and while the disease itself is a nasty one, the overall risk to the general U.S. population from bringing the infected doctor here remains extremely low.

FACTS YOU NEED TO KNOW:

  • Ebola is spread only through direct contact with infected bodily fluids
  • Ebola has been genetically stable since it was first discovered (has not mutated)
  • Ebola is not spread through the air
  • It is often fatal to humans and has a general mortality rate of 90%
  • Ebola has an incubation period of two to 21 days
  • The Ebola virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission
  • Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus
  • Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals
  • There are five distinct types of Ebola Virus Disease, the current outbreak is being caused the Zaire ebolavirus (ZEBOV)
  • The other types are – Bundibugyo ebolavirus (BDBV), Sudan ebolavirus (SUDV), Reston ebolavirus (RESTV) Found in the Philippines and the People’s Republic of China, and Taï Forest ebolavirus (TAFV)
  • The RESTV can infect humans, but no illness or death in humans from this species has been reported to date.
  • Ebola outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests
  • Transmission can also be spread to healthcare workers from exposure to contaminated objects, such as needles and other Bloodborne Pathogens (BBP) contaminants, extreme BBP precautions should be taken

Why is the Current Outbreak So Bad?

There are numerous reasons for this, but it is mostly attributed to the infected areas culture and customs of handling the infected. In particular infected dead bodies are cleansed before burial and in many cases those doing the cleaning are not taking the needed or necessary precautions.

In addition, there is also trust issues among the locals against Western doctors. In numerous cases infected patients placed under quarantine have “escaped” their quarantine and traveled to be with family members.

Each outbreak area requires its own entire medical team to investigate, track, quarantine, control and contain the spread, and provide supportive care to the infected. The current outbreak has spread more rapidly and beyond the current control mechanisms in place. Many organizations, have said this outbreak has spread beyond their current control in areas of West Africa.

This does not mean that the current outbreak will continue to spread out of control, but more resources will be required to gain the upper hand over the outbreak.

Can it Spread Beyond West Africa?

Yes. In fact one U.S. citizen was traveling back to the U.S. when he became ill. However, this does not mean it will become a world wide global pandemic, but further precautions are now currently in place to monitor travelers.

However, though there is some risk of the Ebola Virus spreading the current risk to the U.S. remain very minimal at this time.

Sign and Symptoms of Ebola Virus:

Symptoms of Ebola Virus typically include:

  • Fever
  • Headache
  • Joint and muscle aches
  • Weakness
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Lack of appetite

Some patients may experience:

  • A Rash
  • Red Eyes
  • Hiccups
  • Cough
  • Sore throat
  • Chest pain
  • Difficulty breathing
  • Difficulty swallowing
  • Bleeding inside and outside of the body

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola Virus though 8 – 10 days is most common.

Some who become sick with Ebola Hemorrhagic Fever are able to recover, while others do not. The reasons behind this are not yet fully understood. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.

Ebola Virus is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Transmission of Ebola Virus:

Because the natural reservoir of Ebola Viruses has not yet been proven, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers have hypothesized that the first patient becomes infected through contact with an infected animal.

When an infection does occur in humans, there are several ways in which the virus can be transmitted to others.

These include:

  • Direct contact with the blood or secretions of an infected person

  • Exposure to objects (such as needles) that have been contaminated with infected secretions

The viruses that cause Ebola Hemorrhagic Fever are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.

During outbreaks of Ebola Hemorrhagic Fever, the disease can spread quickly within healthcare settings (such as a clinic or hospital).

Exposure to Ebola Viruses can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.

Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, Ebola Virus transmission can continue and amplify an outbreak.

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.

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through 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.

People are infectious as long as their blood and secretions contain the virus. Ebola Virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

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.

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 immuno-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 humans.

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 haemorrhagic fevers.

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

  • antibody-capture enzyme-linked immunosorbent 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.

Additional Information About Ebola Virus:

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This graphic shows the life cycle of the ebolavirus. Bats are strongly implicated as both reservoirs and hosts for the ebolavirus. Of the five identified ebolavirus subtypes, four are capable of human-to-human transmission. Initial infections in humans result from contact with an infected bat or other wild animal. Strict isolation of infected patients is essential to reduce onward ebolavirus transmission.

Cases of Ebola Hemorrhagic Fever in Africa, 1976 – 2012

Country

Town

Cases

Deaths

Species

Year

Dem. Rep. of Congo

Yambuku

318

280

Zaire ebolavirus

1976

South Sudan

Nzara

284

151

Sudan ebolavirus

1976

Dem. Rep. of Congo

Tandala

1

1

Zaire ebolavirus

1977

South Sudan

Nzara

34

22

Sudan ebolavirus

1979

Gabon

Mekouka

52

31

Zaire ebolavirus

1994

Ivory Coast

Tai Forest

1

0

Taï Forest ebolavirus

1994

Dem. Rep. of Congo

Kikwit

315

250

Zaire ebolavirus

1995

Gabon

Mayibout

37

21

Zaire ebolavirus

1996

Gabon

Booue

60

45

Zaire ebolavirus

1996

South Africa

Johannesburg

2

1

Zaire ebolavirus

1996

Uganda

Gulu

425

224

Zaire ebolavirus

2000

Gabon

Libreville

65

53

Zaire ebolavirus

2001

Republic of Congo

Not specified

57

43

Zaire ebolavirus

2001

Republic of Congo

Mbomo

143

128

Zaire ebolavirus

2002

Republic of Congo

Mbomo

35

29

Zaire ebolavirus

2003

South Sudan

Yambio

17

7

Zaire ebolavirus

2004

Dem. Rep. of Congo

Luebo

264

187

Zaire ebolavirus

2007

Uganda

Bundibugyo

149

37

Bundibugyo ebolavirus

2007

Dem. Rep. of Congo

Luebo

32

15

Zaire ebolavirus

2008

Uganda

Luwero District

1

1

Sudan ebolavirus

2011

Uganda

Kibaale District

11*

4*

Sudan ebolavirus

2012

Dem. Rep. of Congo

Isiro Health Zone

36*

13*

Bundibugyo ebolavirus

2012

Uganda

Luwero District

6*

3*

Sudan ebolavirus

2012

Guinea, Sierra Leone, Liberia

multiple

909*

?

Zaire ebolavirus

2014

*Numbers reflect laboratory confirmed cases only.

Resources:

All information and facts sourced from CDC and WHO as of August 3, 2014

CDC Ebola Virus

WHO Ebola Virus Disease

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