Ebola virus disease

بسم ال الرحمن الرحيم

Ebola virus disease

Dr. Kamal Fayez El TohamiProfessor of Pediatrics

Al Azhar University - Cairo

Agenda

• What is Ebola• Symptoms of Ebola• Transmission• Risk• Prevention• Diagnosis• Treatment

Ebola virus disease• Ebola virus disease (EVD), Ebola hemorrhagic

fever (EHF), or simply • Ebola is a disease of humans and other primates

caused by an ebola virus. • Symptoms start two days to three weeks after

contracting the virus, with a fever, sore throat, muscle pain and headaches. Typically, vomiting, diarrhea and rash follow, along with decreased functioning of the liver and kidneys.

• Around this time, affected people may begin to bleed both within the body and externally

Transmission

Transmission

• Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown.

• However, researchers believe that the first patient becomes infected through contact with an infected animal.

Transmission

• When an infection does occur in humans, the virus can be spread in several ways to others.

Transmission• Healthcare providers caring for Ebola patients and the

family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.

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

• Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.

Risk of Exposure

• Ebola viruses are found in several African countries.

• Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo.

• Since then, outbreaks of Ebola among humans have appeared sporadically in Africa.

• It can affect all age groups.

Ebola Outbreaks

• Ebola outbreaks have occurred in the following countries:

• Democratic Republic of the Congo (DRC)• Gabon• South Sudan• Ivory Coast• Uganda• Mali• Republic of the Congo (ROC)• South Africa

Risk

• All cases of human illness or death from Ebola have occurred in Africa (one in England and two in Russia). One case had been reported in the United States.

Prevention

• There is NO FDA-approved vaccine available for Ebola.

• If you travel to or are in an area affected by an Ebola outbreak, make sure to do the following:

• Practice careful hygiene. • Avoid contact with blood and body fluids.• Avoid funeral or burial rituals that require

handling the body of someone who has died from Ebola

Prevention

• Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.

• Avoid hospitals where Ebola patients are being treated.

• After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms of Ebola.

Prevention

• Healthcare workers who may be exposed to people with Ebola should follow these steps:

• Wear protective clothing, including masks, gloves, gowns, and eye protection.

• Practice proper infection control and sterilization measures.

• Isolate patients with Ebola from other patients.

Prevention

• Avoid direct contact with the bodies of people who have died from Ebola.

• Notify health officials if you have had direct contact with the blood or body fluids, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola.

Diagnosis• Diagnosing Ebola in an

person who has been infected for only a few days is difficult, because the early symptoms, such as fever, are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever.

Diagnosis

• However, if a person has the early  symptoms  of Ebola and has had contact with the blood or body fluids of a person sick with Ebola, they should be isolated and public health professionals notified.

• Samples from the patient can then be collected and tested to confirm infection.

Laboratory tests used in diagnosis include

• Within a few days after symptoms begin

• Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing

• IgM ELISA

• Polymerase chain reaction (PCR)

• Virus isolation

Laboratory tests used in diagnosis include

• Later in disease course or after recovery

• IgM and IgG antibodies

• Retrospectively in deceased patients

• Immunohistochemistry testing

• PCR

• Virus isolation

Treatment

• No specific vaccine or medicine (e.g., antiviral drug) has been proven to be effective against Ebola.

• Providing intravenous fluids (IV) and balancing electrolytes

• Maintaining oxygen status and blood pressure

• Treating other infections if they occur

Treatment

• Some experimental treatments developed for Ebola have been tested and proven effective in animals but have not yet been tested in randomized trials in humans.

• Recovery from Ebola depends on the patient’s immune response.

• People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer.

Experimental Treatments and Vaccines for Ebola

• What is ZMapp?• ZMapp, being developed by Mapp

Biopharmaceutical Inc., is an experimental treatment, for use with individuals infected with Ebola virus.

• It has not yet been tested in humans for safety or effectiveness.

• The product is a combination of three different monoclonal antibodies that bind to the protein of the Ebola virus so that the human immune system can clear the virus.

Experimental Treatments and Vaccines for Ebola

• Are there other companies developing experimental

treatments or vaccines?

• Two other companies,

– Tekmira is working with a company called

Newlink to develop an Ebola vaccine candidate.

– BioCryst, with NIH support, is working to develop

an antiviral drug to treat Ebola virus that is

expected to begin Phase 1 testing later this year.

Take Home Message

• Ebola is a lethal disease• It affects all age groups• It is transmitted through body fluids and contact to

an infected animal or person• Prevention is through isolation and means of

disinfectant and sterilization• Treatment uptilnow is supportive• No valid vaccine or antiviral are available yet

ThanksDr. Kamal Fayez El Tohami

Professor of PediatricsAl Azhar University - Cairo