Ebola virus disease (EVD), formerly known as hemorrhagic fever Ebola is a serious and often fatal disease in humans.
The virus is transmitted to people from wild animals and the differences in the human population from human to human transmission.
The average lethal EVD is about 50%. Case fatality rates have ranged from 25% to 90% in the last homes.
The first EVD outbreaks occurred in remote villages in Central Africa, tropical forests nearby, but the most recent epidemic in West Africa has involved large urban areas and rural areas.
Community involvement is the key to successfully control outbreaks. Good control of the epidemic based on the application of a set of interventions, including case management, surveillance and contact tracing, good laboratory service, funerals security and social mobilization.
Early supportive care with rehydration, symptomatic treatment improves survival. There is still no proven treatment authorized to neutralize the virus, but a range of blood and immunological therapies drugs are in development.
There are no licensed vaccines Ebola but two potential candidates are being evaluated.
The Ebola virus causes an acute and serious illness that is often fatal if untreated. Ebola virus disease (EVD) appeared in 1976 in two simultaneous outbreaks, one in Nzara, Sudan, and the other Yambuku, the Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease gets its name.
The current outbreak in West Africa (first cases reported in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was discovered in 1976. There were more cases and deaths in this epidemic than all the others combined. It has also spread among countries in Guinea from then spreading across the land borders with Sierra Leone and Liberia by air (1 traveler only) in Nigeria, and land (1 traveler) in Senegal.
The most affected country, Guinea, Sierra Leone and Liberia have very weak health systems, lack of human resources and infrastructure, having recently emerged from long periods of conflict and instability. August 8, WHO Director-General said the outbreak a public health emergency of international concern.
A Ebola outbreak isolated and unrelated started Boende, Ecuador, a secluded part of the Democratic Republic of Congo.
Family Filoviridae virus comprises three genera Cuevavirus, Marburg and Ebola. There are five species were identified: Zaire, Bundibugyo, Sudan, Reston and forestry Tai. The first 3 Bundibugyo Ebola Zaire Ebola virus, Ebola virus and Sudan have been associated with large epidemics in Africa. The virus causing the epidemic in 2014 in West Africa belongs to the species Zaire.
It is thought that the bats of the family of fruits are natural hosts Pteropodidae of Ebola virus. Ebola is introduced into the human population in close contact with the blood, secretions, organs or bodily fluids of infected other animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found dead or sick or in the rainforest.
Ebola then spreads through human to human transmission by direct contact (through the skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (such as bedding, clothing) contaminated with fluids.
Health workers have frequently been infected while treating patients suspected or confirmed EVD. This occurred through close contact with patients when infection control precautions are not strictly practical.
Burial ceremonies where mourners have direct contact with the body of the deceased person can play a role in the transmission of Ebola.
People are infectious as their blood and body fluids, including semen and breast milk contain the virus. Men who have recovered from the disease can still transmit the virus through semen up to seven weeks after recovery from the disease.
Symptoms of Ebola virus disease
The incubation period is the time interval of the infection of the onset of symptoms is 2 to 21 days. Humans are not contagious until they develop symptoms. The first symptoms are sudden onset of fatigue fever, muscle aches, headache and sore throat. This is followed by vomiting, diarrhea, rashes, symptoms of kidney and liver function, and in some cases, both internal and external bleeding (eg, oozing gums, blood in the stool). Laboratory findings include low white blood cells and platelets and elevated liver enzymes.
It can be difficult to distinguish EVD other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that the symptoms are caused by infection with Ebola virus are made using the following surveys:
antibody capture enzyme linked immunosorbent assay (ELISA)
capture antigen detection tests
serum neutralization test
transcriptase polymerase chain reverse reaction (RT-PCR)
the isolation of the virus in cell culture.
Patient samples are extreme biological risk; laboratory tests on non-inactivated samples must be carried out under maximum biological containment conditions.
Treatment and vaccines
Support-rehydration with fluids- care and treatment of oral or intravenous specific symptoms, improves survival. There is still no proven treatment available for EVD. However, a range of potential treatments, including blood products, immune therapy and drug therapy are being evaluated. No licensed vaccines are still available, but two potential vaccines undergoing human safety tests.
Prevention and Control
Good control of the epidemic based on the application of a set of interventions, including case management, surveillance and contact tracing, good laboratory service, funerals security and social mobilization. Community involvement is the key to successfully control outbreaks. Awareness of risk factors for Ebola virus infection and protection measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:
Reduce the risk of transmission of wildlife to humans through contact with infected bats fruit or monkeys / apes and eating the raw meat. The animals must be handled with gloves and other protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Reduce the risk of human to-human transmission through direct or close contact with people with symptoms of Ebola, especially with body fluids. Gloves and appropriate personal protective equipment should be worn when taking care of sick patients at home. Regular hand washing is needed after visiting patients at the hospital, and after taking care of patients at home.
Containment measures including fast, safe burial of the dead, identifying people who may have been in contact with a person infected with the Ebola virus, health monitoring contacts for 21 days, the importance of separating the health of the sick to prevent spreading the importance of good hygiene and maintain a clean environment.
Infections in health care settings control:
Health workers should always take the standard in patient care precautions, regardless of their presumed diagnosis. These include basic hygiene of the hand, respiratory hygiene, use of personal protective equipment (to block splashing or other contact with infected materials), safe injection practices and funerary practices safe.
Health workers caring for patients with suspected or confirmed Ebola virus should apply additional infection control measures to avoid contact with blood and body fluids of the patient and materials or contaminated surfaces such as clothing and bedding. When in close contact (within 1 meter) of patients with EBV workers, health should wear a protective mask (face shield or a surgical mask and goggles), a long-sleeved gown cleaning, non-sterile, and gloves (sterile gloves for certain procedures).
Laboratory workers are also at risk. The samples taken from humans and animals to the study of Ebola virus infection should be handled by trained staff and processed in suitably equipped laboratories.