EBOLA Virus Disease
Ebola virus disease (also known as Ebola hemorrhagic fever) is a severe, often-fatal disease caused by infection with a species of Ebola virus. The first Ebola virus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Since then, outbreaks have appeared sporadically.The case fatality rate in the epidemic of Ebola virus disease in West Africa has been estimated to be approximately 70 percent ; rates in earlier outbreaks in Africa (including Marburg virus disease in 2005) reached 80 to 90 percent.
Alert case: Illness with onset of fever and no response to treatment of usual causes of fever in the area, OR at least one of the following signs: bleeding, bloody diarrhoea, bleeding into urine OR any sudden death Instructions: If an alert case (living or dead) is identified: Report the case to a surveillance team or to the closest health centre
PROBABLE CASE: Any suspected case evaluated by a clinician OR: Any deceased suspected case (where it has not been possible to collect specimens for laboratory confirmation) having an epidemiological link with a confirmed case Note: if laboratory specimens are collected in due time during the illness, the preceding categories are reclassified as “laboratory confirmed” cases and “non-case”.
Ebola or Marburg case contacts: Any person having had contact with an Ebola or Marburg in the 21 days preceding the onset of symptoms in at least one of the following ways: Having slept in the same household with a case Has had direct physical contact with the case (dead or alive) during the illness Has had direct physical contact with the (dead) case at the funeral,
Has touched his/her blood or body fluids during the illness Has touched his/her clothes or linens Has been breastfed by the patient (baby)
Instructions when a suspected case has been identified: Report the case to the surveillance team After obtaining express consent, collect a sample Fill in a case notification form Draw up a list of contacts of the suspected case If the subject is alive, explain to the patient and his/her family the need to go to hospital to receive adequate medical care.
Where is Ebola? There have been 33 Ebola outbreaks since 1976, but the 2014 outbreak in West Africa is by far the largest. The virus has infected thousands of people and killed more than half of them.
2014 outbreak in West Africa — Most previous Ebola outbreaks occurred in Central Africa, but this outbreak started in the West African nation of Guinea in late 2013 and was confirmed by the World Health Organization (WHO) in March 2014 .On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
The initial case was a two-year-old child in Guinea, who developed fever, vomiting, and black stools, without other evidence of hemorrhage . The outbreak subsequently spread to Liberia, Sierra Leone, Nigeria, Senegal, and Mali. The case-fatality rate has been estimated to be approximately 70 percent
As of October 29, 2014, the cumulative number of probable, suspected, and laboratory-confirmed cases attributed to Ebola virus is 13,567, including 4951 deaths. These include 523 healthcare workers, of whom approximately 50 percent have died. However, Nigeria and Senegal have not reported any new cases since September 5, 2014, and August 29, 2014,
on September 30, 2014, the first travel-associated case of Ebola was reported in the United States and died of Ebola in October. A nurse who helped treat him came down with Ebola
2014 outbreak in the Democratic Republic of Congo — In August of 2014, an outbreak of Ebola virus disease was reported in the Democratic Republic of Congo. The index case was a pregnant woman who prepared bushmeat from an animal that had been killed by her husband
. As of October 28, 2014, a total of 66 cases of Ebola virus disease (confirmed and probable), including 49 deaths, have been connected to this outbreak . Sequence analysis has shown that the Zaire strain of Ebola virus causing this outbreak is most closely related to one that caused the 1995 outbreak in Kikwit; there is no connection with the current epidemic in West Africa
Close contact with an infected person. contact of broken skin or unprotected mucous membranes with virus-containing body fluids from a person who has developed signs and symptoms of illness. According to the World Health Organization, the most infectious body fluids are blood, feces, and vomit.
Ebola virus has also been detected in urine, semen (Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery ), saliva and breast milk, and reverse-transcriptase-polymerase chain reaction testing has identified viral RNA in tears and sweat, suggesting that infectious virus may be present. .
Risk of transmission through contact with contaminated surfaces — Ebola virus may be transmitted though contact with contaminated surfaces and objects. The Centers for Disease Control (CDC) indicates that infectious virus may persist from hours to days.Risk of transmission through the airborne route — There is no evidence that Ebola virus disease can be spread from person-to-person by the respiratory route.
Nosocomial transmission — Transmission to healthcare workers may occur when appropriate personal protective equipment is not available or is not properly used.Transmission from animalsContact with infected animals — Human infection with Ebola virus can occur through contact with wild animals (eg, hunting, butchering, and preparing meat from infected animals)
Exposure to bats — Exposure to bat secretions or excretions may be a potential route for acquisition of Marburg virus The incubation period ranges from 2 to 21 days (most commonly 8-10 days).
Who is most at risk? During an outbreak, those at higher risk of infection are: health workers; family members or others in close contact with infected people; mourners who have direct contact with the bodies of the deceased as part of burial ceremonies. hunters in the rain forest who come into contact with dead animals found lying in the forest.
More research is needed to understand if some groups, such as immuno-compromised people or those with other underlying health conditions, are more susceptible than others in contracting the virus.
The most common signs and symptoms reported from West Africa during the 2014 outbreak include: fever (87 percent), fatigue (76 percent), vomiting (68 percent), diarrhea (66 percent), and loss of appetite (65 percent)
Prevention: Avoid contact with blood and body fluids. wash hands with soap and water or an alcohol-based hand sanitizer Cook food properly. Go to health facility any time you have symptoms of dis. Mentioned previously. Tell every one about Ebola so they can be informed.
Avoid funeral that require handling the body of someone who has died from Ebola. Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals. .
Do not handle items that may have come in contact with an infected person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).
Healthcare workers who may be exposed to people with Ebola should follow these steps:
The risk of transmission is increased amongst Ebola caregivers. Recommended measures when caring for people infected with Ebola include *barrier-isolation, *sterilizing equipment and surfaces, and *wearing protective clothing including masks, gloves, gowns, and gogglesIsolation facilities within the Hospital remain the most important effective measure. Barrier nursing remain the basic need in control of infection spread
Dr.T.V.Rao MD
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One step recommended by the World Health Organization is the education of the general public of the risk factors for Ebola infection and of the protective measures individuals can take. These include: avoiding direct contact with infected people. regular hand washing using soap and water. Bush meat, an important source of protein in the diet of some Africans, should be handled with appropriate protective clothing and thoroughly cooked before consumption.
Quarantine, also known as enforced isolation, is usually effective in decreasing spread. Governments often quarantine areas where the disease is occurring or individuals who may transmit the disease outside of an initial area. In the United States, the law allows quarantine of those infected with Ebola viruses. During the 2014 outbreak, Liberia closed schools.
Is it safe to travel during an outbreak? What is WHO’s travel advice? During an outbreak, WHO reviews the public health situation regularly, and recommends any travel or trade restrictions if necessary. The risk of infection for travelers is very low since person-to-person transmission results from direct contact with the body fluids or secretions of an infected patient.
Dr.T.V.Rao MD
*Dr.T.V.Rao MD
*Dr.T.V.Rao MD
*Dr.T.V.Rao MD
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