NAV JIVAN Hospital: Detailed about Ebola virus?

Ebola Virus

'I think it's important to say that survivors are heroes and we need to commend them and welcome them into our communities because we need them.
'With the increasing number of orphans that we have – and from the Ebola situation we have approximately 350 of them – we are aware that we need to find suitable families and homes for these children.
'The survivors are well-positioned to actually support these children, if not themselves looking after children, then helping them back into communities.'

What is Ebola virus?

In 2016 the Ebola virus will celebrate the 40th year of its discovery. It was first reported in 1976 in humans in both Zaire (now the Democratic Republic of the Congo – DRC) and Sudan.
This virus has five known subtypes, four of which can cause severe illness in man:

Bundibugyo ebolavirus (BDBV)
Zaire ebolavirus (EBOV)
Reston ebolavirus (RESTV)
Sudan ebolavirus (SUDV)
Taï Forest ebolavirus (TAFV).

Reston ebolavirus mainly affects monkeys. Although it can infect man, it does not cause any significant illness.
Ebola virus is one of three members of the Filoviridae family (filovirus). Marburg virus is one of the other two.

What causes Ebola?

How long this virus has existed is unknown, but we do know that it is carried by animals, such as fruit bats and other mammals.
Outbreaks in humans are thought to be caused by animal-to-human transmission after people consume or come into contact with animals harbouring the virus.
Interestingly, the virus is known to survive several weeks in semen, but we do not know if that is a definite mode of transmission.
Controlling this virus in a country with good public health, trust in medical services, non-traditional practices and rule of law was thought to be relatively straightforward.
However, recent events in the USA and Spain have now shown that this is not the case and that there may be significant risk during and after the removal of complicated personal protective equipment (PPE).
On the other hand, both Nigeria and Senegal contained the virus and prevented onward transmission in their countries.
The spread within Africa could be down to a lack of early political involvement, public health dysfunction and lack of trust (understandably) in poorly functioning health systems, in some cases with workers or burial teams reportedly not getting paid on time.

Which other viruses are like Ebola?

There are other haemorrhagic (bleeding) viruses. These include Marburg, Lassa, Crimean-Congo, Argentine, Bolivian, Brazilian and more than 10 others.
The Marburg and Ebola viruses are the most alike, both being string-like (filamentous) and relatively large.

How does Ebola spread?

Healthcare workers can become infected with Ebola through contact with blood or mucus, hence the need for basic precautions, such as gloves, masks, goggles, boots and, where available, bio-suits.
Infection can occur after removal of PPE if instructions are not followed to the letter.
Relatives become infected with the virus through caring for patients and becoming directly exposed to blood or mucus.
In many traditional African funeral practices, it is customary to wash and clean the dead body, which increases the risk for infection.
Non-medically trained nuns also spread the infection by using unsterilised needles on patients.

Where does Ebola occur and how many people are affected?

The virus has a predilection for Africa.
Outbreaks have occurred in the Democratic Republic of the Congo, Sudan, Guinea, Liberia, Sierra Leone, Nigeria, Central African Republic, Ethiopia, Gabon, Ivory Coast, Kenya, Uganda, Zimbabwe and Madagascar.
Governments have now decided on airport screening of passengers from affected areas.

What are the symptoms of the disease?

The symptoms of Ebola virus disease usually start five to seven days after becoming infected, but this can vary to between two to 21 days after becoming infected.
The symptoms are non-specific and include headache, joint and muscle pains, sore throat and muscle weakness. This is then followed by diarrhoea, vomiting, fever, rash and stomach cramps.
Internal bleeding quickly follows, accompanied by bleeding from the ears, eyes nose or mouth.
Ebola virus disease is fatal in 50 to 90 per cent of cases.

What can you do yourself?

We know that Ebola spreads by contact with infected blood or mucus. To date we do not know if the virus can be air-borne, but fortunately we think it is not.
To avoid Ebola, do not travel to an outbreak area when it can be avoided.
Use basic hygiene precautions at all times, such as hand washing with soap and water after contact with cases or suspected cases.
Health care workers and relatives need to take specific precautions as above.
If you are infected, you need to be isolated from other non-medical people.
If you have had exposure as a health care worker, a self-quarantine of 21 days with daily temperature measurements now seems to be a sensible precaution and in some areas, such as New York, it will be imposed.

How is the disease diagnosed?

Laboratories with high levels of bio-security can test for the virus or the antibody reaction to it.
The test will not be positive before symptoms occur, which is usually on day three of the infection.

How is Ebola treated?

There are no medicines that are effective against this virus, so doctors are advised to treat the symptoms.
Patients may require admission to an intensive care unit.
Patients with Ebola need their fluid levels managed by medical staff.
Experimental treatments, such as ZMapp, do exist. However, it is only available on a named patient, government ethics committee-backed basis.
Some experts think we should use the serum antibodies of those who survive Ebola to treat others.
There is no current vaccine against Ebola. But three companies including Glaxo Smith Kline (GSK) are fast-tracking the vaccine production process with the hope that something may be available in the first quarter of 2015.

Detailed about Ebola virus?