All about the Ebola virus - "The African Curse" and its historical outbreaks.

Overview

What is EVD

Ebola virus disease (EVD) is a devastating disease that primarily affects the African continent with occasional outbreaks. The most common victims of EVD are humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).

It is caused by an infection with the “Zaire ebolavirus,” a group of viruses from the genus Ebolavirus.

In 1976, near the Ebola River in what is now the Democratic Republic of Congo, the Ebola virus was found for the first time. Since then, the virus has infected people regularly, causing Ebola outbreaks in several African countries.

Science doesn’t know where the Ebola virus originated from. Based on similar viruses, they believe EVD is spread by animals, with bats or nonhuman primates being the most likely source.

Infected animals, such as apes, monkeys, duikers, and humans, can spread the virus to other animals.

Transmission

Scientists believe that individuals contract the Ebola virus after coming into touch with an infected animal, such as a fruit bat or a nonhuman primate. The virus then spreads from person to person, potentially harming thousands of individuals.

Humans get the virus after coming into close touch with animal blood, bodily fluids, or tissues. The Ebola virus then transmits to others by direct contact with the body fluids of someone who is sick or has died from the disease.

The virus then enters the body through abrasions on the skin or mucous membranes in the eyes, nose, and mouth. Sexual contact with someone who is infected with EVD or has recovered from it can spread the virus. After recovery from the disease, the virus can be found in somebody’s fluids, such as sperm.

When people are infected with Ebola, they may not immediately show signs or symptoms. The incubation period is the time between being exposed to an infection and developing symptoms. After developing Ebola symptoms, a person can only spread the disease to others.

Furthermore, the Ebola virus doesn’t spread through food. However, the Ebola virus can be spread by handling and eating wild animals or hunting Ebola-infected wild animals.

There is no proof that mosquitos or other insects may spread the Ebola virus.

If a pregnant woman has Ebola and recovers, the virus may still be present in her breastmilk, as well as other pregnancy-related fluids and tissues. This puts their unborn child, as well as others, in danger. Women who become pregnant after surviving Ebola are not at risk of passing the infection on to their children.

If an Ebola-infected breastfeeding mother desires to continue breastfeeding, she should be encouraged to do so. Before she can start, her breast milk must be screened for Ebola.

Persistence of the virus

During an Ebola outbreak, the virus can quickly spread within medical facilities (such as clinics or hospitals). Clinics and other healthcare providers should employ specialized, ideally disposable medical equipment for giving care.

Instruments such as needles and syringes must be cleaned and disposed of properly. If the tools aren’t disposable, they’ll need to be sanitized before they can be used again.

The Ebola virus can persist for several hours on dry surfaces such as doorknobs and counters, and up to several days at room temperature in body fluids such as blood. A hospital-grade disinfectant should be used for cleaning and disinfection.

Signs and Symptoms

Symptoms can emerge anywhere from two to twenty-one days following viral exposure, with an average of 8 to 10 days. As the person develops sicker, the sickness often advances from “dry” symptoms (such as fever, aches and pains, and weariness) to “wet” symptoms (such as diarrhea and vomiting).

EVD symptoms can appear suddenly and include:

Headache
Sore throat
Fever
Fatigue
Muscle pain

The following symptoms appear:

Vomiting
Diarrhea
Rash
Internal and external bleeding (for example, leaking from the gums or blood in the feces)
Symptoms of reduced kidney and liver function
Low white blood cell and platelet counts, as well as increased liver enzymes, were discovered in the lab.

EVD is a rare, yet serious, and frequently fatal disease. The patient’s immunological response and strong supportive clinical treatment are both important factors in EVD recovery.

Vaccine and Prevention

Vaccine for Ebola

The rVSV-ZEBOV (Ervebo®) Ebola vaccine was authorized by the US Food and Drug Administration (FDA) in December 2019. The FDA has given its approval for the first Ebola vaccine.

This vaccine, which is administered as a single dose, is safe and effective against the Zaire ebolavirus variant of Ebola, which has caused the world’s largest and deadliest Ebola outbreaks “epidemics” to date.

During an Ebola outbreak in the Democratic Republic of the Congo in 2019, a study program employed a two-dose immunization regimen of a separate vaccine that was also supposed to protect against the Zaire ebolavirus species of Ebola.

This vaccine has two doses, each with two separate vaccine components (Ad26.ZEBOV and MVA-BN-Filo), and the regimen requires an initial dosage and a “booster” injection 56 days later. The FDA has not yet authorized this vaccination for normal use.

Prevention

There are several ways to protect yourself and prevent the spread of the Ebola virus if you live in or go to a place where the virus may be prevalent.

Avoid contact with ill people’s blood and bodily fluids (urine, excrement, saliva, perspiration, vomit, breast milk, amniotic fluid, sperm, and vaginal secretions).
Don’t touch a man’s sperm who has recovered from EVD until testing proves that the virus is no longer present in his sperm.
Anything that has come into touch with an infected person’s blood or body fluids should be avoided (such as clothes, bedding, needles, and medical equipment).
Avoid touching the body of someone who died from EVD or is suspected of having EVD at a funeral or burial.
Do not come into contact with the blood, fluids, or raw meat of bats, woodland antelopes, or nonhuman primates, such as monkeys and chimps.

When residing in or traveling to an area where an Ebola outbreak is occurring, the same precautions should be taken.

People should monitor their health for 21 days after returning from an Ebola outbreak region and seek medical help once they develop EVD symptoms.

Diagnosis

Clinically, it might be difficult to tell the difference between EVD and other infectious disorders like malaria, typhoid fever, and meningitis.

Many of the symptoms of pregnancy and Ebola are very similar. Because of the risks to the unborn child, pregnant women should be checked as soon as possible if Ebola is suspected.

It might be difficult to diagnose Ebola virus disease (EVD) soon after infection. Early signs of Ebola virus infection, such as fever, headache, and weakness, are frequent in individuals with other, more common infections, such as malaria and typhoid fever.

A combination of symptoms suggestive of EVD and possible exposure to EVD within 21 days before the onset of symptoms is required to evaluate whether EVD is a possible diagnosis. Contact with:

blood or bodily fluids from a person sick with or who died from EVD.
objects contaminated with blood or bodily fluids from a person sick with or who died from EVD.
infected fruit bats and nonhuman primates (apes or monkeys).
sperm from a man who has recovered from EVD.

If a person exhibits symptoms of EVD and has been exposed, he or she should be isolated (removed from other people) and public health authorities should be alerted.

The virus may take up to three days to reach detectable levels once symptoms begin.

The following diagnostic procedures are used to confirm that symptoms are caused by Ebola virus infection:

antigen-capture detection tests.
antibody-capture enzyme-linked immunosorbent assay (ELISA).
a reverse transcriptase polymerase chain reaction (RT-PCR) assay.
a serum neutralization test.
electron microscopy.
cell culture virus isolation.

Treatment

Therapeutic

The US Food and Drug Administration (FDA) has approved two treatments* to treat EVD caused by the Ebola virus, a variation of Zaire ebolavirus, in adults and children.

InmazebTM external icon, the first medicine approved in October 2020, is a mixture of three monoclonal antibodies.

EbangaTM external icon, the second medication, is a single monoclonal antibody that was approved in December 2020. Monoclonal antibodies (mAbs) are proteins made in a lab or other manufacturing facility that behave like natural antibodies to prevent a pathogen, such as a virus, from multiplying after it has infected a person.

Patients who received either of the two FDA-approved therapies had a substantially better overall survival rate.

Supportive Care

Basic therapies, whether or not further treatments are available, can greatly enhance survival odds when given early. Supportive care encompasses a wide range of services, including:

Providing fluids and electrolytes (body salts) either orally or through vein infusion (intravenously).
Supporting blood pressure, reducing vomiting and diarrhea, and managing fever and discomfort with medicines.
Treating any additional infections that may arise.

Between 1976 and 2020, to know the number of cases and deaths caused by the Ebola virus widespread outbreaks “epidemics” as broken down by nation, click here

Keynotes

Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, is an uncommon but serious and often fatal infection that affects people.
The virus is propagated in the human population by human-to-human transmission once it is transmitted to people from wild animals.
The average case fatality rate for EVD is roughly 50%. In previous outbreaks inflicted by the Ebola virus, case mortality rates have ranged from 25% to 90%.
Successful Ebola outbreak control requires community participation.
Case management, infection prevention, and control measures, surveillance and contact tracing, a good laboratory service, safe and respectful burials, and social mobilization are all important components of effective outbreak control.
Ebola vaccines have been created and are being used to help control the spread of the disease in Guinea and the Democratic Republic of the Congo (DRC).
Early supportive care, such as rehydration and symptomatic therapy, increases the chances of survival. In late 2020, the US Food and Drug Administration authorized two monoclonal antibodies (Inmazeb and Ebanga) for the treatment of adult and pediatric Zaire ebolavirus (Ebolavirus) infections.
Women with Ebola who are pregnant or breastfeeding should receive early supportive treatment. Vaccine prophylaxis and experimental treatment should be provided to pregnant women in the same settings as non-pregnant women.

Summarizing

Case management, surveillance, and contact tracing, as well as strong laboratory service, safe burials, and social mobilization, are all important components of effective epidemic control.

To successfully control Ebola outbreaks, community engagement is essential. Raising public awareness about the risk factors for Ebola infection and the preventative measures (such as vaccination) that individuals may take is an effective method for limiting human transmission.

Several factors should be emphasized in risk reduction messaging:

Reducing the risk of wildlife-to-human transmission by avoiding contact with infected fruit bats, monkeys, apes, forest antelope, or porcupines, as well as eating raw meat. Handling animals should be done with gloves and other protective gear. Before eating animal products (blood and meat), make sure they are completely cooked.
Reducing the risk of human-to-human transmission by avoiding direct or close contact with people who have Ebola symptoms, especially their bodily fluids. When caring for sick patients, gloves and other proper personal protective equipment should be worn. Hand cleaning is necessary after visiting patients in the hospital and after caring for them at home
Containment measures include safe and dignified burials for the dead, identifying people who may have had contact with an Ebola patient and monitoring their health for 21 days, separating the healthy from the sick to prevent further spread, and emphasizing the importance of good hygiene and maintaining a clean environment.
Reducing the risk of possible sexual transmission, WHO recommends that male EVD survivors practice safer sex and hygiene for 12 months from the onset of symptoms or until their semen tests negative twice for the Ebola virus, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response. Contact with bodily fluids should be avoided, and soap and water should be used to clean. Male and female convalescent patients whose blood has been tested negative for Ebola virus should not be isolated, according to the WHO.
Lowering the risk of infection from pregnancy-related fluids and tissue. Pregnant women who have survived Ebola illness require community assistance to attend regular antenatal care (ANC) appointments, manage pregnancy problems, and satisfy their sexual and reproductive health and delivery needs safely. This should be done in conjunction with Ebola and Obstetric health care specialists. Pregnant women’s sexual and reproductive health decisions should always be respected.

The Ebola epidemic in West Africa from 2014 to 2016 was one of the largest and most severe outbreaks since the virus was identified in 1976. This epidemic had more cases and fatalities than all others combined.

Citation

https://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease

https://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease.cdc.gov/vhf/ebola/index.html
https://www.statista.com/statistics/328962/ebola-virus-disease-outbreaks-by-country-deaths-case-fatality/

Featured photo: https://upload.wikimedia.org/wikipedia/commons/c/c0/Ebola_Signs_and_Symptoms.jpg

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