Marburg, N’zara, Yambuku, Reston, Kikwit, West Africa Emerging Diseases Lecture 9: Filoviruses 9.1 Overview 9.2: Outbreaks: Marburg, N’zara, Yambuku, Reston, Kikwit, West Africa 9.3 Summary

9.1: Overview “Mystery” viruses Seem to come out of nowhere Frightening symptoms Very lethal A recipe for disease terror

Marburg 1967 Laboratory animals Mystery disease 31 infected Terrifying threat Filovirus First recorded filovirus outbreak-brought To Europe by imported lab monkeys

Nzara June-August 1976 Different strains of Ebola (Ebola Zaire/Ebola Sudan) 151 dead/284 cases Source of the virus-unknown!

Yambuku Death Toll 280/318 EBO-Z surfaced shortly after the first Ebola outbreak in Sudan and killed 280 of the 318 people it infected. On September 1, 1976, four days after returning from a tour of northern Zaire, the index case, a 44 year-old male teacher at the Mission School, sought medical intervention for a febrile illness he thought to be malaria. He received a parenteral injection of chloroquine (an anti-malaria drug) from Yambuku Mission Hospital (YMH). YMH did not use disposable needles or sterilize the needles between uses. Parenteral injection was the primary mode of administering nearly all medicines, and Ebola-Zaire (EBO-Z) was quickly disseminated into the surrounding villages serviced by YMH. After 11 of its 17 staff members fell ill with EHF, YMH closed on September 30, 1976, 29 days after the index case received his injection of chloroquine. The WHO International Commission was formed on October 18th, and research teams were mobilized on October 30th. The last case of EBO-Z died on November 5, 1976. Transmission of Ebola during this outbreak occurred mainly through the use of contaminated needles to administer medicine.

Yambuku disease cowboys in action

Reston, 1989 Philippine animals Airborne Lethal in monkeys but mild in humans US outbreak halted by military before spreading

Kikwit-1995 Death toll = 244/315 Urban outbreak in Africa- Source unknown

West Africa Outbreak Largest ever December 2013-??? Guinea, Liberia, Sierra Leone Bushmeat source? misdiagnosis

9.3:Summary Recent evidence indicates that various types of bats carry filoviruses. Human-bat contact spreads the disease to humans.