The Deadly African Virus Presented by Claudia Hacker Ebola The Deadly African Virus Presented by Claudia Hacker

Ebola Virus Introduction First appeared in Africa 1976 “African Hemorrhagic Fever” acute,mostly fatal disease causes blood vessel “bursting” systemic (all organs/tissues) humans and nonhuman primates Excluding ‘2000 outbreak 1,500 cases over 1,000 deaths (monkeys, gorillas,chimpanzees)

Scientific Classification Ebola Taxonomy Scientific Classification Order: Mononegavirales Family: Filoviridae Genus: Ebola like viruses Species: Ebola Subtypes Ebola-Zaire, Ebola-Sudan,Ebola-Ivory Coast disease in humans Ebola-Reston disease in nonhuman primates Copyrighted Dr. Fre:derick A. Murphy, D.V.M., Ph.D. 1976.

Filoviridae or “Filoviruses” Most mysterious virus group Pathogenesis poorly understood Ebola natural history/reservoirs unknown exist throughout the world endemic to Africa filamentous ssRNA- (antisense) viruses biosafety level 4 agents because of the extreme pathogenicity of certain strains and the lack of a protective vaccine or effective antiviral drug Image courtesy of the Centers for Disease Control

Copyright: Russell Kightley Media, Australia Ebola Pathogenesis Enters Bloodstream skin, membranes,open wounds Cell Level docks with cell membrane Viral RNA released into cytoplasm production new viral proteins/ genetic material New viral genomes rapidly coated in protein create cores Examples of coiled virions are shown in the background. Copyright: Russell Kightley Media, Australia

Ebola Pathogenesis, cont Viral cores stack up in cell migrate to the cell surface produce trans-membrane proteins push through cell surface become enveloped by cell membrane ssRNA- Genome Mutations capable of rapid mutation very adaptable to evade host defenses and environmental change Theory virus evolved to occupy special niches in the wild The core of the Ebola protein thought to mediate membrane fusion

Symptoms and Diagnostic Tests Early symptoms muscle aches, fever, vomiting red eyes, skin rash, diarrhea, stomach pain Acute symptoms bleeding/hemorrhaging from skin, orifices, internal organs Early Diagnosis very difficult signs & symptoms very similar to other infections Laboratory Test PCR detection ELISA (enzyme-linked immuno-absorbant) assay Nosocomial transmission(spread of a disease within a health-care setting, Non disposabel needles or syringes:they, or may not have been sterilized, but only rinsed before reinsertion into multi-use vials of medicine. lack of protective clothing contact with contaminated objects improper sterilization of medical equipment

Treatment No Standard Treatment available Patients receive supportive therapy treating complicating infections balancing patient’s fluids and electrolytes maintaining oxygen status and blood pressure

Prevention No vaccines! Patients are isolated Medical Staff Training western sanitation practices intake care during stay after patient dies Infection-control Measures complete equipment and area sterilization Medical Resources scarce Africa

Virus contagious in fluids for days Prevention After Death Virus contagious in fluids for days Burial use extreme caution handling and transport cultural practices/ religious belief incinerate all waste !!!! Handling and transport protective clothing body sealed in body bag and coffin sanitation of all equipment before and after risk for exposure special steps need to be taken to protect the family and community from illness. family only why open casket not possible some practices cannot be done

Ebola Epidemiology Reservoirs in Nature Transmission largely unknown possibly infected animals (primates?) Transmission direct contact blood/secretions of infected person possible airborne (Reston primate facility) Onset of illness abrupt incubation period: 2 to 21 days infections are acute and mostly deadly

Latest Morbidity and Mortality Reports Ebola-Reston Virus Infection Among Quarantined Nonhuman Primates -- Texas, 1996 report describes death and blood testing of cynomolgus monkey imported from the Philippines held in a private quarantine facility in Texas Outbreak of Ebola Hemorrhagic Fever ---Uganda, August 2000--January 2001 report describes surveillance and control activities related to the EHF outbreak presents preliminary clinical and epidemiologic findings Reference:last modified January 08, 2002 Internet: http://www.cdc.gov/ncidod/EID/vol1no3/sanchez.htm; © 1994-1998 Stephan Spencer & Jean-Yves Sgro. Web Design By Internet Concepts LLC

Current Basic Research The assembly of Ebola virus nucleocapsid requires virion-associated proteins 35 and 24 and posttranslational modification of nucleoprotein Report describes distinct VP35 and VP24 proteins mechanism of regulation for filovirus assembly suggests new approaches for viral therapies and vaccines for Ebola and related viruses Detection of antibodies against the four subtypes of Ebola virus in sera from any species using a novel antibody-phage indicator assay assesses the presence of specific antibodies in serum describes development of a novel assay for the detection of seroconversion irrespective of Ebola virus subtype or animal species

References Reemergence of Ebola Virus in Africa; Anthony Sanchez et al,EID Volume 1 * Number 3 July-September 1995 http://www.cdc.gov/ncidod/EID/vol1no3/sanchez.htm Viral Hemorrhagic Fever, Healthlink, Medical College of Wisconsin, 2000 http://healthlink.mcw.edu/article/955159073.html Isolation and Phylogenetic Characterization of Ebola Viruses Causing Different Outbreaks in Gabon Emerging Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention ,February 5, 1997 http://www.cdc.gov/ncidod/EID/vol3no1/courbot2.htm Hemorrhagic fevers; Julia Barrett, Gale Encyclopedia of Medicine, Gale Research, 1999 http://www.findarticles.com/cf_dls/g2601/0006/2601000652/p1/article.jhtm l Key Issues in the Prevention and Control of Viral Hemorrhagic Fevers Clarence J.Peters, MD, Special Pathogens Branch/Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases/Centers for Disease Control and Prevention, 1997 http://www.cdc.gov/od/ohs/sympsium/symp43.htm Scientific Stock Images Library; Russell Kightley Media,Australia http://www.rkm.com.au/imagelibrary/index.html Outbreak of Ebola Hemorrhagic Fever ---Uganda, August 2000--January 2001, Morbidity and Mortality Weekly Report, Vol 50, No 05;73, 02/09/2001 / 50(05);73-7 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5005a1.htm Ebola-Reston Virus Infection Among Quarantined Nonhuman Primates -- Texas, 1996 Morbidity and Mortality Weekly Report, Vol 45, No 15;314  ,April 19, 1996 / 45(15);314-316 http://www.cdc.gov/mmwr/preview/mmwrhtml/00040920.htm The assembly of Ebola virus nucleocapsid requires virion-associated proteins 35 and 24 and posttranslational modification of nucleoprotein, Huang Y et al, Mol Cell. 2002 Aug;10(2):307-16. PMID: 12191476 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12191476&dopt=Abstract Detection of antibodies against the four subtypes of ebola virus in sera from any species using a novel antibody-phage indicator assay.; Meissner F et al , PMID: 1235035 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12350354&dopt=Abstract