Viral Hemorrhagic Fevers - Filoviridae Electron micrograph of Marburgvirus www.cdc.gov/ncidod/dvrd/spb/images/pix/pathimag/Marburg-emb.jpg. Electron micrograph of Ebola Zaire virus http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/25000000.htm

Marburg recognized in 1967 with an outbreak in Marburg, Germany Ebola recognized in 1976 with outbreaks in Sudan and Zaire, Africa 5 strains of Ebola African strains: Zaire, Sudan, Ivory Coast, Uganda Pilipino strain: Reston

Transmission to humans and non-human primates unknown Transmission among humans and non-human primates through direct contact of bodily fluids of an infected individual Ebola Zaire is most lethal with mortality rate of 60-90%; Ebola Uganda’s current mortality rate of 22%

Onset usually about 5-7 days after infection Initial symptoms: fever, chills, muscle pain, headache, nausea, vomiting, abdominal pain, diarrhea As disease progresses, show signs of impairment of blood coagulation system (conjunctival hemorrhages, easy bruising, blood in urine or stool), some will develop a red-purple macropapular rash on the chest, back and stomach Eventually patient will go into shock, become tachypneic, jaundiced and delirious, and will have severe weight loss Death occurs 6-9 days after onset of symptoms and usually due to multi-organ dysfunction and failure

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Definitive diagnosis by identifying the virion in the host serum Currently no preventative measures available Treatment is supportive maintain patient’s fluid and electrolytes maintain proper oxygen and blood pressure levels treat complicating infections some success with transfusion of FFP, replacement of clotting factors, and heparin

Two main areas: 1. finding the natural reservoir narrowed to a small mammal, possibly fruit bats may help to minimize outbreaks

Spatial distribution of human filovirus outbreaks in relation to geographical conditions. The political boundaries and the names of the countries where Ebola virus or Marburg virus outbreaks have been reported are indicated, as are the relevant lines of latitude. The site of each Ebola virus or Marburg virus outbreak is also indicated, as well as the year in which the outbreak occurred. Color patterns in the satellite image are shown at the side, correlated to the ecological conditions they represent.

2. Creation of a vaccine lots of difficulty because of the high virulence and potential of many side effects one promising possibility: using VLPs (virus-like replicon particles) resemble morphology but can’t cause an infection capable of activating both humoral and cell-mediated immune responses

Travelers could unknowingly bring back an infection With Ebola Uganda having milder symptoms, the virus may not be recognized as quickly and spread easier The potential of Ebola and/or Marburg fashioned and used as a bioterror weapon