1. Ebola Virus Rohan Patel HLTH 3011 Ryan Martin Section 001

2. What is Ebola? It is an extremely contagious filovirus causing an acute, usually fatal hemorrhagic fever and spreads through contact with bodily fluids of infected persons and by airborne particles.

3. Definitions Filovirus – Any of a group of filamentous RNA viruses of the family Filoviridae that are characterized by elongated, branched, curved, or spherical virions and that cause hemorrhagic fevers. Ebola Hemorrhagic Fever – Severe and often deadly illness that can occur in humans and primates. Highly destructive. Zoonotic – animal-borne

4. Ebola Hemorrhagic Fever Severe and often deadly illness that can occur in humans and primates. Patients usually die from low blood pressure cause by shock rather than from the actual blood loss. Ebola HF has been considered to be a possible cause of the Plague of Athens in 430 B.C. The first officially recorded outbreak occurred in July 1976 in Sudan.

5. What actually happens… Quick acting virus, highly destructive Within 2 days after exposure, headaches begin. Headaches will get worse, causing eyeballs and temples to ache Then you become nauseated, spike a fever, and vomit. Vomiting gradually gets worse, you vomit until you can’t anymore. Dry heaves follow. Personality will change to a more passive state. Face will come emotionless and you start to become more zombie-like. Bruises start appearing all over your body and your eyes turn red. Your personality will change again to an angrier state. Blood clots start forming inside of you. This causes dead spots to appear in many of your organs. Your skin appears to have one continuous bruise and becomes soft and pulpy. Your mouth bleeds and the surface of your tongue sloughs off. You start vomiting blood and chunks of dead stomach and esophagus cells.

6. What actually happens… Unbelievably horrific way to die. The lining of the throat and windpipe are thrown up. Your eyes fill up with blood and you start crying blood. You may have a stroke from the blood clots in the brain. Your heart bleeds. The lining of the bowels open and blood vents out of your anus. Basically, blood flows out of every orifice in your body. Stops clotting because it has lost all of its clotting factors. In males, testicles can grow to the size of a grapefruit. Your kidneys fail and your blood becomes toxic with urine. Your spleen grows to the size of a baseball. You have grand mal seizures. You eventually become delirious from brain damage and go into shock and die.

7. Different Strains of Ebola Ebola-Zaire Deadliest strain Ebola-Sudan More manageable than Ebola-Zaire Ebola-Reston Initial outbreak in Reston, VA (First United States contact) Discovered in animals that had been imported from the Philippines Caused disease in nonhuman primates, but not in humans. Ebola-Ivory Coast Severely affected monkeys Caused disease in humans, but no known human deaths. Ebola-Bundibugyo Most recent Ebola virus strain discovered

9. Prevalence Rates The most common strain of the Ebola virus in humans is the Ebola-Zaire, which carries approximately a 90% mortality rate. Ebola-Sudan, the second most common strain, has an average mortality rate of roughly 58%. Ebola-Bundibugyo, the most recently discovered strain, has a 34% mortality rate.

11. Natural Whereabouts Most commonly found in Africa, but the exact origin, location, and natural habitat of the virus remains unknown. 4 out of the 5 strains originated in Africa. Ebola-Reston most likely originated in the Philippines. It is not known to be native to other continents, such as North America. Considered zoonotic.

12. How Does Ebola Spread? The manner in which the virus first appears in a human at the start of an outbreak has not been determined. First patient became infected through contact with an infected animal. Individuals can be exposed from direct contact with the blood and/or secretions of an infected individual. Most often spread through families and friends because they come in close contact when caring for infected individuals.

13. Symptoms Incubation period symptoms Fever Severe headache Joint and muscle aches Chills Sore throat Vomiting (often bloody) Hiccups (very bad sign)

14. Symptoms (cont.) Later symptoms Bleeding from eyes, ears, nose, mouth, and rectum Bloody diarrhea Red eyes Rash over the entire body that often contains blood Roof of mouth looks red Chest and stomach pain with a cough Severe weight loss

15. Diagnosis Initial diagnosis is difficult because early symptoms, such as red eyes and a skin rash, are nonspecific to the virus. The initial incubation period is between 2 and 21 days. Tests that can be done to diagnose a case of Ebola Hemorrhagic Fever within a few days of the onset of symptoms. Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing IgM ELISA Polymerase chain reaction (PCR) Virus isolation

16. Preventive Strategies These strategies should be considered prior to travelling to Africa. Avoid any areas where there has been an epidemic (Ex. Zaire, Sudan) Wear a mask, gown, and gloves around infected or potentially infected patients.

17. What to do if infected with the Ebola Virus? Call Health Care provider immediately if you have travelled to Africa recently or if you know you have been exposed to Ebola Fever and you are starting to develop symptoms of the disorder. Early diagnosis and treatment may improve the chances of survival.

18. Containment Measures Should be isolated from other patients and strict barriers should be implemented. Tracing and follow-up of individuals who could have been exposed to Ebola through contact with infected patients. Hospital staff must be immediately educated on the destructive of the virus and its transmission routes. Particular emphasis on the handling of blood and secretion. Clothing must also be disinfected.

19. Treatment No standard treatment Patients receive supportive therapy. Pre-existing medicines typically effective in fighting viruses are ineffective against Ebola. Immediate hospitalization, intensive care will most likely be required Supportive measures for shock will include medications and fluids given through a vein. Transfusions of platelets or fresh blood may be required due to bleeding problesms.

20. Contact Resources If you or someone you know has been infected with the Ebola virus, the best thing to do is immediately seek medical attention by calling 911. If your healthcare provider is having trouble with the virus, it is a good idea to contact the Centers for Disease Control and Prevention (CDC) at 770-488-7100 for more information.