EBOLA VIRUS, A PANDEMIC THAT MUST BE TACKLED

This deadly disease that have just been shipped into our country must be tackled with immediate alacrity or else we will begin to fight another issue that may engulf and sip our money like the known age long HIV virus .The medical personnel’s involved must be very careful  not to be agents in the spread of this forest imported disease. It is so deadly that it does not allow its bearer time for atonement. Therefore it becomes pertinent and pivotal for all hunters to cook their meat properly before eating.

Nigeria must question the activities of those at the quarantine. They should be effective in their duties to check migrants coming into the country not minding their purpose and status. In an introductory and eye opening way, I will through the findings done explain on the history of this ugly life threatening disease.

• In 1976, Ebola named after the Ebola River in Zaire first emerged in Sudan and Zaire. The first outbreak of Ebola was in Sudan where it infected over 284 people, with a mortality rate of 53%. Fortunately, the few people who were infected with EBOR (seroconverted) never developed Ebola hemorrhagic fever (EHF). It has different strains due to its place of discovery as follows
• Ebola Cote d'Ivoire
• Ebola Reston
• Ebola Sudan
• Ebola Zaire
• 1999 Marburg Outbreak

• Ebola Sudan
• 1976. Nzara and Maridi, Sudan. Infected 284, killed 150 (53% mortality).
• 1979. Nzara, Sudan. Infected 34, killed 22 (65% mortality).

• Ebola Zaire
• 1976. Yambuku, Zaire. Infected 318, killed 280 (88% mortality).
• 1977. Tandala, Zaire. Infected and killed 1.
• 1994. Minkebe and Makokou, Gabon. Infected 44, killed 28 (63%).
• 1995. Kikwit, Zaire. Infected 317, killed 247 (78%).
• 1996. Mayibout, Gabon. Infected 37, killed 21 (57%).
• 1996. Booue, Gabon (and transported to Johannesburg, South Africa (2 cases, 1 fatal)). Infected 62, killed 41 (66%).

• Ebola Cote d'Ivoire
• 1994. Tai Forest, Cote d'Ivoire. 1 non-fatally infected.
• 1995. Liberia transported to Cote d'Ivoire. 1 non-fatally infected.

Symptoms typically start two days to three weeks after contracting the virus, with a fever, throat and muscle pains, and headaches. There is then typically nausea, vomiting, and diarrhea, along with decreased functioning of the liver and kidneys. At this point, some people begin to have problems with bleeding.

The disease is usually acquired when a person comes into contact with the blood or bodily fluids of an infected animal such as a monkey or fruit bat. Fruit bats are believed to carry and spread the virus without being affected by it. Once infection of a human occurs, the disease may be spread from one person to another. Male survivors may be able to transmit the disease via their semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fever are first excluded. The blood may then be tested for antibodies to the virus, or the viral RNA, or the virus itself, to confirm the diagnosis.

Prevention includes decreasing the spread of the disease from infected monkeys and pigs to humans. This may be done by checking these types of animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may also be helpful, as is wearing protective clothing and washing hands when around a person who has the disease. Samples of bodily fluids and tissues from people with the disease should be handled with special caution.

There is no specific treatment for the virus. Efforts to help persons who are infected include giving them either oral rehydration therapy or intravenous fluids. The disease has a high mortality rate: often between 50% and 90% of those who are infected with the virus. The disease was first identified in the Sudan and the Democratic Republic of the Congo. It typically occurs in outbreaks in tropical regions of Sub-Saharan Africa. Between 1976, when it was first identified, and 2014, fewer than 1,000 people a year have been infected. The largest outbreak to date is the ongoing 2014 West Africa Ebola outbreak, which is affecting Guinea, Sierra Leone, and Liberia. Efforts are ongoing to develop a vaccine; however, none exists as of 2014.

Experimental therapies

Hyper immune equine immunoglobulin raised against EBOV was used in Russia to treat a laboratory worker who accidentally infected herself with EBOV. The treatment, however, was unsuccessful in saving her life. Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has been used successfully in nonhuman primate models as post-exposure prophylaxis. Such a recombinant post-exposure vaccine was also used to treat a German researcher who accidentally pricked herself with a possibly EBOV-contaminated needle. Treatment might have been successful as she survived. However, actual EBOV infection could never be demonstrated without a doubt. Other promising experimental therapeutic regimens rely on antisense technology. Both small interfering RNAs and Phosphorodiamidate Morpholino Oligomers (PMOs) targeting the EBOV genome could prevent disease in nonhuman primates.

Searching through various material, it became very obvious to say that many lives will be lost if this is not curbed properly. The medical professionals should go to their drawing boards.

Transmission

According to World Health Organization (WHO), Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Among workers in contact with monkeys or pigs infected with Reston Ebola virus, several infections have been documented in people who were clinically asymptomatic. Thus, RESTV appears less capable of causing disease in humans than other Ebola species.

However, the only available evidence available comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immune-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.

Signs and symptoms

Sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. The incubation period (interval from infection to onset of symptoms) varies between 2 to 21 days. During Ebola outbreaks, the case-fatality rate has varied from outbreak to outbreak between 25% and 90%.

Diagnosis

Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic fevers.

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:

• antibody-capture enzyme-linked immuno sorbent assay (ELISA)
• antigen detection tests
• serum neutralization test
• reverse transcriptase polymerase chain reaction (RT-PCR) assay
• electron microscopy
• Virus isolation by cell culture.

Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.

Vaccine and treatment

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids. No specific treatment is available. New drug therapies are being evaluated.

Natural host of Ebola virus

In Africa, fruit bats, particularly species of the genera Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are considered possible natural hosts for Ebola virus. As a result, the geographic distribution of Ebola viruses may overlap with the range of the fruit bats.

Controlling Reston Ebola virus in domestic animals

No animal vaccine against RESTV is available. Routine cleaning and disinfection of pig or monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.

If an outbreak is suspected, the premises should be quarantined immediately. Culling of infected animals, with close supervision of burial or incineration of carcasses, may be necessary to reduce the risk of animal-to-human transmission. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.

As RESTV outbreaks in pigs and monkeys have preceded human infections, the establishment of an active animal health surveillance system to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of Ebola infection in people

In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

In Africa, during EVD outbreaks, educational public health messages for risk reduction should focus on several factors:

• Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
• Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Ebola patients should be avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
• Communities affected by Ebola should inform the population about the nature of the disease and about outbreak containment measures, including burial of the dead. People who have died from Ebola should be promptly and safely buried.

Pig farms in Africa can play a role in the amplification of infection because of the presence of fruit bats on these farms. Appropriate bio-security measures should be in place to limit transmission. For RESTV, educational public health messages should focus on reducing the risk of pig-to-human transmission as a result of unsafe animal husbandry and slaughtering practices, and unsafe consumption of fresh blood, raw milk or animal tissue. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues and when slaughtering animals. In regions where RESTV has been reported in pigs, all animal products (blood, meat and milk) should be thoroughly cooked before eating.

Controlling infection in health-care settings

Human-to-human transmission of the Ebola virus is primarily associated with direct or indirect contact with blood and body fluids. Transmission to health-care workers has been reported when appropriate infection control measures have not been observed.

It is not always possible to identify patients with EBV early because initial symptoms may be non-specific. For this reason, it is important that health-care workers apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times. These include basic hand hygiene, respiratory hygiene, and the use of personal protective equipment (according to the risk of splashes or other contact with infected materials), safe injection practices and safe burial practices.

God help us!!!

References

https://web.stanford.edu/group/virus/filo/history.

http://en.wikipedia.org/wiki/Ebola_virus_disease

http://www.who.int/mediacentre/factsheets/fs103/en