Ebola virus: Difference between revisions
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==Background== |
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===Microbiology=== |
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*The ebolavirus genus includes five species: |
*The ebolavirus genus includes five species: |
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**Zaire ebolavirus (EBOV), the most common |
**Zaire ebolavirus (EBOV), the most common |
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**Bundibugyo ebolavirus (BDBV) |
**Bundibugyo ebolavirus (BDBV) |
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**Reston ebolavirus (RESTV) |
**Reston ebolavirus (RESTV), which does not cause disease in humans |
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**Sudan ebolavirus (SUDV) |
**Sudan ebolavirus (SUDV) |
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**Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV) |
**Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV) |
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===Epidemiology=== |
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*Essentially located exclusively in west Africa |
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*Outbreaks occur where there is food insecurity (with resultant hunting for bush meat), increased population density, and insufficient public health infrastructure |
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*Human-to-human transmission occurs via exposure to contaminated blood or fluids, including providing care to infected family or patient and preparing an infected body for funeral |
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*Mainly infectious during symptoms, which corresponds to viremia |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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*Incubation period [[Incubation period range::2 to 21 days]] (generally [[Usual incubation period::3 to 13 days]]) |
*Incubation period [[Incubation period range::2 to 21 days]] (generally [[Usual incubation period::3 to 13 days]]) |
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*Initially starts as a non-specific influenza-like illness with fever, fatigue, myalgias, weakness, and dizziness |
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*Followed by multiorgan involvement and hemorrhagic manifestations (30-50%) |
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*EBOV can persist after resolution of symptoms in privileged sites: the eyes, CNS, male reproductive tract, and mammary glands |
*EBOV can persist after resolution of symptoms in privileged sites: the eyes, CNS, male reproductive tract, and mammary glands |
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*Relapse can occur as uveitis or meningitis |
*Relapse can occur as uveitis or meningitis |
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*Death usually within 6 to 16 days of symptom onset |
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===Prognosis and Complications=== |
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*Hiccups associated with increased mortality |
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==Diagnosis== |
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*Ensure to notify the lab before sending samples, and contact Public Health for instructions |
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**[[Biosafety risk groups|Biosafety level 4 agent]] |
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*qPCR at the Public Health Laboratory Ontario, but only for Zaire ebolavirus |
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*Canada's National Microbiology Laboratory does RT-PCR, viral isolation, and serology |
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==Management== |
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*Supportive care alone can decrease mortality to 20-30% |
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*Monoclonal antibodies |
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**REGN-EB3 (6% mortality) |
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**mAb-114 (11% mortality) |
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**Zmapp (24% mortality) |
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*Medications |
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**[[Remdesivir]] (33% mortality) |
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==Prevention== |
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===Vaccination=== |
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*Vaccination with a recombinant vesicular stomatitis virus that has its glycoprotein replaced by Ebola virus glycoprotein |
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**Used in large West African and DRC outbreaks with ring vaccination |
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**Efficacy 95-100% |
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**>100,000 doses give |
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===Infection Prevention and Control=== |
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*Isolate patient |
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*Droplet precautions and face protection within 1 meter of patient |
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*Limit hospital staff who have contact |
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[[Category:Filoviridae]] |
[[Category:Filoviridae]] |
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Latest revision as of 12:53, 29 August 2020
Background
Microbiology
- Negative-sense single-stranded RNA virus in the Filoviridae family, related to Marburg virus and Cueva virus
- The ebolavirus genus includes five species:
- Zaire ebolavirus (EBOV), the most common
- Bundibugyo ebolavirus (BDBV)
- Reston ebolavirus (RESTV), which does not cause disease in humans
- Sudan ebolavirus (SUDV)
- Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV)
Epidemiology
- Essentially located exclusively in west Africa
- Outbreaks occur where there is food insecurity (with resultant hunting for bush meat), increased population density, and insufficient public health infrastructure
- Human-to-human transmission occurs via exposure to contaminated blood or fluids, including providing care to infected family or patient and preparing an infected body for funeral
- Mainly infectious during symptoms, which corresponds to viremia
Clinical Manifestations
- Incubation period 2 to 21 days (generally 3 to 13 days)
- Initially starts as a non-specific influenza-like illness with fever, fatigue, myalgias, weakness, and dizziness
- Followed by multiorgan involvement and hemorrhagic manifestations (30-50%)
- EBOV can persist after resolution of symptoms in privileged sites: the eyes, CNS, male reproductive tract, and mammary glands
- Relapse can occur as uveitis or meningitis
- Death usually within 6 to 16 days of symptom onset
Prognosis and Complications
- 40 to 70% mortality, depending mostly on supportive care
- Hiccups associated with increased mortality
Diagnosis
- Ensure to notify the lab before sending samples, and contact Public Health for instructions
- qPCR at the Public Health Laboratory Ontario, but only for Zaire ebolavirus
- Canada's National Microbiology Laboratory does RT-PCR, viral isolation, and serology
Management
- Supportive care alone can decrease mortality to 20-30%
- Monoclonal antibodies
- REGN-EB3 (6% mortality)
- mAb-114 (11% mortality)
- Zmapp (24% mortality)
- Medications
- Remdesivir (33% mortality)
Prevention
Vaccination
- Vaccination with a recombinant vesicular stomatitis virus that has its glycoprotein replaced by Ebola virus glycoprotein
- Used in large West African and DRC outbreaks with ring vaccination
- Efficacy 95-100%
- >100,000 doses give
Infection Prevention and Control
- Isolate patient
- Droplet precautions and face protection within 1 meter of patient
- Limit hospital staff who have contact
