Ebola virus: Difference between revisions
From IDWiki
(→) |
No edit summary |
||
Line 3: | Line 3: | ||
===Microbiology=== |
===Microbiology=== |
||
− | *Negative-sense single-stranded RNA virus in the [[Filoviridae]] family |
+ | *Negative-sense single-stranded RNA virus in the [[Filoviridae]] family, related to [[Marburg virus]] and [[Cueva virus]] |
*The ebolavirus genus includes five species: |
*The ebolavirus genus includes five species: |
||
**Zaire ebolavirus (EBOV), the most common |
**Zaire ebolavirus (EBOV), the most common |
||
**Bundibugyo ebolavirus (BDBV) |
**Bundibugyo ebolavirus (BDBV) |
||
− | **Reston ebolavirus (RESTV) |
+ | **Reston ebolavirus (RESTV), which does not cause disease in humans |
**Sudan ebolavirus (SUDV) |
**Sudan ebolavirus (SUDV) |
||
**Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV) |
**Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV) |
||
Line 15: | Line 15: | ||
*Essentially located exclusively in west Africa |
*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 |
*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== |
==Clinical Manifestations== |
||
Line 49: | Line 51: | ||
==Prevention== |
==Prevention== |
||
− | === |
+ | ===Vaccination=== |
*Vaccination with a recombinant vesicular stomatitis virus that has its glycoprotein replaced by Ebola virus glycoprotein |
*Vaccination with a recombinant vesicular stomatitis virus that has its glycoprotein replaced by Ebola virus glycoprotein |
||
Line 56: | Line 58: | ||
**>100,000 doses give |
**>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 |
[[Category:Filoviridae]] |
[[Category:Filoviridae]] |
Latest revision as of 08:53, 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