Ebola virus: Difference between revisions
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==Background== |
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=== Microbiology === |
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*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family |
*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family |
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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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==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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*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 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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[[Category:Filoviridae]] |
[[Category:Filoviridae]] |
Revision as of 13:31, 28 August 2020
Background
Microbiology
- Negative-sense single-stranded RNA virus in the Filoviridae family
- The ebolavirus genus includes five species:
- Zaire ebolavirus (EBOV), the most common
- Bundibugyo ebolavirus (BDBV)
- Reston ebolavirus (RESTV)
- 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
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 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