Ebola virus: Difference between revisions

From IDWiki
No edit summary
No edit summary
Line 1: Line 1:
==Microbiology==
+
==Background==
  +
  +
=== Microbiology ===
   
 
*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family
 
*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family
Line 8: Line 10:
 
**Sudan ebolavirus (SUDV)
 
**Sudan ebolavirus (SUDV)
 
**Taï Forest (or Cote d'Ivoire) ebolavirus (TAFV)
 
**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==
 
==Clinical Manifestations==
   
 
*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]])
*Fever, fatigue, myalgias, weakness, and dizziness
+
*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
 
*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
 
*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
  +
** [[Biosafety risk groups|Biosafety level 4 agent]]
  +
* 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 ==
=== Prognosis and Complications ===
 
   
  +
* Vaccination with a recombinant vesicular stomatitis virus that has its glycoprotein replaced by Ebola virus glycoprotein
* 33 to 75% mortality, depending mostly on supportive care
 
  +
** Used in large West African and DRC outbreaks with ring vaccination
  +
** Efficacy 95-100%
  +
** >100,000 doses give
   
 
[[Category:Filoviridae]]
 
[[Category:Filoviridae]]

Revision as of 09:31, 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

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