Ebola virus: Difference between revisions
From IDWiki
No edit summary |
No edit summary |
||
Line 1: | Line 1: | ||
− | == |
+ | ==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]]) |
||
− | * |
+ | *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 |
||
+ | |||
⚫ | |||
+ | |||
⚫ | |||
+ | *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 == |
||
⚫ | |||
+ | * 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 |
||
[[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
- 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