Ebola virus: Difference between revisions
From IDWiki
No edit summary |
(ββ) |
||
Line 1: | Line 1: | ||
==Background== |
==Background== |
||
=== |
===Microbiology=== |
||
*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family |
*Negative-sense single-stranded RNA virus in the [[Filoviridae]] family |
||
Line 11: | Line 11: | ||
**TaΓ― Forest (or Cote d'Ivoire) ebolavirus (TAFV) |
**TaΓ― 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== |
||
Line 30: | Line 30: | ||
*Hiccups associated with increased mortality |
*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 === |
|||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
⚫ | |||
=== 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]] |
Revision as of 13:42, 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)
- TaΓ― 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
- 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