Ebola OutbreakResearch Paper

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Ebola Virus and Its Effect on Humans

The Ebola Virus

How ebola Virus Affects Host

The ebola Symptoms

Transmission of the Disease

The Spread of the Disease

Diagnosis of Ebola Virus

Investigation of Ebola

Management of Ebola

Fluid and electrolyte replacement

Treatment of Ebola Symptoms

The Emerging Treatments

Summery

Ebola is one of the latest killer diseases that have affected humans. It is often fatal with no known vaccinations for the disease. The fatality rate for the disease is nearly 90%. The Ebola virus disease appeared for the first time during two simultaneous outbreaks in 1976 in two regions of Sudan and the Democratic Republic of Congo. The disease got its name from an adjoining river where the disease broke out in the Democratic Republic of Congo. The disease seems to have been isolated in the East African region and there have not been reports of the disease spreading to Europe of Asia. However, with the interconnectedness of societies in the present day there are chances that the virus can be transmitted in the body of an infected person and quickly travel from one place to another (Ebola virus disease -- an introduction).

The disease is caused by a virus of the Filoviridae family. This virus often lies dormant in infected animals and humans can be infected when in close contact with an infected animals. It can also be transmitted into humans through contact with body fluids of infected patients. The virus has an incubation period post infection of 5 to 9 days which can extend to 21 days in some patients. A patient would be considered to be infected by the Ebola virus only after the patient shows signs and symptoms of infection. Clinical diagnosis is made difficult as the initial presentation is non-specific (Ebola virus disease -- an introduction). Depending on the species of Ebola virus and quality of treatment made available to a patient, the Ebola virus can be fatal. This disease is also considered to be part of the viral haemorrhagic fevers disease.

Animals, such as bats and non-human primates are believed to be the carriers of the disease initially and any contact with their body fluid can transfer the disease. However the exact mode of transfer and the natural reservoir of the disease are yet to be confirmed. Though bats and rodents can be infected with the virus under laboratory conditions, plants or arthropods seemed to be unaffected of the virus. There is also a belief among scientists that consumption of food that is contaminated with bat feces can cause the disease in humans (Peters and Peters).

As in human to animal transmission of the disease, human-to-human transmission of the disease can occur through exchange or contact with body fluids. For example the re-use of non-sterile injections was responsible for healthcare infections during the early Ebola epidemics. Body fluids such as sweat, blood, feces, vomit, saliva, genital secretions, urine and breast milk of infected humans is the primary cause of transmission and spread of the disease. There is however no evidence of transmission of the disease through air (Peters and Peters).

There are a number of different types of the Ebola virus. The first virus of Ebola, Reston Ebola virus, was discovered in 1989 in a laboratory in Reston in Virginia, United States among crab eating macaque monkeys. About ten years later, the virus was also found in pigs. In the Philippines in 2009, six people tested positive for Reston Ebola virus antibodies when they came in contact with sick pigs. Currently there is no vaccine or specific treatment for Ebola virus disease.

The Ebola Virus

The Ebola virus gene is made up of a single 19 kb strand of negative sense RNA with seven viral genes that are transcribed by the viral RNA dependent RNA polymerase that exists in the virus body. Helically arranged viral nucleoproteins NP and VP30 cover the single strand of RNA in the virus. Matrix proteins VP24 and VP4 to the lipid bilayer are linked to the RNA of the virus.

How Ebola Viruses Affects the Host

The virus enters the human body through the skin. This happens when humans come in contact with the body fluids of infected persons or animals. The virus breaks into the body through cracks and fissures in the mucosa or skin. This type of transmission can happen for both animal to human and human to human transmissions. While initially infecting the human body, the virus prefers to replicate itself in monocytes, macrophages, and dendritic cells. When the virus replicates and multiplies in these cells, the infected cells travel to the regional lymph nodes, liver, and spleen and hence spread the virus across the body. In this process the vital organs of body function in the body get affected and infected by the virus (Stimola).

A number of cell types can be infected by the Ebola virus as it has a wide cell tropism. The virus has the ability to control and modulate the functioning of the genes that are associated with the immune system response in a host body ('Micrornas And The Ebola Virus'). This ability of the Ebola virus is the cause of lymphocyte apoptosis and attenuation of the virus fighting effects of interferon. The outcome of the infection is critically dependent on the immune response and ability in the host body. The virus causes pro-inflammatory cytokines and interleukins (ILs) such as IL-2, IL- 6, IL-8, and IL-10; interferon inducible protein; and tumor necrosis factor ? (TNF-?) to become active which increases the severity of the disease in a patient (Bueche). This is again due to the ability of the virus to control and change the way the immune system cells function in a host. In the severe condition of an Ebola infected patient, the virus causes endothelial activation and reduced vascular integrity, release of tissue factor and increases the level of nitric oxide in the cells and thus the blood and the organs ('Micrornas And The Ebola Virus'). The virus also has the ability to reduce the number of platelets from damaged tissue thereby weakening the tissue and the organ in the host body. Therefore, the coagulation process is affected. Severe internal bleeding and related complications occur when the virus causes intravascular coagulation, along with acute hepatic impairment. Acute kidney damage, hepatitis and pancreatitis are some of the other critical illness that the virus causes in a host body (Stimola). Therefore, for effective treatment of the disease it is critical that the diagnosis occur early so that lymphocyte depletion is controlled for survival of the patient.

The Ebola Symptoms

The symptoms of the disease are very similar in the initial phases to those of common viral fever. Scientists have identified three stages of outbreak of symptoms in an Ebola patient. In the first week, the virus manifests with a few days of non-specific fever, headache and myalgia. These are very common symptoms of any viral infection and tend to be overlooked. However such feverish symptoms are followed by other symptomatic diseases that are gastrointestinal in nature like diarrhea and vomiting, abdominal symptoms and dehydration. After a week of this, scientists have noted that the patients tend to recover for about a week only to go back into a more severe condition soon after. In this severe condition, patients again develop fever but also accompanied with serious complications including collapse, neurological manifestations, and bleeding. This phase is the critical phase of the disease where the fatality is very high ('Recovering Ebola Virus').

In the latest epidemic of Ebola in Africa in 2014, the primary and the most common symptoms that were seen in a majority of the patients were fever, fatigue, loss of appetite, vomiting and diarrhea accompanied with headache, abdominal pain and unexplained bleeding mostly in the internal organs. Dehydration among the patients occurs due to continuous vomiting and diarrhea.

Transmission of the Disease

Though the exact mode of the first transmission of the disease has not yet been ascertained as the natural reservoir host of Ebola viruses has not yet been identified, it is generally believed by scientists that the first human infection occurs when humans come in contact with infected animals like a fruit bat or primate like apes and monkeys. Such an occurrence is referred to as a spill over event. Such first human infection can happen when humans come in close contact with infected animals and come in contact with infected body fluids of the animals (Anker and Andraghetti). Once the human infection happens, the virus can spread quickly from one human to another through close contact and contact with body fluids. Since human-to-human contact is more frequent, the transmission of the disease can be rapid and large numbers of people can be quickly affected. It has been noted that infection also occurs when meat of infected animals are consumed by humans as animals are also as vulnerable to the disease and transmission as humans ('Micrornas And The Ebola Virus').

The Spread of the Disease

In humans, the… [END OF PREVIEW]

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