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EBOLA: The other virus

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Dar Shahid Hussain

Ebola Virus Disease (EVD) is one of the deadliest diseases arouse during the late 20th century, discovered in 1976 when two consecutive outbreaks of fatal Hemorrhagic fever occurred in different parts of Central Asia. The first outbreak transpired in the Republic of Congo in a village near the Ebola river, which the virus derive its name. The second outbreak occurred in what is now south Sudan, approximately 500 miles away from Congo.
Ebola Virus Disease (EVD) formerly known as Ebola Hemorrhagic Fever is a rare but severe, often fatal to humans. The virus transmitted to people from wild animals and spreads in the human population through human to human transmission. The average EVD case fatality rate is around 50% (varied from 25% to 90% in the past out breaks). At the onset, public health officials assumed these outbreaks were a single event associated with an infected person who travelled between the two locations. However scientists later discovered that the two outbreaks were caused by two genetically distinct viruses- Zaire Ebolavirus and Sudan Ebolavirus. After this discovery, scientists concluded that the virus came from two different sources and spread independently to the people in each of the affected areas.
Ebola Virus Disease is not transmitted through the air and does not spread through casual contact, such as being near an infected person. Unlike respiratory illness, which can spread by particles that remain in the air after an infected person cough or sneezes, Ebola is spread by direct contact with body fluids of a person who is sick with Ebola.
It is first introduced into human population through handling or eating certain infected mammals such as monkeys, fruit bats, forest antelope and porcupines and it then spread from human to human through direct contact with the body fluids of another infected person. There is no evidence that mosquitoes or other insects can transmit Ebola virus.
People infected with Ebola aren’t contagious unless they have symptoms. If a person affected with Ebola coughs or sneezes, saliva or mucus touches another person’s eyes, nose, mouth, or an open cut or wound these fluids may spread Ebola. Handling objects that have been contaminated with body fluids from Ebola affected person or who have died from Ebola virus may also spread the disease with.
Community engagement is a key to control outbreaks. Good outbreak control relies on applying a package of intervention namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials and social mobilization, vaccines to protect against Ebola are under development and have been used to help to control the spread of Ebola outbreaks in Guinea and in the Democratic Republic of Congo.
Early supportive care with rehydration, symptomatic treatment improves survival. There is no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development. Pregnant and breastfeeding women with Ebola should be offered early supportive care, likewise vaccine prevention and experimental treatment should be offered under the same conditions as for non–pregnant population.
Viral and epidemiologic data suggests that Ebola virus existed long before these recorded outbreaks occurred. Factors like population growth, encroachment into forested areas and direct interaction with wildlife (such as bush meat consumption) may have contributed to the spread of the Ebola virus.
The Symptoms of the EVD are like fever fatigue, muscle pain, headache, sore throat. This is followed by vomiting, diarrhea, and rash-symptoms of impaired kidney and liver function and in some cases, both internal and external bleeding (oozing from the gums or blood in the stools).
Supportive care-rehydration with oral or intravenous fluids-and treatment of specific symptoms improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. In the 2018-19 Ebola outbreak in Congo, the first ever multi-drug randomized control trial is being conducted to evaluate the effectiveness and safety of drugs used in the treatment of Ebola patients under an ethical framework developed in consultation with experts in the field and the DRC.
An experimental of Ebola vaccine proved highly protective against EVD in a major trial in Guinea in 2015. The vaccine, called Rvsv-ZEBOV was studied in a trial involving 11841 people. Among the 5837 people who received the vaccine, no Ebola cases were recorded after 10 days of vaccination.
Subsequent to the discovery of the virus, scientists studied thousands of animals, insects and plants in search of its source (called reservoir among virologist). Gorillas, chimpanzees, and other mammals may be implicated when the first cases of an EVD outbreak in people occur.
However, they like people are “dead-end” hosts, meaning the organism dies following the infection and doesn’t survive and spread the virus to other animals. Like other viruses of its kind, it is possible that the reservoir host animal of Ebola virus doesn’t experience acute illness despite the virus being present in its organs, tissues, and blood. Thus the virus is likely maintained in the environment by spreading from host to host.

 


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