Ebola virus

describe you about ebola virus its transmission,pathology etc.

1. EBOLA VIRUS PRESENTED TO : MA’AM MARIA RANA PRESENTED BY : SAMAWIA IQBAL

2. CONTENTS INTRODUCTION HISTORY EPIDEMIOLOGY TRANSMISSION PATHOLOGY CONTROL DIAGNOSIS TREATMENT ROLE OF PHARMACIST

3. INTRODUCTION Ebola virus disease  ( EVD ), or simply  Ebola , is a  hemorrhagic fever of humans and other  primates caused by ebolavirus. Ebolaviruses contain single-stranded, non-infectious  RNA genome. Ebolavirus belongs to the  Filoviridae  family and contains 5 members: EBOV, SUDV, TAFV, BDBV and  Reston virus  (RESTV ).

4. STRUCTURE

5. HISTORY Ebola virus was first discovered in 1976 near the Ebola  River. Since then , the virus has been infecting people from time to time, leading to outbreaks in several African countries. Scientists do not know where Ebola virus  come  However, based on the nature of similar viruses, they believe the virus is animal-borne, with bats or nonhuman primates (chimpanzees, apes, monkeys, etc.) being the most likely source. Infected animals carrying the virus can transmit it to other animals, like apes, monkeys, duikers and human.

6. EPIDEMIOLOGY Ebola virus disease (EVD), one of the deadliest viral diseases, was discovered in 1976 when two consecutive outbreaks of fatal hemorrhagic fever occurred in different parts of Central Africa. The first outbreak occurred in the Democratic Republic of Congo (formerly Zaire) in a village near the Ebola River, which gave the virus its name. The second outbreak occurred in what is now South Sudan, approximately 500 miles (850 km) away.

7. TRANSMISSION ROUTE OF TRANSMISSION : Close contact is the most important route of transmission of EVD , it can survive in the body fluids of patients and cadavers for days and invade to the recipients via mucous membranes or injured skin. Besides all this it can spread through contaminated items like clothes. Oral transmission is also an important route in Africa.

8. CONT… Other routes were found out to be associated with hospital –mediated dissemination and intra familial transmission. Sick animals were hunted for food , like bush meat if not cooked properly and fruit bats were among the reservoirs for the virus.

9. SUSCEPTIBILITY Humans of all races are susceptible to the virus , but the outcome depends on the transmission routes , viral load , age and genetic background. Case fatality rate infected with contaminated syringes is more common than those through contact exposure. Case fatality load of patients with high viral load (> 10 7  copies/ml ) is 3 times higher than in patients with low viral load  (<10 4  copies/ml ).

10. CONT… Patients over age 45 have higher fatality rate than those below age 21. Clinical characteristic suggest that genetic diversity plays a significant role in EVD pathogenesis.

11. CONTROL Since there are no proper medications available to cure EVD , the most important thing is to prevent susceptible people from infection and restrict the spread. Contact tracing and quarantine policies should be strengthened. Well operated disease surveillance system should be in place.

12. PATHOLOGY EBOV is thought to infect humans through contact with mucous membranes or skin breaks . After infection, endothelial cells, liver cells, and several types of immune cells such as macrophages, monocytes and  dendritic cells  are the main targets of attack .  Following infection, immune cells carry the virus to nearby  lymph nodes where further reproduction of the virus takes place .

13. CONT… From there the virus can enter the bloodstream and lymphatic system and spread throughout the body. Macrophages are the first cells infected with the virus, and this infection results in programmed cell death . Other types of white blood cells are also infected. This contributes to the weakened immune response seen in those infected with EBOV.

14. CONT… Endothelial cells may be infected within three days after exposure to the virus. The breakdown of endothelial cells leading to blood vessel injury can be attributed to EBOV  glycoproteins  leading to improper clotting .   The widespread bleeding that occurs in affected people causes  swelling and shock due to loss of blood volume .  

15. Filovirus infection also interferes with proper functioning of the innate immune system. EBOV proteins blunt the human immune system's response to viral infections by interfering with the cells' ability to produce and respond to interferon proteins.

16. SINGS AND SYMPTOMS ONSET : The length of time between exposure to the virus and the development of symptoms ( incubation period ) is between 2 and 21 days, and usually between 4 and 10 days .

17. Symptoms usually begins with influenza like stage leading to : Feeling of tiredness Fever Loss of appetite Muscular and joint pain Headache and sore throat. Vomiting Nausea

18. This often leads to : Diarrhea Abdominal pain Dehydration Short breath In about half of the cases, the skin may develop a maculopapular rash, a flat red area covered with small bumps, five to seven days after symptoms begin.

19. CONT… Bleeding : In some cases, internal and external bleeding may occur .  This typically begins five to seven days after the first symptoms. All infected people show some decreased blood clotting .  Bleeding from mucous membranes or from sites of needle punctures has been reported in 40–50% of cases.

20. DIAGNOSIS Laboratory testing Possible non-specific laboratory indicators of EVD include a low platelet count  decreased white blood cell count  increased white blood cell count elevated levels of the liver enzymes alanine (ALT ) and  (AST ). abnormalities in blood clotting . Filoviruses such as EBOV may be identified by their unique filamentous shapes in cell cultures examined with electron microscopy.

21. CASE STUDIES

22. PREVENTION People who care for those infected with Ebola should wear protective clothing including masks gloves, gowns and goggles .  The U.S. Centers for Disease Control (CDC) recommend that the protective gear leaves no skin exposed . These measures are also recommended for those who may handle objects contaminated by an infected person's body fluids.

23. The infected person should be in barrier-isolation from other people .   All equipment, medical waste, patient waste and surfaces that may have come into contact with body fluids need to be  disinfected.

24. TREATMENT Vaccines An Ebola vaccine,  rVSV-ZEBOV , was approved in the United States in December 2019. It appears to be fully effective after ten days of being given .  It was studied in Guinea between 2014, and 2016 .  More than 100,000 people have been vaccinated against Ebola as of 2019 .

25. ROLE OF PHARMACIST Pharmacist are given new responsibilities to address the issue of this pervasive disease. They evaluate the medication – use process , from procurement to administration. Making changes needed to safely care for the patients with EVD. They play pivotal role in educating the patients They promote disease prevention. They should refer any suspected case to the health care facilities.

26. REFERENCES https://rhochistj.org/RhoChiPost/the-role-of-pharmacists-in-the-evd-outbreak/ https:// en.wikipedia.org/wiki/Ebola_virus_disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440555 / https://www.ncbi.nlm.nih.gov/pmc/articles/PMC224575 / https:// www.google.com/search?q=ebola+virus+pathology&hl https://www.google.com/search?q=ebola+structure&sxsrf