4093207 Ebola and Marburg

7/29/2019 4093207 Ebola and Marburg

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EBOLA and MARBURG Viral Infections

Dr.T.V.Rao MD


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Viral Hemorrhagic fevers The term v ira l hem orrh agic fever refers to a c l in ical

syn dro m e ch aracter ized by acute ons et of fever acco m panied by n on spec i f ic find ing s of malaise,pro st ra t ion, d iarrhea,and headach e. Pat ients f requent ly

sho w s igns of inc reased vascular permeabi l i ty, and m any develop bleeding d iatheses . The hem orrh agic fever vi rus es represent po tent ial agents fo r biolo gic w arfare because of capabi l i ty of aeroso l t rans m iss io n,h igh m orbid i ty,and m or ta li ty asso c iated w i th infec t ion ,

and abi l i ty to repl icate in cel l cul tu re in h igh co nc entra t ions . , The im po rtant infect ing agents are Ebola and Marbu rg


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Ebola and Marburg Virus

Ebola and Marburg viruses are highly virulent inhumans and non human primates, ends indeath.

Both the viruses are identified to cause Africanhemorrhagic fevers


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FilovirusFilo is Latin for Thread

Marburg and Ebolaare members of theFiloviridae

Appear as longthreads,

Can be U shaped, Genome 19 kb long Enveloped viruses. A single stranded,

unregimented, -Helical, ve senseRNA genome

80 nm Diameter


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Events on Ebola Ebola virus were discovered in 1976 with

occurance of two severe epidemics of hemorrhagic fever in Sudan and Zaire.

The Epidemic invloved > 500 persons and killed >400 infected individual.

The importance of epidemic lies with in eachoutbreak hospital staff become infected throughclose contact with patients, their blood and

excreta. The mean time of death from onset to symptomsis 7 8 days.


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Events on Marburg

Marburg Viruses were discovered in 1967 First identified in Laboratory workers

exposed to tissues of African greenMonkeys imported to Germany andYugoslavia.

Transmission from patients to Medical

personal occurred with highly mortality. Marburg virus can infect Guinea pigs, Mice,

Hamsters, Monkeys


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Epidemic Outbreaks of Marburg

Out breaks occured inKenya, South Africa,Democratic Republicof Congo.

Recent outbreak in Angola in 2005


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Ebola Patient


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Reservoir Hosts Reservoirs can be a

Rodent or Bat Humans infected

accidentally

Monkeys are not provedas reservoirs as die withinfection early

Infected humans are richsource of infections toothers.

By direct contact withblood and body fluids of infected persons canspread the disease


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Spread of Infections

Transmission appears to be associated withcontamination of Blood, Blood stained bodyfluids or tissues.

Nosocomial spread is common mode of spread, Doctors and Nurses at risk whenattending the patients.

Transmission by sexual intercourse has beenon record from a case of man infecting hiswife 83 days after initial infection.


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Viral Replication

The viruses are grownin variety of cell lines

includingVeroM A 104

S W 13 cellsFiloviruses replicates in

the cytoplasam


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Pathology and Pathogenesis

The viruses belong togroup of Filoviruses

The viruses havetropism for

Cells of macrophage systemDendritic cells

Interstitial fibroblastsEndothelial cells


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Mode of Spread


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Virus infect several Organs

High titer of viruses are foundinLiver Spleen,LungsKidneysBloodOther Body fluids


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How the Illness is Presented inMarburg and Ebola

Fever Head ache Sore throat

Muscle pain Abdominal pain, Vomitting Diarrhea Incubation period 3 -9

days in Marburg In Ebola 2 21 days.


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Serious manifestation of Ebola and Marburg

Internal andExternalbleeding,

Shock,Death


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Diagnosis

Viruses are isolatedfrom Blood by cellculture on Vero

cells ( Vero E 6 ) ELISA for antigen

detection

ELISA for IgM RT - PCR


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Control of Infection

Isolation facilitieswithin the Hospitalremain the most

important effectivemeasure. Barrier nursing

remain the basicneed in control of infection spread


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The health care workers should

Avoid

InfectedBlood,secretions,

Tissues,Wastes


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Treatment of Ebola and Marburg

Antiviral drugs are not available

Interferons are not effective To date no Vaccine Electrolyte corrections

Dealing with hemorrhagic complications .


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Barrier Nursing remains the onlybest option in Prevention


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Created for Health

awarness on Filoviruses Dr.T.V.Rao MD

Email [email protected]

4093207 Ebola and Marburg

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