BIOLOGY PROJECT

Ebola VirusAN EMERGING

PANDEMIC

SUBMITTED BY Mr.Marwan.k.m

CLASS XIIROLL NO-

[2015-2016]

General information Title Of The Project : Ebola Virus

Performed By : Marwan.k.m

Roll Number :

Class : XII

Guide : Mrs.Ammini

Date Of Submission :

ACKNOWLEDGEMENTFirst of all, I heartily thank my Biology Teacher, Mrs. Ammini for her incomparable efforts, support and constant cooperation indeed towards me in the completion of this project. She has also been the vital source of encouragement for me throughout the working of this project.

Finally I would also grateful to my friends and parents who devoted their auspicious time in completion of this project.

Marwan.k.m

PrefaceBiology is the study of life in it’s entirely. The growth of biology as

a natural science is interesting from many points of view. This

project is meant to describe about the basic information, origin,

cure, and different aspects of Ebola Virus. One may notice a

perceptible change in writing style. Most of the topics are written

in an easy dialogue style engaging the readers constantly and

included with more informatics comments.

I assure you to go through this project thoroughly to know a

bit more and facts about Ebola virus disease.

INDEX

Sl. No. Topic Page no.

1. Introduction 9

2 Outbreak & Impact 11

3. Transmission Route 12

4. WHO Response 13

5. Statistics by WHO 14

6. Symptoms and Cure 15

7. Prevention 16

8. What India Can Do? 17

9. Conclusion 18

10. Bibliography 19

IntroductIonThe past two decades have seen this world experiencing, with alarming regularity, outbreaks of viral diseases like Severe Acute Respiratory Syndrome (SARS), bird flu and swine flu. These have caused alarm spread panic not only in populations that are directly affected but also in places away from the locations of these outbreaks; the recent re-emergence of Ebola Virus, for example has underscored the fact that humans are increasingly and continuously at risk from life threatening viral diseases, and that the unexpected can be expected anytime. These emerging infectious diseases that occur in most parts are generally connected with a rapid growth in population. Human activities like changes in land use, increased urbanization and high population densities in cities, increased contact with wild animal reservoirs, climate change and deterioration in health-care systems, particularly in developing and poor countries are the major causes.

Ebola is a rare disease caused by one of five virus strains found in Several African countries. There is no cure or vaccine against it. And the largest Ebola outbreak in history is currently spinning out of control in West Africa.

Increased human mobility and connectivity have radically changed the way in which emerging infectious diseases spread across regions and across the world. India is at risk and it is only a matter of time before cases of Ebola appear in the continent (45,000 Indians are estimated to be living in the affected regions of West Africa).

The Indian government has some plans to ward off an Ebola outbreak. But the Ebola epidemic also demands that swift and decisive action be taken in support of affected countries. Airborne transmission has not been documented during EVD outbreaks. They are, however, infectious as breathable 0.8-µm to 1.2-µm laboratory-generated droplets. The virus has been shown to travel, without

contact, from pigs to primates, although the same study failed to demonstrate similar transmission between non-human primates.

Bats are considered the natural reservoir of the EBOV, plants, arthropods, and birds were also considered. Bats were known to reside in the cotton factory in which the first cases for the 1976 and 1979 outbreaks were employed, and they have also been implicated in Marburg virus infections in 1975 and 1980. Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected. The absence of clinical signs in these bats is characteristic of a reservoir species. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and The Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments.

One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly. Medical workers who do not wear appropriate protective clothing may contract the disease. Hospital acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions. Some health care centers caring for people with the disease do not have running water.

In 1976, when Peter Piot, a young Belgian microbiologist, was sent to investigate an outbreak of a mysterious virus in a remote part of the Democratic Republic of Congo (then Zaire), he could never have predicted how the new pathogen that he viewed through his microscope would change his life – nor the devastation it would cause nearly four decades later.

Almost four decades ago, Peter Piot was part of the team that discovered the Ebola virus

Peter Piot, second from left, on site in Yambuku during the first Ebola outbreak in 1976.

Nearly 40 years after his discovery, made when he was only 27, Professor Piot is one of the foremost experts in the never-ending war against infectious disease. He was the founding director of Unaids, the joint United Nations Programme on HIV/Aids, a position he held from 1995 to 2008.

Outbreak & Impact

The current outbreak of Ebola virus in some West African countries isunprecedented and seems to have spun out of control. What started in three of the poorest countries in West Africa – Guinea, Liberia and Sierra Leone – already ravaged by political turmoil and civil war, has now spread beyond their borders. The epidemic – which the World Health Organization (WHO) says has affected more than a million humans. Although officially reported cases are between2,000-3,000.

In the current outbreak, the first reported case was that of a two-year-old boy who died on December 6, 2013, which was soon followed by deaths of his other family members. By the end of March 2014, the disease had erupted in many locations and the outbreak was termed as “unprecedented.” By end July, it had caused widespread panic, fear and disruption, including steps that led to the closure of borders between the affected countries. The death of a nurse in Lagos, Nigeria, on August 6 and, since then, has added an entirely differentdimension to this extraordinary health threat.

After an incubation period of 2 – 20 days, the Ebola infection shows a suddenonset of the disease resulting initially in flu-like symptoms: fever, chills and malaise. As the disease progresses, it results in multi-system involvements indicated by the person experiencing lethargy, nausea, diarrhea and headache. Haemorrhagic conditions usually set in at its peak, resulting in uncontrolled bleeding, shock, convulsions and severe metabolic disorders. Fatal clinical signs come up early, with death occurring within about two weeks. In non-fatal cases the fever resolves itself and is generally co-antibody response, suggesting and possibility of a protective mechanism.

TRANSMISSION ROUTE The African fruit bat (of the Pteropodidae family) is considered to be the

natural host for the Ebola viruses as well as the major source of human infections.

The chimpanzee, gorilla, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest can also carry the virus and can infect humans [wildlife-to-human transmission].

Whereas Chimpanzee and gorillas are merely accidental hosts and not the natural reservoirs.

Close contact with bats is considered to be the major reason. Ebola spreads through human-to-human transmission via direct contact

(through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Indirect contact with environments contaminated with such fluids. Close contact with infected dead persons can also cause the infection. People remain infectious as long as their blood and body fluids, including

semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

It doesn’t spreads through air like flu viruses.

Who responseWHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to developed preparedness plans. The document provides overall guidance for control of Ebola and Marburg virus outbreaks.

When an outbreak is detected WHO responds by supporting surveillance, community engagement, case management, laboratory services, contact tracing, infection control, logistical support and training and assistance with safe burial practices. WHO has developed detailed advice on Ebola infection prevention and control :

StatiSticS by Who

SymptomS & cureOver time, symptoms become increasingly severe and may include:

Nausea and vomiting Fever (greater than 38.6°C or 101.5°F) Diarrhea (may be bloody) Red eyes Raised rash Chest pain and cough Stomach pain Severe weight loss Bleeding, usually from the eyes, and bruising (people near death may bleed

from other orifices, such as ears, nose and rectum).

No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.Symptoms of Ebola are treated as they appear. The following basicinterventions, when used early, can significantly improve the chances of survival:

Providing intravenous fluids (IV)and balancing electrolytes (body salts) Maintaining oxygen status and blood pressure Maintaining oxygen status and blood pressure

Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.

PreventionIf we travel to or are in an area affected by an Ebola outbreak, then following measures should be taken:

Practice careful hygiene. For example, wash your hands with soap and water or an alcohol-based hand sanitizer and avoid contact with blood and body fluids.

Do not handle items that may have come in contact with an infectedperson’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).

Avoid funeral or burial rituals that require handling the body of someonewho has died from Ebola.

Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.

Avoid hospitals where Ebola patients are being treated. The U.S. embassy or consulate is often able to provide advice on facilities.

After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms for Ebola.

If we travel to or are in an area affected by an Ebola outbreak, then following measures should be taken:

Wear protective clothing, including masks, gloves, gowns, and eye protection.

Practice proper infection control and sterilization measures. Notify health officials if you have had direct contact with the blood or

body fluids, such as but not limited to, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola. The virus can enter the body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth

WHAT INDIA CAN DO?

India, too, can contribute to global efforts to quell the Ebola crisis. It has a large cadre of epidemiologists, laboratory scientists, doctors and nurses who are experienced in epidemic control and can help support diagnosis, the training of health workers, or clinical services in Ebola treatment units. It also has a large number of social mobilisers who have proved their abilities in health campaigns such as the polio eradication campaign. They could contribute their experiences in community empowerment (one of the cornerstones of the Ebola response), address rumours and fears and help communities regain trust in the humanitarian response.

These resources are waiting to be mobilised, both to help contain the crisis in West Africa and to ensure that India is prepared for a possible Ebola emergency in the near future.

By stepping decisively into the fray, India will signal that it stands withother world powers in the front line of the global fight against Ebola as well as other emerging infectious diseases. It is only when the outbreak is controlled in West Africa that nations will have done all they could to protect their own citizens from a possible outbreak of Ebola on their shores.

INTERVIEWDr Mohanan, Associate professor in community medicine at Calicut Medical College talks about how the spread of the Ebola virus can be checked and whether India is equipped to take on the challenge.

Excerpts from the interview:

How can we better prepare ourselves to deal with scare of an Ebola outbreak?

It is important to first understand a little bit about the epidemiology of this virus. Ebola is a viral disease like Dengue and Chikungunya. The preliminary symptoms are very much like the flu. For instance, you'll have a high fever, headaches, body ache. And it can also lead to haemorrhaging tendencies, where you start to bleed from different parts of the body. It can further lead to a shock-like state and ultimately death.

The problem with this virus is that the case-fatality rate is very high. That is, if there are 100 people who are suffering from this viral disease, 90 out of them will eventually die.

There two reasons that.

First, the period of infection is very small. Within two to 14 days, anyone who is exposed to it will get it. And two, a country like India does not have any history of his virus and if this virus is imported in any form or there is an indigenous outbreak, people will not have immunity against it.

They have not been exposed to this virus earlier so their body does not have immunity against it. As I have said, because the case-fatality rate is very high, the morbidity and mortality rate will be very high.

Now, how is Ebola transmitted? It spreads via body fluids – saliva, sweat, semen, blood and physical contact. The risk of exposure to those who are handling Ebola cases, health care workers, for instance, is very high.

And when a patient dies and the body is being cremated or buried, at that stage too, the infection can be transmitted.

What we need to do is try and stop importation of the virus into India and if there is importation, we should be able to isolate and quarantine such a patient. The best way to do that is put check points at the entry points like airports and sea ports. For some time, people should avoid non-urgent travel to West African countries and to the Middle East. This will minimize risk of importation.

Eventually, the mortality and morbidity will wane off like in the case of Swine Flu because the population will start developing immunity.

Are there any symptoms that distinguish an Ebola flu from a normal flu?

It starts of like a normal flu. Headaches, fever, cough. In the case of Ebola, however, the symptoms won't subside despite medication. Then within a period of two-three days, you'll begin to have joint pains. Then you may develop rashes leading to bleeding from the nose or other sides of the body. It could eventually lead to a

shock-like situation and organ-failure and ultimately death.

The best bet is to ensure prevention. If you can't prevent, isolate and quarantine so that it does not spread to others, especially to health care professionals.

Does Ebola treatment require specialised care? Is India equipped to provide the necessary care?

The treatment stays the same. It is conservative treatment. Isolate the patient, maintain blood parameters, maintain blood pressure and so on. So Internal Medicine specialists will be equipped to provide care to the patient. The problems arise when complications set in. And for that, what is necessary is an ICU set-up.

The first and foremost requirement is to isolate the patient. And what is needed are designated wards. You can't keep an Ebola patient in a normal ICU ward because the chance of spread of infection is so high.

So you need to have a designated nodal officer, a nodal ward, where

every suspected case is tracked and tested. Till such time as test results come

out, the patient has to be isolated and quarantined.

At present, the government has created a nodal centre at Trivandrum, where any patient who has Ebola-like symptoms can be tested. The hospital has set up wards to quarantine such patients.

We also have the National Centre for Disease Control and National Institute of

Virology. So we are equipped.

It is just that half-baked knowledge creates panic. If people are educated well and they are taught about preventive care, it can be contained.

Should India also make arrangements to procure the experimental drug thatWHO has approved for use to combat the Ebola outbreak?

So far there has not been any confirmed case of Ebola in India. It is my personal view that if we put our maximum resources on the preventive aspect of disease we will be alright.

I think the resources and manpower should be more towards the preventive aspect. Let's make sure that the infection does not come into India. I think that will be a better investment.

Given India's size and the number of people travelling to and from Ebola- affected countries, what do you think will be the key challenge for the government and health professionals in keeping Ebola out?

I think the biggest challenge will be tracking the movement of people.

So far the virus has been seen in three Africa countries. We are also hearing of cases in the Middle East. I think it is important to educate travellers.

The biggest intervention is when you make people aware of their own health needs. In India, a lot of people don't know what Ebola is. So we need to educate travellers and issue directives to avoid Ebola-affected countries. And if you have to travel, use personal protective measures like wearing gloves and masks.

ConClusionWHO is supporting the national authorities in the response to an outbreak of Ebola virus disease (EVD; formerly known as Ebola Haemorrhagic fever). The outbreak is now confirmed to be caused by a strain of Ebola virus with very close homology (98%) to the Zaire Ebola virus. This is the first time the disease has been detected in West Africa, though it has not been detected in India.

The current outbreak is sure to subside, though unfortunately only after consuming many lives. At the same time, it is bound to reappear somewhere, sometime, and mostly for man-made reasons. Unfortunately,it might happen before long. Would the world have learnt from the presentdeadly out-break? If and when Ebola strikes again, would it be able to deal with it better? Hopefully during the lull, scientists, researchers, and the industry would treat Ebola as a common enemy that must be defended with modern medicine and better health-care infrastructure. Modernization and development should not become the key reasons for viruses to take centre stage.

BiBliographyInternet :

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h tt p :// w w w . c d c . g o v / v h f / e bo l a / s y m p t o m s/

h tt p :// h ea v y . c o m / h ea lt h / 2 0 14 / 04 / e bo l a - o u t b r eak -

2 0 14 - f a c t s - i n f o r m a ti o n - d ea t h s/

h tt p :// w w w . w ho .i n t/ c sr / d i s ea s e / e bo l a / e n /

h tt p:// en . wi ki p ed i a. o rg/ wi ki/E bo la vi ru s d i sease

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