Ebola Virus Disease
Ebola virus
disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often
fatal illness in humans.EVD outbreaks have a case fatality rate of up to
90%.EVD outbreaks occur primarily in remote villages in Central and West
Africa, near tropical rainforests. The virus is transmitted to people from wild
animals and spreads in the human population through human-to-human
transmission. Fruit bats of the Pteropodidae family are
considered to be the natural host of the Ebola virus.
Ebola first
appeared in 1976 in two simultaneous outbreaks, in Nzara, Sudan, and in
Yambuku, Democratic Republic of Congo. The latter was in a village situated
near the Ebola River, from which the disease takes its name.
Although non-human primates have been a source of infection for humans, they
are not thought to be the reservoir but rather an accidental host like human
beings.
Transmission
Ebola is
introduced into the human population through close contact with the blood,
secretions, organs or other bodily fluids of infected animals. In Africa,
infection has been noticed among those handling infected chimpanzees, gorillas,
fruit bats, monkeys, forest antelope found ill or dead or in the rainforest.
Ebola then spreads in the community through human-to-human transmission, with
infection resulting from direct contact (through broken skin or mucous
membranes) with the blood, secretions, organs or other bodily fluids of
infected people, and indirect contact with environments contaminated with such
fluids. Men who have recovered from the disease can still transmit the virus
through their semen for up to 7 weeks after recovery from illness.
Health-care workers have frequently been infected
while treating patients with suspected or confirmed EVD when infection control
precautions are not strictly practiced.
Signs and symptoms
EVD is a
severe acute viral illness often characterized by the sudden onset of fever,
intense weakness, muscle pain, headache and sore throat. This is followed by
vomiting, diarrhoea, rash, impaired kidney and liver function, and in some
cases, both internal and external bleeding. The incubation period, that is, the
time interval from infection with the virus to onset of symptoms, is 2 to 21
days.
Diagnosis
Before a
patient is diagnosed as infected with EVD, one should rule out malaria, typhoid
fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, meningitis,
hepatitis and other viral hemorrhagic fevers like dengue, yellow fever and
kyasanur forest disease etc.
Vaccine and treatment
There is no specific treatment nor is any licensed
vaccine for EVD available. Several vaccines are being tested, but none are
available for clinical use. Severely ill patients require intensive supportive
care. Patients are frequently dehydrated and require oral rehydration with
solutions containing electrolytes or intravenous fluids.
Prevention and control
No animal vaccine against this is available.
Routine cleaning and disinfection of pig or monkey farms (with sodium
hypochlorite or other detergents) should be effective in inactivating the
virus.
If an outbreak is suspected, the premises should be
quarantined immediately. Culling of infected animals, with close supervision of
burial or incineration of carcasses, may be necessary to reduce the risk of
animal-to-human transmission. Restricting or banning the movement of animals
from infected farms to other areas can reduce the spread of the disease.
As this viral outbreak in pigs and monkeys have
preceded human infections, the establishment of an active animal health
surveillance system to detect new cases is essential in providing early warning
for veterinary and human public health authorities.
In the absence of effective treatment and a human
vaccine, raising awareness of the risk factors for Ebola infection and the
protective measures individuals can take is the only way to reduce human
infection and death.
India and EBOLA
There is a risk the deadly virus could be imported
into the country if the large population of Indians working in the four
affected West African nations returns. There are nearly 45,000 Indian nationals living and working in
Guinea, Liberia, Sierra Leone and Nigeria - where an outbreak of the disease
has killed 932 people. While the risk of Ebola virus cases in India is low,
preparedness measures are in place to deal with any case of the virus imported
to India. Government has advised against all non-essential travel to the four
countries, and authorities will screen travelers who originate from or transit
through affected nations, and track them after their arrival in India.
The government will also set up facilities at airports and ports to manage travelers showing symptoms of the disease. State authorities have been instructed to designate hospitals with isolation wards for response to possible cases and to stock personal protective equipment.
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