EMERGING AND RE-EMERGING
INFECTIOUS DISEASES
PPt Notes
Introduction
•Emerging infectious diseases are commonly defined as
those that have newly appeared in a population or
those that have existed in the past, but whose
incidence in humans has increased within the past 2
decades or threaten to increase in the near future.
•Emergency may be due to the spread of a new agent,
recognition of an infection that has been present in the
population but has gone undetected, or the realization
that an established disease has an infectious origin.
• Re-emerging may also occur because of breakdown in
public health measures for previously controlled
infection.
Cont. Introduction
•There are two groups of new and emerging
infectious diseases that pose a public health
threat in SSA:
•Viral Haemorrhagic Fevers (VHF )
•Severe acute respiratory illness
RIFT VALLEY FEVER
•Is a viral disease that can cause mild to severe
symptoms. The mild symptoms may include:
fever, muscle pains, and headaches which
often last for up to a week.
Cause
Virology
•The virus belongs to the Bunyavirus family. This
is a family of enveloped negative single
stranded RNA viruses. All Bunyaviruses have an
outer lipid envelope with two glycoproteins—
G (N) and G(C)—required for cell entry. They
deliver their genome into the host-cell
cytoplasm by fusing their envelope with an
endosomal membrane
Transmission
•The virus is transmitted through mosquito vectors, as well as
through contact with the tissue of infected animals.
•Two species—Culex tritaeniorhynchus and Aedes vexans—
are known to transmit the virus.
• Other potential vectors include Aedes caspius, Culex
pipiens, Culex antennatus, Culex perexiguus, Culex
zombaensis and Culex quinquefasciatus.
• Contact with infected tissue is considered to be the main
source of human infections.
• The virus has been isolated from two bat species: the
Peter's epauletted fruit bat (Micropteropus pusillus) and the
aba roundleaf bat (Hipposideros abae), which are believed
to be reservoirs for the virus.
Epidemiology
•The disease was first reported among livestock
in Rift Valley of Kenya in the early 1900s and
the virus was first isolated in 1931.
•Kenya had an outbreak in 1997/98
•Somalia/Tanzania also had an outbreak in
2000
•It was first been reported outside Africa in
Saudi Arabia and Yemen (WHO, 2010)
Outbreaks that have occurred since 2000
•Severe form of RVF in humans
•2018 June, Republic of Kenya: In Wajir county where it claimed
the first casualties who died of internal and external bleeding.
•2016, Republic of Niger: Ministry of Health reported 105
suspected cases including 28 deaths of RVF in humans in
Tahoua region.
•2012 Republic of Mauritania: The Ministry of Health in
Mauritania declared an outbreak of RVF where a total of 36
cases, including 18 deaths were reported from 6 regions.
•2010, Republic of South Africa: From February to July 2010, the
Government of South Africa reported 237 confirmed cases of
RVF in humans, including 26 deaths from 9 provinces.
•2008–2009, Madagascar: The Ministry of Health, Madagascar
reported 236 suspected cases including 7 deaths.
Outbreaks that have occurred since 2000
•2008, Madagascar: The Ministry of Health, Madagascar reported an
outbreak of RVF and a total of 476 suspected cases of RVF including 19
deaths were reported from 4 provinces.
•2007, Sudan: The Federal Ministry of Health, Sudan, reported an
outbreak of RVF. A total of 738 cases, including 230 deaths, were
reported in Sudan between November 2007 and January 2008.
•2006, Kenya, Somalia and Tanzania: A total of 684 cases including 234
deaths from RVF was reported in Kenya. Another total of 114 cases
including 51 deaths was reported in Somalia. Later, a total of 264 cases
including 109 deaths was reported in Tanzania.
•2003, Egypt: In 2003 there were 148 cases including 27 deaths of RVF
reported by the Ministry of Health of Egypt.
•2000, Saudi Arabia and Yemen: There were 516 cases with 87 deaths
of RVF reported by the Ministry of Health of Saudi Arabia. In 2000, the
Ministry of Public Health in Yemen reported 1087 suspected cases,
including 121 deaths.
Clinical features
•In humans, the virus can cause several syndromes namely:
• Usually, sufferers have either no symptom
•A mild illness with fever, headache, muscle pains, and liver
abnormalities
• In a small percentage of cases (< 2%), the illness can progress to
hemorrhagic fever syndrome, meningoencephalitis, or it may
affect the eye.
• Patients who become ill usually experience the following;
•Fever,
• Generalised weakness,
• Back pain,
• Dizziness,
• Weight loss at the onset of the illness.
Cont. Clinical features
• Typically, people recover within two to seven days after onset and
about 1% of people with the disease die of it.
• In livestock, the fatality level is significantly higher.
•Pregnant livestock infected with RVF abort virtually 100% of
foetuses.
•An animal disease epidemic of RVF is usually first indicated by a
wave of unexplained abortions.
•The severe symptoms may include:
•Loss of the ability to see beginning three weeks after the infection,
•Infections of the brain causes severe headaches and confusion,
•Bleeding together with liver problems which may occur within the
first few days,
• Those who have bleeding may lead to death in as high as 50%.
Etiology/Spread
•The disease is caused by the RVF virus, which is of the
Phlebovirus type.
• It is spread by either touching infected animal blood,
breathing in the air around an infected animal being
butchered, drinking raw milk from an infected animal,
or the bite of infected mosquitoes.
• Animals such as cows, sheep, goats, and camels may
be affected.
• In these animals it is spread mostly by mosquitoes. It
does not appear that one person can infect another
person.
Diagnosis
•Diagnosis relies on viral isolation
from tissues and blood,
•Serological testing with an ELISA
Prevention
•Prevention of the disease in humans is by
vaccinating animals against the disease.
• This must be done before an outbreak occurs
as if it is done during an outbreak it may
worsen the situation.
• Stopping the movement of animals during an
outbreak may also be useful.
• Decreasing mosquito numbers and avoiding
their bites.
Cont. Prevention
• Once infected, there is no specific treatment.
•Outbreaks of the disease have only occurred
in Africa and Arabia.
•Outbreaks usually occur during periods of
increased rain which increase the number of
mosquitoes.
•There is a human inactivated vaccine;
however, as of 2018 it was licensed and not
Commercially available (WHO).
Treatment
•Most human cases of RVF are relatively mild, of
short duration and self limiting.
• For the more severe cases, supportive treatment
should be offered. This may include:-
•Analgesics
•Antimicrobials against possible bacterial infections
•Fluids and electrolytes therapy
•Oxygen
•ICU care in case of severe cases
•Anticonvulsants may be required in patients with
CNS manifestation
YELLOW FEVER
PPt Notes
Introduction
•Yellow fever, known historically as yellow jack, yellow
plague, or bronze john, is an acute viral disease.
• In most cases, symptoms include fever, chills,
anorexia, nausea, muscle pains particularly in the back,
and headaches.
•Symptoms typically improve within five days.
• In some people within a day of improving, the fever
comes back, abdominal pain occurs, and liver damage
begins causing yellow skin. If this occurs, the risk of
bleeding and renal disorders is also increased.
Etiology
•The disease is caused by the yellow fever virus and is
spread by the bite of the female mosquito.
• It infects only humans, other primates, and several species
of mosquitoes.
•In cities, it is spread primarily by mosquitoes of the Aedes
aegypti species.
• The virus is an RNA virus of the genus Flavivirus.
• The disease may be difficult to tell apart from other
illnesses, especially in the early stages.
• To confirm a suspected case, blood sample testing with
polymerase chain reaction is required.
Epidemiology
Yellow fever causes 200,000 infections and 30,000
deaths every year, with nearly 90% of these occurring
in Africa.
Nearly a billion people live in an area of the world
where the disease is common.
It is common in tropical areas of South America and
Africa, but not in Asia.
Since the 1980s, the number of cases of yellow fever
has been increasing.
This is believed to be due to fewer people being
immune, more people living in cities, people moving
frequently, and changing climate.
Cont…Epidemiology
The disease originated in Africa, where it
spread to South America through the slave
trade in the 17th century.
Since the 17th century, several major
outbreaks of the disease have occurred in the
Americas, Africa, and Europe.
In the 18th and 19th centuries, yellow fever
was seen as one of the most dangerous
infectious diseases.
The yellow fever virus was the first human
virus discovered.
Cause
•Yellow fever is caused by the yellow fever virus, a 40-
to 50-nm-wide enveloped RNA virus, the type species
and belonging to the family Flaviviridae.
•It was the first illness shown to be transmissible by
filtered human serum and transmitted by mosquitoes.
• The single-stranded RNA is around 11,000 nucleotides
long and has a single open reading frame encoding a
polyprotein.
• Host proteases cut this polyprotein into and seven
nonstructural proteins.
• Yellow fever belongs to the group of hemorrhagic
fevers.
Pathogenesis
•The viruses infect, amongst others, monocytes,
macrophages, and dendritic cells.
• They attach to the cell surface via specific receptors
and are taken up by an endosomal vesicle.
•Inside the endosome, the decreased pH induces the
fusion of the endosomal membrane with the virus
envelope.
• The capsid enters the cytosol, decays, and releases
the genome.
•Receptor binding, as well as membrane fusion, are
catalyzed by the protein E, which changes its
conformation at low pH.
Cont. Pathogenesis
•After entering the host cell, the viral genome is
replicated in the rough endoplasmic reticulum (ER)
and in the so-called vesicle packets.
• At first, an immature form of the virus particle is
produced inside the ER, whose M-protein is not yet
cleaved to its mature form and is therefore denoted
as prM (precursor M).
•The immature particles are processed in the Golgi
apparatus.
• This releases E from the complex which can now
take its place in the mature, infectious virion.
Transmission
•Yellow fever virus is mainly transmitted through the bite of the
yellow fever mosquito Aedes aegypti, but other mosquitoes such
as the tiger mosquito (Aedes albopictus) can also serve as a
vector for this virus.
•Like other Arboviruses which are transmitted by mosquitoes, the
yellow fever virus is taken up by a female mosquito when it
ingests the blood of an infected human or other primates.
•Viruses reach the stomach of the mosquito, and if the virus
concentration is high enough, the virions can infect epithelial
cells and replicate there.
•From there, they reach the haemocoel (the blood system of
mosquitoes) and from there, to the salivary glands.
•When the mosquito next sucks blood, it injects its saliva into the
wound, and the virus reaches the bloodstream of the bitten
person.
Cont. Transmission
Three epidemiologically different infectious cycles that
occur, in which the virus is transmitted from
mosquitoes to humans or other primates.
In the "urban cycle", only the yellow fever mosquito
A. aegypti is involved.
It is well adapted to urban areas and can also transmit
other diseases, including dengue fever and
chikungunya.
The urban cycle is responsible for the major
outbreaks of yellow fever that occur in Africa.
Except in an outbreak in 1999 in Bolivia, this urban
cycle no longer exists in South America.
Cont. Transmission
Besides the urban cycle, both in Africa and South America, a
sylvatic cycle (forest cycle or jungle cycle) is present, where
Aedes africanus (in Africa) or mosquitoes of the genus
Haemagogus and Sabethes (in South America) serve as vectors.
In the jungle, the mosquitoes infect mainly (non-humans)
primates; the disease is mostly asymptomatic in African
primates.
In South America, the sylvatic cycle is currently the only way
humans can infect each other, which explains the low incidence
of yellow fever cases on the continent.
People who become infected in the jungle can carry the virus to
urban areas, where A. aegypti acts as a vector.
Because of this sylvatic cycle, the yellow fever cannot be
eradicated.
Cont. Transmission
In Africa, a third infectious cycle known as
"savannah cycle" or intermediate cycle,
occurs between the jungle and urban
cycles.
Different mosquitoes of the genus Aedes
are involved.
In recent years, this has been the most
common form of transmission of yellow
fever in Africa.
YELLOW FEVER IN AFRICA
Yellow fever has in the past reported in the following countries:-
Angola in 2016
Kenya in 2016
Nigeria in 2000 and 2007
Uganda in 2011
Democratic Republic of the Congo in 2010, 2013, 2014 and 2016
Cameroon in 2009, 2010, 2012 and 2013
Ethiopia in 2013
Chad in 2013
Republic of Congo in 2012 and 2009
Ghana in 2012
Liberia in 2000 , 2001 and 2004
YELLOW FEVER IN AFRICA
Outbreaks of Yellow fever continued to occur in:-
Côte d'Ivoire in 2001, 2005, 2006, 2008, 2010 and 2011
Senegal in 2005
Burkina Faso in 2003, 2004 and 2008
Sierra Leone in 2003, 2009 and 2011
Togo in 2006 and 2007
Sudan in 2003, 2005, 2012 and 2013
Mali in 2005
Guinea in 2000, 2001, 2003, 2005, 2008, 2009 and 2010
Central African Republic in 2008 and 2009
Liberia in 2008 and 2009
Clinical features
Yellow fever begins after an incubation
period of three to six days.
Most cases only cause a mild infection
with fever, headache, chills, back pain,
fatigue, anorexia, muscle pain, nausea,
and vomiting.
In these cases, the infection lasts only
three to four days.
Cont. Clinical features
In a few cases, however, sufferers enter a
second, toxic phase of the disease with
recurring fever, this time accompanied by
jaundice due to hepatic damage, as well as
abdominal pain.
Other features include renal failure, Brain
dysfunction, including delirium, seizures and
coma.
Bradycardia
Cont. Clinical features
Bleeding in the mouth, nose, the eyes, and the
gastrointestinal tract will cause hematemesis.
The toxic phase is fatal in about 20% of cases,
making the overall fatality rate for the disease
3%.
In severe epidemics, the mortality may
exceed 50%.
Surviving the infection provides lifelong
immunity, and normally there is no permanent
organ damage.
Diagnosis
•Yellow fever is a clinical diagnosis, which often
relies on where the diseased persons are
during the incubation time.
• Mild cases of the disease can only be
confirmed virologically.
•Since mild cases of yellow fever can also
contribute significantly to regional outbreaks,
every suspected case of yellow fever is treated
seriously.
Cont. Diagnosis
•If yellow fever is suspected, the virus cannot be
confirmed until six to 10 days after the illness.
• A direct confirmation can be obtained by
reverse transcription polymerase chain reaction
•Another direct approach is the isolation of the
virus and its growth in cell culture; this can take
one to four weeks.
•Serologically, an ELISA can be used during the
acute phase of the disease.
Cont. Diagnosis
•Together with clinical symptoms, the detection
of IgM or a fourfold increase in IgG-titer is
considered sufficient indication for yellow
fever.
•Liver biopsy can verify inflammation and
necrosis of hepatocytes and detect viral
antigens.
• Because of the bleeding tendency of yellow
fever patients, a biopsy is only advisable post
mortem to confirm the cause of death.
Differential Diagnosis
•Infections with yellow fever must be
distinguished from other febrile illnesses such
as:-
• malaria
• Ebola virus
• Lassa virus
• Marburg virus
• Junin virus must be excluded as cause.
Prevention
Personal prevention of yellow fever includes vaccination, as
well as avoidance of mosquito bites in areas where yellow
fever is endemic.
Institutional measures for prevention of yellow fever include
vaccination programs and measures of controlling
mosquitoes.
Programs for distribution of mosquito nets for use in homes
are providing reductions in cases of both malaria and yellow
fever.
Vaccination
The cover of a certificate that confirms the holder has been
vaccinated against yellow fever
Yellow fever vaccine
• Vaccination is recommended for those traveling to affected
areas, because non-native people tend to suffer more
severe illness when infected.
•Protection begins by the 10th day after vaccine
administration in 95% of people, and lasts for at least 10
years.
• About 81% of people are still immune after 30 years.
•The attenuated live vaccine stem 17D was developed in
1937 by Max Theiler.
•The World Health Organization (WHO) recommends
routine vaccinations for people living in affected areas
between the ninth and 12th month after birth.
Vector control
Control of the yellow fever mosquito A.
aegypti is of major importance, especially
because the same mosquito can also transmit
dengue fever and chikungunya disease.
A. aegypti breeds preferentially in water, for
example in installations by inhabitants of areas
with precarious drinking water supply, or in
domestic waste; especially tyres, cans, and
plastic bottles.
These conditions are common in urban areas
in developing countries.
Cont. Vector Control
•Two main strategies to reduce mosquito populations
include:-
To kill the developing larvae.
To reduce the water accumulations in which the
larva develops
Larvicides are used, as well as larvae-eating fish
Pyriproxyfen is recommended as a chemical larvicide
mainly because it is safe for humans and
effective even in small doses.
Treatment
No cure is known for yellow fever.
Is dependent on supportive
measures
Acetylsalicylic acid (aspirin) should
not be given because of its
anticoagulant effect
EBOLA
•PPt Notes
Introduction
•Ebola cause an acute systemic febrile illness
associated with high mortality. It is also a
hemorrhagic fever
•The illness is characterized by the abrupt onset
of headache, myalgia, pharyngitis, rash, and
haemorrhagic manifestations.
• Person to person and nosocomial contact may
lead to secondary cases and intermittent
outbreaks of infection.
The virus
•Ebola (EHF) is an acute severe and often fatal
disease that affects both human and non
human primates (Monkeys, gorillas and
chimpanzees).
•It is caused by a unique zoonotic RNA virus of
the filovirus family.
Epidemiology
•Ebola Hemorrhagic Fever (EHF) was first
recognized in the democratic Republic of Congo
and Sudan in 1976.
•On the other hand, Marburg haemorrhagic
fever was first documented in 1967 when 31
people became ill in the German town of
Marburg.
•The outbreak was traced to infected monkeys
which were inported from an undisclosed
location in Uganda.
Ebola Outbreaks 2000-2018
Recent Ebola Outbreak in Africa
•2018 Ebola epidemic in DRC with 61 cases and 28 deaths
between April and May , 2018. There were other outbreaks from
May to July, and recently from August to Mid October 2018
(WHO, 2018).
•The 2014 Ebola epidemic is the largest in history and affected
multiple countries in West Africa.
• More than 23,200 people in Guinea, Liberia, Mali, Nigeria,
Senegal and Sierra Leone contracted Ebola since March,
according to the World Health Organization, making this the
biggest outbreak on record.
•More than 9,300 people died.
•WHO declared outbreaks in Nigeria and Senegal were over (Jan
26, 2015).
Ebola deaths in West Africa
•Figures up to 14 March 2015 were 10,159
•Deaths - probable, confirmed and suspected
(Includes one in the US and six in Mali)
•4,241 Liberia
•3,687 Sierra Leone
•2,216 Guinea
•8 Nigeria Source: WHO, 2014
Ebola Outbreak
•2014: Ebola Outbreak in Democratic Republic of the Congo
•The index case was a pregnant woman from Ikanamongo
Village who butchered a bush animal. She became ill with
symptoms of EVD, reported to a private clinic in Isaka
Village, and died on August, 2014.
•2012: Ebola Hemorrhagic Fever Outbreak in Uganda
•2012: Ebola Hemorrhagic Fever Outbreak in Democratic
Republic of the Congo (DRC)
•2012: Ebola Hemorrhagic Fever Outbreak in Uganda
•2011: Ebola Hemorrhagic Fever Case in Uganda
Cont. Ebola Outbreak
•2008: Ebola-Reston Virus Detected in Pigs in
Philippines
•2007: Ebola Hemorrhagic Fever Outbreak in
Uganda
•2007: Ebola Hemorrhagic Fever Outbreak in
Democratic Republic of the Congo (DRC)
•2004: Ebola Hemorrhagic Fever Outbreak in South
Sudan
•2003: Ebola Hemorrhagic Fever Outbreak in
Republic of the Congo
Cont. Ebola Outbreak
•2002: Ebola Hemorrhagic Fever Outbreak in
Gabon and Republic of the Congo
•2000-2001: Ebola Hemorrhagic Fever
Outbreak in Uganda
•Definition
•Ebola hemorrhagic fever is a severe, often
fatal viral hemorrhagic disease. The virus can
be transmitted by close contact with persons
symptomatic with the disease.
Transmission
•Because the natural reservoir host of Ebola viruses has not
yet been identified, the way in which the virus first appears
in a human at the start of an outbreak is unknown.
•However, scientists believe that the first patient becomes
infected through contact with an infected animal, such as a
fruit bat or primate (apes and monkeys), which is called a
spillover event.
• Person-to-person transmission follows and can lead to
large numbers of affected people.
• In some past Ebola outbreaks, primates were also affected
by Ebola and multiple spillover events occurred when
people touched or ate infected primates.
Cont. Transmission
•When an infection occurs in humans, the virus can be
spread to others through direct contact (through
broken skin or mucous membranes in, for example, the
eyes, nose, or mouth) with;
•blood or body fluids (including but not limited to urine,
saliva, sweat, feces, vomit, breast milk, and semen) of
a person who is sick with Ebola
•objects (like needles and syringes) that have been
contaminated with the virus
•infected fruit bats or primates (apes and monkeys)
Cont. Transmission
•Ebola is not spread through the air, by water, or in
general, by food.
•However, in Africa, Ebola may be spread as a result
of handling bushmeat (wild animals hunted for
food) and contact with infected bats.
• There is no evidence that mosquitoes or other
insects can transmit Ebola virus.
•Only a few species of mammals (e.g., humans, bats,
monkeys, and apes) have shown the ability to
become infected with and spread Ebola virus.
Cont. Transmission
•Healthcare providers caring for Ebola patients and
family and friends in close contact with Ebola
patients are at the highest risk of getting sick
because they may come in contact with infected
blood or body fluids.
•During outbreaks of Ebola, the disease can spread
quickly within healthcare settings (such as a clinic or
hospital).
•Exposure to Ebola can occur in healthcare settings
where hospital staff is not wearing appropriate
personal protective equipment.
Cont. Transmission
•Medical equipment especialy disposable,
equipment should be used by healthcare personnel
providing patient care.
• Proper cleaning and disposal of instruments, such
as needles and syringes, also are important.
• If instruments are not disposable, they must be
sterilized before being used again.
• Without adequate sterilization of instruments,
virus transmission can continue and amplify an
outbreak.
Cont. Transmission
•It is known scientifically that the Ebola virus can
stay in semen and in vaginal fluids even after
recovery.
• Scientists continue to study whether and for
how long Ebola can be spread through sex.
• Until more is known, Ebola survivors should not
have sex for at least three months after
recovery.
• If abstinence is not possible, a condom should
be used every time.
Risk of Exposure
•Ebola viruses are found in several African
countries.
•Ebola was first discovered in 1976 near the
Ebola River in what is now the Democratic
Republic of the Congo.
•Since then, outbreaks of Ebola among humans
have appeared sporadically in Africa.
Risk
Healthcare providers caring for Ebola patients and family
and friends in close contact with Ebola patients are at the
highest risk of getting sick because they may come in
contact with the blood or body fluids of sick patients.
People also can become sick with Ebola after coming in
contact with infected wildlife.
For example, in Africa, Ebola may spread as a result of
handling bushmeat (wild animals hunted for food) and
contact with infected bats.
The virus also can be spread through contact with objects
(like clothes, bedding, needles, syringes/sharps or medical
equipment) that have been contaminated with the virus.
Clinical features
Symptoms of Ebola include
Fever
Severe headache
Muscle pain
Weakness
Extreme fatigue
Diarrhea
Nausea and vomiting
Abdominal pain
Profuse watery diarrhoea
Unexplained hemorrhage from body orifices and injection sites
Cont. Clinical features
•Symptoms may appear from 2 to 21 days after
exposure to Ebola, but average is 8 to 10 days.
• Recovery from Ebola depends on good
supportive clinical care and the patient’s
immune response.
• People who recover from Ebola infection
develop antibodies that last for at least 10
years.
Diagnosis
•Diagnosing Ebola in a person who has been
infected a few days is difficult since early
symptoms, such as fever, are nonspecific to
Ebola infection and are seen in patients with
common diseases, such as malaria and
typhoid fever.
Cont. Diagnosis
•If a person has early symptoms of Ebola and
has had contact with the blood or body fluids of
a person sick with Ebola; contact with objects
that have been contaminated with the blood or
body fluids of a person sick with Ebola; or
contact with infected animals, they should be
isolated and public health professionals
notified.
•Samples from the patient can then be collected
and tested to confirm infection.
Diagnosis
•Ebola virus is detected in blood only after
onset of symptoms, most notably fever, which
accompany the rise in circulating virus within
the patient's body.
• It may take up to three days after symptoms
start for the virus to reach detectable levels.
Laboratory tests used in diagnosis include:
Next Slide..
Diagnosis: Timeline of Infection
Diagnostic tests available
Within a few days after symptoms begin;
Antigen-capture enzyme-linked immunosorbent assay
(ELISA) testing
IgM ELISA
Polymerase chain reaction (PCR)
Virus isolation
Later in disease course or after recovery;
IgM and IgG antibodies
Retrospectively in deceased patients;
Immunohistochemistry testing
PCR
Virus isolation
Treatment
No approved vaccine or drugs (e.g., antiviral drug) is available for
Ebola.
Symptoms of Ebola and complications are treated as they appear.
The following basic interventions, 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.
Treating other infections if they occur.
Experimental vaccines and treatments for Ebola are under
development, but they have not yet been fully tested for safety or
effectiveness.
Cont.. Treatment
Recovery from Ebola depends on good supportive
care and the patient’s immune response.
People who recover from Ebola infection develop
antibodies that last for at least 10 years, possibly
longer.
It is not known if people who recover are immune
for life or if they can become infected with a
different species of Ebola.
Some people who have recovered from Ebola have
developed long-term complications, such as joint
and vision problems.
Complications
These include:-
Retinitis,
Orchitis,
Hepatitis,
Transverse myelitis and uveitis.
In those who recover from Lassa fever,
complications include; deafness, miscarriages
and also renal insufficiency.
Prognosis
Fatality rate is around 90% with Ebola-Zaire
virus.
An outbreak of Ebola virus occurred in 2001
in Uganda.
The mortality rate was 36%; this lower rate
was thought to be due to better infrastructure
and more experienced care than that seen in
previous outbreaks.
Prevention
If someone travel to or is in an area affected by an Ebola outbreak, one
should make sure to do the following:
Practice careful hygiene. For example, wash 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 infected
person’s blood or body fluids (such as clothes, bedding, needles, and
medical equipment).
Avoid funeral or burial rituals that require handling the body of
someone who has died from Ebola.
Avoid contact with bats and nonhuman primates or blood, fluids, and
raw meat prepared from these animals.
Avoid facilities in where Ebola patients are being treated.
There is no approved vaccine available for Ebola but Zmapp was used in
DRC as the damage caused by Ebola out weighs the effects of the
vaccine.
Cont. Prevention
After you return, monitor your health for 21 days and seek
medical care immediately if you develop symptoms of Ebola.
Healthcare workers who may be exposed to people with
Ebola should follow these steps:
Wear appropriate personal protective equipment.
Practice proper infection control and sterilization measures.
Avoid direct, unprotected contact with the bodies of people
who have died from Ebola.
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.
OTHERS
•Zika virus and SARS will not be cover because
of time.
