Question

Discuss the pathogenesis and progression of ebola. What safety concerns were addressed during the 2014 outbreak?

Answer 1

Ebola virus was first recognized near the Ebola river valley during an outbreak in zaire in 1976.

• Ebola virus infection runs it's course within 14 - 21 days .
• Initial complaints are nonspecific flu like symptoms such as fever, music is and malaise.
• AS the infection progresses, patients exhibit severe bleeding and coagulation abnormalities, including gastrointestinal bleeding, rash and a range of hematological irregularities such as lumphopenia and neutrophils.
• Cytokines are released when reticuliendothelial cells encounter virus, which can contribute to exaggerated inflammatory responses that are not protective.
• Damage to liver , combined with massive viremia, leads to disseminated intravascular coagulopathy.
• The virus eventually infects microvascular endothelial cells and compromises vascular integrity.
• The terminal stages of Ebola virus infection usually include diffuse bleeding and hypotensive shock accounts for many Ebola virus fatalities.

Safety concerns addressed during 2014 outbreak:

1. Applying a package of interventions ie case management, surveillance and contract tracing, good laboratory services, safe burials, and social mobilization.
2. Raising awareness of risk factors for Ebola infection protective measures.
3. Reducing the risk of wildlife to human transmission from contact with infected fruits bats or monkeys and consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing.
4. Reducing the risk of human to human transmission: from direct or close contact with people with Ebola symptoms particularly with their body fluids. Regular handwashing is required after visiting patients in hospital as well as after taking care of patients at home.
5. Reducing the risk of possible sexual transmission: WHO recommends that male survivors of Ebola virus disease practise safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus.
6. Outbreak containment measures : prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 day, the importance of separating the healthy from the sick to prevent further spread and the importance of good hygiene and maintaining a clean environment.