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EbolaEbola is an acute viral infectious disease that causes hemorrhagic fever in humans and primates (monkeys, gorillas and chimpanzee), caused by the Ebolavirus, which was first described in 1976 by Dr. David Finkes, when several cases of haemorrhagic fever in Zaire and Sudan. The name of the virus is the Ebola River, geographically located in Zaire.
The Ebola virus is one of the two members of a family of virus RNA (ribonucleic acid) called Filoviridae. There are five serotypes of the virus of the Ebola: Ebola-Zaire, Ebola-Sudan, Ebola-Côte d'Ivoire and Ebola-Bundibugyo. The fifth serotype, Ebola-Reston, has caused disease in primates, but not in humans. It is an infection that is characterized by a high mortality rate, ranging between 50% and 95% of those affected. Because of its lethal nature, this virus is considered a biological weapon.
The prevalence of ebola is difficult to determine, because it usually occurs in the form of outbreaks or epidemic, however, in countries such as United States this virus infection is not endemic, although there are records of several people who work in direct contact with primates and that have acquired the infection by Ebola-Reston type; Fortunately, this type of virus has not proved pathogenetic effects in humans. Other people at potential risk include laboratory workers who work with infected animals or with the virus in tissue cultures.
Currently, it is considered that persons at risk of contracting the Ebola virus hemorrhagic fever are those with a history of travel to sub-Saharan Africa, people who care for infected patients, as well as workers who are in contact with infected African primates.
Countries like Sudan and Zaire have recorded outbreaks in 1976, with 284 cases and 151 deaths, and 318 cases 280 deaths respectively, England that same year to record a single case without deaths; in the year 1979 is produced a new another outbreak in Sudan with 34 cases and 22 deaths. Towards the 1990s cases are presented in the Philippines (3), Virginia and Texas (4), likewise during the years 1994 to 2000 Gabon recorded the greatest number of cases, with more than 350 people infected and around 280 deaths. In the year 2007 Uganda registers a new outbreak of hemorrhagic fever of Ebola with dead infected and 37 149. This same country decreed at the beginning of October, 2012 the end of the outbreak of the hemorrhagic fever of Ebola that has claimed the lives of 17 people, according to who data. In March 2014, there has been the last outbreak in Guinea Conakry, where the number of affected people exceeds the hundred and seems to extend by Liberia, Sierra Leone and Mali.
How is the Ebola virus transmitted?The Ebola virus is regarded as extremely ineffective, due to its high mortality rate, the speed with which causes death and remote areas where infections occur. It is transmitted to humans through contact with an infected host animal and spreads from person to person by contact with blood and body fluids of the infected subject, and contact with medical equipment contaminated, such as needles.
Ebola virus infections are acute, and there is no 'carrier' status. Since the natural reservoir of the virus is unknown, the way in which the virus first appears in a human at the start of an outbreak has not been determined yet.
Nosocomial transmission refers to the spread of disease within a hospital, this type of transmission occurs frequently during outbreaks of the Ebola virus. In the health centres in Africa most patients are seen without mask, gowns or gloves. In addition, when needles or syringes that are used may not be replaceable, if they are contaminated with the virus and then become to use, many people can be infected.
Symptoms of Ebola virus infectionThe incubation period of this disease varies between two and 21 days, after which happens the onset of symptoms of ebola:
- High fever.
- Discomfort in the joints and muscle aches.
- Sore throat and general weakness.
- Diarrhea, vomiting and stomach pain.
- Appearance of a reddish rash on the skin.
- Conjunctival congestion (red eyes).
- In some affected you can see internal and external bleeding.
Diagnosis of infection with Ebola virusThe patient's symptoms and a thorough interrogation that includes questions about recent travel to endemic areas of Ebola, malaria and influenza virus are of vital importance to elucidate the diagnosis of infection with the Ebola virus.
There are specific laboratory tests that can detect the presence of the Ebola virus in blood or serum, especially in the acute phase, such as the determination of the RNA genome or subgenómico; However, the most common technique to determine infection by this virus is the antibodies IgM and IgG detection by capture or sandwich ELISA method, this technique is an immunological test which is based on the capture of antibodies present in the serum of the patient when they react with a protein from the virus attached to a well of a rectangular plate of polystyrenea special type of plastic
Other laboratory tests such as blood count can provide data suggestive of infection, such as white blood cells that tend to be decreased (leukopenia). Likewise, you can see elevation of the figure of hematocrit, which is an indirect measure of the State of dehydration of the patient and platelets involved in coagulation, which are decreased (what is known as thrombocytopenia). More than half of the affected patients develop some degree of bleeding.
Ebola treatmentCurrently there is no medication to combat the Ebola virus, so it only can be symptomatic treatment measures of support. Among them are: fever, administer acetaminophen, never take aspirin (acetylsalicylic acid) because of the risk that there is in haemorrhagic manifestations; It should also drink lots of fluids to prevent dehydration and keep bed rest.
If the patient has hemorrhagic manifestations Administration will require intravenous fluids, as well as concentrate of platelets, blood transfusions or clotting factors if there are major losses.
Similarly, in the treatment of ebola, it is necessary to keep strict track of vitals such as heart rate, pulse, and blood pressure to determine any signs indicative of shock.
Prognosis of EbolaThe prognosis of Ebola virus hemorrhagic fever is bad enough, as it is considered a life-threatening disease. The period of time between the onset of symptoms until death ranges between 2 and 21 days. It is estimated that mortality due to failure of multiple organs and subsequent hypovolemic shock goes from 50 to 90%, vary depending on the type of Ebola virus that causes the infection.
Prevention of infection with Ebola virusAccording to the recommendations of the World Health Organization (who) the control and prevention of the Ebola virus is based on three fundamental pillars:
- Control of the infection in animals: there are currently no vaccines aimed at preventing infection with the Ebola-Reston virus in animals, so that chemical disinfection methods using sodium hypochlorite and other detergents on a regular basis in the farms of animals such as monkeys and pigs should be applied. Any outbreak of suspected animals should be quarantined or could even sacrifice himself to prevent transmission to humans.
- Reduce the risk of human infection: in the absence of a vaccine for humans nor a specific treatment against infection with the Ebola virus the education of the population at risk is a fundamental weapon. Awareness-raising campaigns on different risk factors and measures of protection against them must be implemented. In certain African countries, upon the occurrence of an outbreak of ebola mechanisms of information and dissemination of messages are activated to reduce the risks of transmission, which should focus on the following aspects:
- Reduce contact with wild animals that may be infected as apes, monkeys and some types of bats. Avoid consumption of raw meat.
- Use of gloves and protective clothing to handle animals.
- Wear gloves, masks and special robes to decrease the risk of transmission from person to person as a result of close contact with people infected, particularly with their body fluids.
- Wash your hands frequently, especially after visiting sick relatives in the hospital, as well as after caring for patients at home.
- Disseminate messages of information to the population about the characteristics of the disease and measures of control of the outbreak, including the burial of corpses.
- Prevent infection in health centers: this refers to the use of measures of isolation and use of necessary equipment (gloves, masks, gowns) to reduce the risk of transmission from patients to health workers, doctors, nurses, as well as lab technicians who handle blood and other body fluids of patients infected with the virus.