EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15

Ebola
Infectious
Disease Fact
Sheet
12/10/15
http://www.popsci.com/sites/popsci.com/files/styles/medium_1x_/pu
blic/ebola_virus_on_a_green_monkey_cell.jpg?itok=MiH7btVq

“At this time the odds of getting Ebola in the U.S. are close to nil…the understanding of Ebola
and how its transmitted is REALLY low, we have to expect that one day there will be another By Jenny Butler
epidemic that has the capacity to enter our borders, and if we don’t know how it is transmitted,
we can’t protect ourselves properly.” For Clinical Microbiology
– Brandon Brown Section 2
Date published
12/8/15

carrying the virus, they spread the there are exposed mucous
What is Ebola virus to primates and jungle membranes or a weakness in the
Ebola is a viral infection also animals such as antelope and skin. It is important to note that
commonly known as Ebola porcupine.1,2,3,4 Coming in contact dirty needle exposure and other
hemorrhagic fever. More with body fluids of infected fomite transmission is another
specifically, Ebolavirus is an animals, their excrement, or way of contracting the virus.4
enveloped, single stranded RNA infected humans in the same
ways, will likely lead to an Although Ebola can be lethal, it is
virus, which among many other
Ebolavirus infection, especially if not nearly as contagious as other
transcriptional codons, carries the
codes for seven structural
proteins and two secreted soluble
proteins.1,3 These few sequences
not only help the virus to remain
hidden from the host cells, but
also carry the deadly protein
portion of the structure. 1

Virus Spread
The Ebolavirus lives in bats and
spread through droplet
transmission. Bats are considered
to be both a vector and reservoir
for the virus.2, 4 Although bats do
not appear to show any http://blog.thomsonreuters.com/index.php/how-contagious-is-ebola-graphic-of-the-day/
symptoms or problems related to
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
infectious diseases (see the chart
above).
Once the virus has penetrated the
host’s defenses, it attaches to the
host cells via a glycoprotein and is
then
phagocytized
leading to the
subsequent
translation,
transcription
and spread of
the virus.1,3
The
Ebolavirus’
main target
seems to be
monocyte,
macrophage
and dendritic http://www.who.int/csr/disease/ebola/global_ebolaoutbreakrisk_20140818-1.png?ua=1
cells which are
used in both innate and adaptive
immune responses. Neither
leukocytes nor NK cells are
affected directly by the virus, but
do spontaneously undergo
apoptosis as part of the disease
process.3
Signs and Symptoms
If infected with the Ebolavirus,
the host will have roughly 2-21
days before beginning
symptoms will appear. 1,2,3,4
Symptoms include fever,
weakness, vomiting, diarrhea,
headache and sore throat.
Because of the nonspecific
primary symptoms treatment
can often be delayed.2 The
infected individual does not
realize they have Ebola until
they have contaminated other
well-meaning individuals.
After symptoms have appeared
they progress in severity to
include organ necrosis, most
notably the liver, swelling of the
brain and kidneys as well as
reduced clotting factor which is
evidenced in bruising and
appearance of blood in the feces
and urine.1,2,3
Mortality and Risk factors
Unfortunately, Ebolavirus has a
40%-90% mortality rate
depending on the strain. From
onset of initial symptoms, the
patient has anywhere from 6-16
days before death. 1,2,3,4 It affects
https://thoughtfullyprepping.files.wordpress.com/2014/10/wh 612, localized to the South Sudan
oebolasuit1.png
2
both young and old, though there
is a significant advantage for
people who have adequate
nutrition and access to clean food
and water supplies. 3,4 The
poorest countries in
Western Africa are some
at greatest risk of death
and spread of the disease
because of way of life,
living conditions,
traditions, lack of
education and lack of
access to adequate
medical care.
In the map, the purple
dotted line represents the
migratory patterns of the
fruit bats known to harbor
the Ebolavirus. Notice
that the outbreaks (in
dark orange and peach) are found
in Africa, right near these
migratory patterns.
Local Epidemiology
In 2014, there were few cases of
1, 3
Ebola in the United States and
none in Utah. The cases in the
U.S. were from people who
contracted the virus in Africa,
then flew here. 1
There were two exceptions,
nurses who unknowingly cared
for an Ebola patient without
wearing appropriate protective
clothing.
Ebolavirus Numbers
and Trends
When Ebolavirus was first
identified during a 1976 outbreak,
scientists documented the
incidence of the disease to be
and The Democratic Republic of
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
Congo regions.1 Since 1976
Ebolavirus has been shown to be
endemic in Africa. Every few
years there is a brief and small
epidemic of Ebola infections in
localized regions, not reaching an
incidence
over 425
cases which
occurred
during the
year 2000 in
Uganda. In
the first 20
years from
1976-1996 the
prevalence of
Ebolavirus
was 924, and
more recently http://www.broadsheet.ie/2014/10/01/a-limerick-a-day-485/
from 1997-2014 the
prevalence was 2250, showing
about a 41% increase in
prevalence over the initial 20 year
recorded cases.1
Recent numbers of cases from
the 2014 Ebola outbreak estimate
the incidence of infected
individuals at around 1009 yet the
most glaring difference between
previous outbreaks and the 2014
outbreak is that (in addition to
the number of infected
individuals) the outbreak was not
isolated to just one or two specific
locations, it affected other
regions throughout Western
Africa including Guinea, Sierra
Leone, Liberia, Nigeria and
others.1, 2
Diagnostic procedures
Initial diagnosis of Ebola is
difficult. The beginning
prodromal symptoms are not
definitive enough to warrant
further testing.2,4 However,
because of the mortality of the
disease, the necessity for quick
and accurate testing is
paramount.2,3 This need for quick
testing is one of the biggest
challenges faced in Africa today.
Accurate, timely tests which are
sensitive and require specialized
equipment are simply not
available in the field abs.4 Lab
tests like Polymerase Chain
reaction test, which use blood
samples to detect viral nucleic
acids, and the Antigen ELISA
(Enzyme-linked immunosorbent
assay) test, which also uses blood
but detects a viral antigen, are
accurate and quick. However
both require specialized
equipment and conditions. The
standard ELISA test, which uses
blood samples to detect virus
antibodies, is accurate, but
slower.2 Other lab tests like
Immuno-blot (western blot) and
Indirect immunofluorescence
assay (IFA) which both use blood
samples to detect the presence of
virus-specific antibodies, are
quick and require little
equipment, but results are often
up to interpretation which can be
3
difficult at times which can lead
to error and misdiagnosis.2
Diagnosis
When Ebola is suspected, the
time to make a
conclusive diagnosis
using proper laboratory
techniques can range
from 6 hours to 3 days,
delaying interventions
and increasing the
patient’s risk of
succumbing to the virus.
2,4The need for quick
diagnostics is critical
because once infected,
the virus multiplies very
rapidly and in many
cases, the body simply
does not have enough time to
develop the antibodies to fight
the infection before death
occurs.4
Disease Treatment
Viruses in general are notoriously
difficult to treat. No antiviral
medications have yet been
developed for the specific use on
Ebola patients. Some
anticoagulant administration has
been effective in laboratory
animals, which slows the progress
of the disease, but does not treat
it directly. A combination of many
drugs may be necessary to fully
treat the virus. 2, 3
Development of a vaccine for
Ebolavirus has come a long way,
and has shown progress in
laboratory animals, however,
there is not an approved vaccine
against Ebola.2
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
Since there is not yet a cure or
Disease Prevention
vaccine for Ebolavirus, much of
the ability to survive the disease is
dependent on access to adequate
medical care, including
rehydration and the use of IV
fluids, comfort care. 4
The greatest chance at survival is
not contracting the virus.
Educating the populations most
at risk about how the virus is
transmitted specifically the best
ways of cleaning and using bush
meat, clean drinking water,
proper hand washing and
sanitizing procedures. Also
addressing the cultural burial
practices of certain African tribes
will go a long way in stopping the
spread of the Ebolavirus. 4
Survival
Chance of recurrence of the
disease in a person who has
already been infected is not well
known, but studies on animals
have shown that system
immunity can be developed.2
Surviving the disease has much to
do with the incubation period of
the virus in an individual. 4
Survivor’s blood work
consistently shows elevated IgM
and IgG levels, where deceased
individuals show little IgM and no
beneficial IgG levels. Also, those
who succumbed to the virus show
significantly lower levels of T-
cells.3
It is not yet clear if the immunity
is long-term or temporary and if
the antibodies produced protect
against all strains of the virus. For
http://news.sciencemag.org/africa/2014/08/who-reports-ebola-deaths-drc
obvious reasons, this hasn’t been
tested in humans.2
If you are one of the lucky ones,
and survive, problems such as
deafness, joint pain,
inflammation of the testicles and
pericarditis may linger.2, 4 Also,
just because your major
symptoms have disappeared does
not mean the virus is completely
gone. The specific Ebolavirus RNA
sequence has been isolated in
survivors up to 101 days after
development of initial
symptoms.4
Implications for
healthcare
In order to treat and prevent
Ebola, in addition to faster
diagnostics and access to medical
care, healthcare workers must
use proper antisepsis techniques
such as running water and soap as
well as an alcohol based solution.
Also imperative is the use of PPE
(personal protective equipment)
which will provide protection
4
from and diminish virus
transmission. Until a vaccine or
cure is found, the solution to
ongoing epidemics and the
possibility of a pandemic is
prevention, education and
disinfection.
1. Chowell, Nishiura. 2014. Transmission
dymanmics and control of Ebola virus
Disease (EVD): a review. BMC Medicine
12:196
2. Clercq. 2014. Ebola virus (EBOV) infection:
Therapeutic strategies. Biochemical
Pharmacology. V 93, issue 1, p 1-10.
3. Falzarano, Feldmann, Groseth, Hoenen.
2006. Ebola virus: unravelling pathogenesis
to comba a deadly disease. Trends in
Molecular Medicine, V 12, Issue 5, p 206-215.
4. Jayant, Kaushik, Nair, Tiwari. 2015.
Towards detection and diagnosis of Ebola
virus disease at point of care. Biosensors and
Bioelectronics. V75, 15 Jan 2016, p 254-272.
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 | 5

Using styles helps save you time and keep

your document consistent. To modify a style,

Using Styles
on the Home tab, in the Styles group, right-
click the name of the style you want to edit
and then click Modify. All content where the
by Name Style style is applied will update automatically.

Another way to modify a style is to simply

The body text throughout the articles in this
template uses the Normal paragraph style.
Following are some other styles applied
throughout the template:
customize an instance of the style where it’s
applied in the document. Then, on the Home
tab, in the Styles group, right-click the style
name and then click Update [style] to Match
Selection.

 Large article titles, such as on the first HEADING 4 STYLE

page, use Heading 1 style.
 Orange headings in the sidebars and Use the small tables provided in some of the
within articles use Sidebar Heading articles to call out quick reference
style. information related to the article, such as
contact information or event dates.
 Orange section titles in articles use the
Heading 2 style. HEADING 5
Contact Info
 Small article titles use Heading 3 style.
 This style is List Bullet 2.
This style is List Continue.
 Text in sidebars uses the Sidebar Text
style.
 White headings on orange text in tables
uses the Heading 4 style.
 The heading inside contact information
tables uses Heading 5 style.
 Contact Info is the name of the gray
text style inside the small contact
tables.
Access all styles used in this template on the
Home tab, in the Styles group.
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15
This picture caption uses the Caption 2
paragraph style and is inside a text box
so that you can move it easily as
needed to accompany a photo.
To setup a document for multiple column
text, on the Page Layout tab, in the Page
Setup group, click Columns and then click
the number of columns you need. You can
also click More Columns to specify column
widths, the space between columns, or to
automatically add a vertical line between
columns.
To change the number of columns for just
part of the document (or if you want text to
wrap to just the top part of the page and a
new article to start below – as shown on this
page), insert a section break before the
position where you want to start the new
column layout. To do this, on the Page
Layout tab, in the Page Setup group, click
Breaks and then click the type of section
break you need.
Select a section break
When changing many types of page layout
formatting for just part of the document—
such as paper size, margins, or orientation,
the best section break type to use is a Next
Page section break because it automatically
starts the new section on a new page.
However, when changing the number of
columns as you might in this newsletter, you
may prefer to select a Continuous break. The
continuous section break (used a few times
throughout this template) starts a new
section immediately after the preceding one.
So, for example, you can have a three-
column article followed by a four-column
article, on the same page.
Working with Columns
by [Article Author]
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 | 7

HEADING 4 This placeholder article provides the

42%
following tips: Caption 2 style is used to add
picture captions. Captions are in
 Creating “thermometer charts”
text boxes for easy using
placement
relative
tables, as shown attoleft.
images.
Cras ut blandit diam. Suspendis quis urna semper
aliquam.  Setting up multipage articles.
 Wrapping text around images
FOR MORE INFORMATION  Adding article titles and bylines

Abico eum, ille et, conventio obruo duis
ullamcorper ut, neo demoveo. Vel reprobo:
HEADING 5
Contact Info
Creating the sidebar
thermometer charts
When you work in Word 2010 (or PowerPoint
2010), you have the full power of Excel 2010

Formatting Tips
by [Article Author]

charts (provided that Excel is installed on

your computer). Insert a chart in Word from
the Insert tab, in the Illustrations group.
Charts are easy to create and use and
automatically coordinate with your active
document theme.

However, notice in the sidebar at left that the

“thermometer charts” were created using
single-row Word tables. This is because they
automatically fit the tight space without
Sidebar Setup having to remove any chart elements. And
The sidebars in this template use simple, single-row you might be surprised to learn that it’s easy
tables for the gray-shaded headings and thermometer to make them essentially mathematically
charts shown below for easy alignment. accurate.

To use a table as a thermometer chart, do

the following:

1. On the Insert tab, in the

Tables group, click Table
and then drag across the
grid to select the first
two cells in the
first row. Click to
insert a two-cell,
one-row table.
2. Click in the table and
Add Sidebar Content then, on the Table
Adding content into a column to create a sidebar is no
different from adding text. As noted earlier in this Tools Layout
template, apply the styles provided for headings, tab, in the
sidebar text, and even pictures to align them quickly and Table group,
easily. click Properties.
3. On the Columns tab of
FAST FACTS the Table Properties dialog box, change
the Measure In setting to Percentage.
You can then set the percentage to up

68%
to one decimal point in accuracy.

Setting up multipage articles

Word is designed to allow text to
Learn about these “thermometer charts” in the article at automatically flow from one page to the
right.
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
next. So, when you want an article to
continue on the next page, just keep typing.
In the case of this placeholder article, it is
separated into two placeholder content
controls (one on this page and another that
starts at the top of the following page) just so
that you can still see the layout of the
following page while you begin adding your
own text on this page. As mentioned on the
first page of this template, remember that it
might look like the layout is skewed when
you replace a long piece of placeholder text
by starting to type your own, but it is not. As
you add your content, the layout that follows
will move down automatically and back into
position.
To remove the second placeholder control
that starts immediately following this one,
just select it and then press any key. You can
then continue typing from this page and your
text will automatically flow onto the next.
Wrap text around images
The photos in this article that are angled with
white borders are “floating” images. That is,
they are setup for text to wrap around
them—which is why they can span multiple
columns in a three-column section.
Additionally, as mentioned earlier, the photo
of the young woman in the body of this
article is set to wrap text so that text will flow
around the image as you add your own text.
To select text wrap settings, start by
selecting the image and then do the
following:
Notice the image of the young woman that’s
within a text column on the preceding page.
The background has been removed from that
image to allow text to wrap directly around
the subject.
Office 2010 introduced several new and
improved picture formatting tools in Word,
PowerPoint, and Excel. Among those is the
8
1. On the Picture Tools Format tab, in the because text can wrap around a text box just
Arrange group, click Wrap Text and then like it can around a picture. Similarly, the
select either Square, Tight, or Top and orange divider bars that you see on pages
Bottom—depending on how you want containing more than one article are shapes
the text to wrap. set to wrap text. So, these text boxes and
shapes can easily span multiple columns
You might be happy with the default without having to insert a section break or
behavior as soon as you do this. change the number of columns for just that
Otherwise, continue to step two for portion of the page.
customization options.
When you select a text box or a shape, on the
2. To set a specific position or control
Drawing Tools Format tab, in the Arrange
behavior (such as whether or not the
group, you have the same settings for text
image moves with text), on the Picture
wrapping and positioning that are described
Tools Format tab, in the Arrange
above for wrapping text around pictures.
group, click Position and then click
More Layout Options. Note that, because text is set to wrap around
the orange divider bars, your article might
 On the Text Wrapping tab of the
appear to slip below or above a bar,
Layout dialog box, you can set a specific
depending upon length. To adjust the
distance from the image for text to wrap
position of a divider bar shape to
and control whether text can wrap on
accommodate the length of your articles,
both sides, one side only, or just above
just select the shape and then use the up and
and below the image.
down arrow keys on your keyboard to nudge
 On the Position tab of that dialog box, it to the proper position.
you can set a specific position for the
image on the page
and select or clear
the option to
allow the picture
to move with text.
Adding article
titles, bylines,
and dividers
The article titles and
bylines for this
newsletter are created
in text boxes. This is
Remove Background
tool that you can use to
remove backgrounds
from your own images,
similar to the sample
image on the
preceding page. and then drag your mouse pointer in a line
across the portion of the image you want to
To do this in Word, first insert your image add or remove. When you are finished
into the document (on the Insert tab, click making adjustments, click Keep Changes.
Picture), and then select it. Then, on the
Picture Tools Format tab, in the Adjust FOR MORE INFORMATION
group, click Remove Background.
Abico eum, ille et, conventio obruo duis
The Remove Background feature ullamcorper ut, neo demoveo. Vel reprobo:
automatically displays what it believes to be HEADING 5
the central subject of the image. However, Contact Info
it’s easy to adjust this if the immediate result
is not what you need.
On the Background Removal tab, click Mark
Areas to Keep or Mark Areas to Remove
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 | 9

Remove Image
Backgrounds
by [Article Author]
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
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EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 |
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Duis purus eros, aliquam eu cursus tincidunt,
feugiat vitae magna. Etiam sodales
consequat nibh, eget rhoncus metus
convallis et. Morbi rutrum mollis facilisis.
Aenean faucibus
Ebola
Infectious
Disease
Fact Sheet
12/10/15
[Street Address]
[City, ST ZIP Code]
11
Morbi tempus lacinia nisi, vel scelerisque
nibh facilisis id. Integer urna tortor,
ullamcorper aliquet viverra non, mollis sed
dolor. Etiam sodales consequat nibh, eget
rhoncus metus convallis et.
Phasellus dignissim nulla at diam fermentum
in sollicitudin sem condimentum.
Pellentesque condimentum diam et sem
rhoncus semper sed at libero. Aenean
condimentum, lorem vel faucibus
pellentesque, quam nunc lacinia augue, vel
sagittis dolor ipsum vitae velit. Ut feugiat
odio ac dolor iaculis consequat. Praesent sed
lacus ante. Nullam pretium commodo libero,
at congue sapien dignissim a. Cum sociis
natoque penatibus et magnis dis parturient
montes, nascetur ridiculus mus. In hac
habitasse platea dictumst. Vestibulum ante
ipsum primis in faucibus orci luctus et ultrices
posuere cubilia Curae; Ut fermentum sem
non metus faucibus blandit. Sed placerat
bibendum fermentum.
EBOLA INFECTIOUS DISEASE FACT SHEET 12/10/15 | 12

[Addressee]
[Street Address]
[City, ST ZIP Code]