EBOLA and MARBURG Viral Infections

Dr.T.V.Rao MD

Viral Hemorrhagic fevers

The term viral hemorrhagic fever refers to a clinical syndrome characterized by acute onset of fever accompanied by nonspecific findings of malaise, prostration, diarrhea,and headache. Patients frequently show signs of increased vascular permeability, and many develop bleeding diatheses. The hemorrhagic fever viruses represent potential agents for biologic warfare because of capability of aerosol transmission, high morbidity,and mortality associated with infection, and ability to replicate in cell culture in high concentrations., The important infecting agents are Ebola and Marburg

Ebola and Marburg Virus

Ebola and Marburg viruses are highly virulent in

humans and non human primates, ends in death. Both the viruses are identified to cause African hemorrhagic fevers

Filovirus Filo is Latin for Thread

Marburg and Ebola are members of the Filoviridae Appear as long threads, Can be U shaped, Genome 19 kb long Enveloped viruses. A single stranded, unregimented, Helical, ve sense RNA genome 80 nm Diameter

Events on Ebola
Ebola

virus were discovered in 1976 with occurance of two severe epidemics of hemorrhagic fever in Sudan and Zaire. The Epidemic invloved > 500 persons and killed > 400 infected individual. The importance of epidemic lies with in each outbreak hospital staff become infected through close contact with patients, their blood and excreta. The mean time of death from onset to symptoms is 7 8 days.

Events on Marburg
Marburg

Viruses were discovered in 1967 First identified in Laboratory workers exposed to tissues of African green Monkeys imported to Germany and Yugoslavia. Transmission from patients to Medical personal occurred with highly mortality. Marburg virus can infect Guinea pigs, Mice, Hamsters, Monkeys

Epidemic Outbreaks of Marburg

Out

breaks occured in Kenya, South Africa, Democratic Republic of Congo. Recent outbreak in Angola in 2005

Ebola Patient

Reservoir Hosts

Reservoirs can be a Rodent or Bat Humans infected accidentally Monkeys are not proved as reservoirs as die with infection early Infected humans are rich source of infections to others. By direct contact with blood and body fluids of infected persons can spread the disease

Spread of Infections
Transmission

appears to be associated with contamination of Blood, Blood stained body fluids or tissues. Nosocomial spread is common mode of spread, Doctors and Nurses at risk when attending the patients. Transmission by sexual intercourse has been on record from a case of man infecting his wife 83 days after initial infection.

Viral Replication
The

viruses are grown in variety of cell lines including Vero M A 104 S W 13 cells Filoviruses replicates in the cytoplasam

Pathology and Pathogenesis

The viruses belong to group of Filoviruses The viruses have tropism for Cells of macrophage system Dendritic cells Interstitial fibroblasts Endothelial cells

Mode of Spread

Virus infect several Organs

High

titer of viruses are found in Liver Spleen, Lungs Kidneys Blood Other Body fluids

How the Illness is Presented in Marburg and Ebola

Fever Head ache Sore throat Muscle pain Abdominal pain, Vomitting Diarrhea Incubation period 3 -9 days in Marburg In Ebola 2 21 days.

Serious manifestation of Ebola and Marburg

Internal and External bleeding, Shock, Death

Diagnosis
Viruses

are isolated from Blood by cell culture on Vero cells ( Vero E 6 ) ELISA for antigen detection ELISA for IgM RT - PCR

Control of Infection
Isolation

facilities within the Hospital remain the most important effective measure. Barrier nursing remain the basic need in control of infection spread

The health care workers should

Avoid Infected Blood, secretions, Tissues, Wastes

Treatment of Ebola and Marburg

Antiviral

drugs are not available Interferons are not effective To date no Vaccine Electrolyte corrections Dealing with hemorrhagic complications.

Barrier Nursing remains the only best option in Prevention

Created for Health awarness on Filoviruses

Dr.T.V.Rao MD Email

doctortvrao@gmail.com