Ebola virus
Introduction
It is clear that human beings since time immemorial have been subjected to a wide range of viral diseases. Strauss and Strauss (2008) states that quite a number of these viruses are believed to have evolved along with mankind and have been in existence since the inception of human life. Other viruses were acquired from animals that man came into contact with. These viruses jumped from animal sources to human beings and became human viruses that infect only people. Human beings turned out to be the vertebrate reservoir for these viruses. Some viruses however, even though their original source was animals infect human beings peripherally and human beings do not serve as their vertebrate reservoirs (Strauss and Strauss, 2008). These include Ebola virus, rabies virus, and eastern equine encephalitis among many others. Other viruses have entered the human race more recently. As human beings increase in numbers, they impinge on wildlife more and more, and alterations in the environment result in closer interactions between animals and human beings. This leads to an increased number of zoonotic viruses that result in epidemics of deadly human illnesses (Strauss and Strauss, 2008).
Ebola virus first came into limelight as the causal agent of two major epidemics of viral hemorrhagic fever in the Democratic Republic of Congo, along Ebola River as well as in Sudan three decades ago (Mahy and Regenmortel, 2009). Ebola virus is a very deadly virus that leads to adverse symptoms such as extremely high fever and excessive internal and external bleeding. It results in the death of approximately 90 of the people it infects (Mahy and Regenmortel, 2009). It is one of those viruses that have the ability of causing hemorrhagic fever. Cases of Ebola virus infection are mainly reported in Africa, especially in the Democratic Republic of Congo (DRC), Uganda, Gabon, Sudan and the Ivory Coast (MedicineNet, 2010). Other continents such as North America are believed to be free from Ebola virus. Ebola virus is a hazard to everyone, who is exposed to it, including health care workers. Ebola virus was named after the Democratic Republic of Congo, Ebola River, where its outbreak was first reported. Ebola virus belongs to the family Filoviridae. Filoviridae is a family of RNA viruses. Ebola virus is subdivided into five subgroups referred to as Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast, Ebola-Bundibugyo, and Ebola-Reston, which mainly affects non-human primates (Mahy and Regenmortel, 2009).
Transmission of Ebola virus among human beings has not been sustained. In spite of considerable advances in the comprehension of Ebola, researchers and scientists have not yet discovered the natural source or the factors that lead to its re-appearance in new outbreaks in human beings. Even though non-human primates are believed to be the source of infection for human beings, they are not the natural reservoir. Human beings are not reservoirs of the virus also, and infection with the virus is incidental (MedicineNet, 2010). The appearance of the virus in human beings at the start of an outbreak remains a mystery. Nonetheless, it has been posited that human beings are infected with the virus through contact with an infected animal. It is believed that Ebola virus is transmitted through body fluids. Infection with an Ebola virus subjects a patient to devastating symptoms. These symptoms are so severe that they lead to shock and death within a short period of time. Specific treatment of the disease has not yet been discovered. However, patients are given supportive therapy which includes balancing the patients body fluids and electrolytes (MedicineNet, 2010).
Ebola virus
Ebola virus is the causative agent for Ebola hemorrhagic fever often abbreviated as Ebola HF. This disease is a deadly disease both in human beings and non-human primates such as chimpanzees, monkeys, and gorillas. This disease appears sporadically, and the first case of the disease was reported in 1976 in the Democratic Republic of Congo (Strauss and Strauss, 2008). Confirmed outbreaks of Ebola hemorrhagic fever have been reported in a number of African countries, after the DRC, including Uganda, the Ivory Coast, Gabon, and the republic of Congo. However, according to Strauss and Strauss (2008), cases of the disease have never been reported in some continents, especially North America. Ebola hemorrhagic fever usually emerges in sporadic outbreaks and spread rapidly within healthcare setting an aspect referred to as amplification.
Ebola hemorrhagic fever is an acute infection. Soon after the first person has been infected with the virus, it can be rapidly transmitted through a number of ways. Human beings are exposed to Ebola virus from direct contact with various body secretions such as saliva, semen, mucus, and blood in addition to tissues of an infected person (Rollin, 1998). Sexual contact can also lead to transmission of the disease. Ebola virus is rapidly spread among family members and friends due to the fact that they are exposed to direct contact with body secretions of an infected person when carrying himher to a medical facility. Centers for Disease Control and Prevention (2009) assert that humans can also be exposed to Ebola virus infection through contact with contaminated materials and objects such as needles. The other mode of transmission besides direct transmission is nasocomial transmission. This is the mode of transmission that occurs within a medical care setting. Nasocomial transmission however, occurs after an outbreak. Nasocomial transmission occurs through direct contact in addition to contact with contaminated objects. In African medical care facilities, mask, gloves and gowns are rarely used while taking care of patients. Failure to wear protective clothing by health care workers, when taking care of patients suffering from Ebola hemorrhagic fever, exposes them to the virus. Re-using of infected needles and syringes exposes a large number of people to the risk of Ebola virus (MedicineNet, 2010).
Ebola hemorrhagic fever has got an incubation period that ranges from two to twenty one days. The onset of disease is sudden and is characterized by a number of symptoms. These symptoms include fever, headache, sore throat, general body weakness, muscular aches and joint pain (Rollin, 1998). These symptoms are then followed by diarrhea, nausea, vomiting, and stomachache. Other symptoms associated with this disease include rashes, reddening of the eyes, excessive internal and external hemorrhage, hiccups, anorexia, asthenia, genital swelling, delirium, seizures, coma, depression, and reddening of the palate (World Health Organization, 2008).
Diagnosis of Ebola hemorrhagic fever is a challenging task due to the fact that early symptoms of the disease such as headache, reddening of the eyes, skin rash, and nausea are non specific to the virus. These symptoms also occur in patients suffering from other illnesses that affect people more frequently (World Health Organization, 2008). Nevertheless, if an individual is diagnosed with as many symptoms of Ebola hemorrhagic fever as possible heshe should be isolated to minimize cases of transmission. There are various laboratory procedures that can be used to diagnose Ebola hemorrhagic fever in a patient. These include Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, virus isolation, Immunoglobulin M ELISA, and polymerase chain reaction (PCR). These procedures can be used to diagnose Ebola hemorrhagic fever in a few days of the start of symptoms.
Immunohistochemistry testing, virus isolation and PCR are used to diagnose Ebola hemorrhagic fever retrospectively after the death of a patient (Centers for Disease Control and Prevention, 2009). World Health Organization (2008) states that tests on samples expose health care workers to intense biohazard danger, and therefore they should be carried out under maximum biological control conditions.
Strauss and Strauss (2008) make it clear that standard treatment of Ebola hemorrhagic fever has not yet been developed. However, patients are given supportive therapy in the course of treatment. Supportive therapy comprises of balancing the body fluids in addition to electrolytes of a patient. Maintenance of blood pressure and oxygen status in addition treating patients for any additional complication are some of the supportive therapy strategies employed in treatment of Ebola hemorrhagic fever. Blood transfusion is carried out to counteract excessive loss of blood (World Health Organization, 2008). Prevention of Ebola, not only in Africa, but also in other continents where Ebola hemorrhagic fever cases have been reported presents a very challenging task. This is mainly due to the fact that the identity and the location of the natural reservoir of the virus currently remains a mystery. Only a few preventative measures have been devised so far. However, no specific vaccine for the disease has been developed. Several potential vaccines are currently being tested, but it may take years before they are released (World Health Organization, 2008). World Health Organization (2008) states that in cases of an outbreak the current socioeconomic factors usually favor the spread of an epidemic both in homes and medical care facilities. It is vital therefore, that healthcare workers possess the capability of recognizing cases of the disease if they happen to occur. They should also have the capacity to carry out diagnostic procedures, and be prepared to use realistic viral hemorrhagic fever isolation precautions and protective nursing techniques. These techniques comprise of wearing protecting clothing such as masks, gloves and gowns in addition to infection control measures such as total sterilization of apparatus, as well as isolation of infected persons from contact with patients who are not protected (Centers for Disease Control and Prevention, 2009).
Conclusion
Ebola virus constitutes some of the major viruses that have the capacity to cause viral hemorrhagic fever syndrome. Ebola virus first came into lime light as the causal agent of two major epidemics of viral hemorrhagic fever in the Democratic Republic of Congo and Sudan three decades ago. Transmission of Ebola virus among human beings has not been sustained. The natural source or the factors that lead to its re-appearance in new outbreaks in human beings have not yet been discovered. Ebola hemorrhagic fever is an acute infection and soon after the first person has been infected with the virus it can be rapidly transmitted through direct contact with various body secretions such as saliva, semen, mucus, and blood in addition to tissues of an infected person. Sexual contact can also lead to transmission of the disease. Direct contact with contaminated equipments can also transmit the infections. Patients suffering from Ebola hemorrhagic fever present with a number of symptoms including headaches, excessive internal and external bleeding, muscular aches, gastrointestinal complications, and anorexia among many others. Standard treatment of Ebola hemorrhagic fever has not yet been developed. However, supportive therapies which include maintenance of electrolyte and body fluid balance, treatment of additional complications, and maintenance of blood pressure and oxygen status, are provided to patients. Vaccine for Ebola hemorrhagic fever has not been developed.
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