EBOLA VIRUS PATHOGEN DISEASE

Etiology

The virus belongs to the Filoviridae family, mononegavirales order, and Ebolavirus genus. Usually, the Ebola virus has a structure that is filamentous, elongated, and its length varies. It is believed that the initial infection is due to contact with the body fluids of primates and bats that have the Ebola virus. Transmission from animals to humans mostly occurs during hunting and consumption of contaminated meat. The virus level in blood increases as the illness advances to the last stages. A larger percentage of the virus exists in the skin so that sweat might have the Ebola virus. Therefore, touching a person who is infected with a virus may lead to virus transmission.

Classification

There are five different species of the Ebola virus that have been identified from different epidemics. The virus is mainly found in Africa, except for Reston species that has the Philippines origin. This species was first identified in the United States in 1989 from monkeys imported from the Philippines. The second species is the Zaire ebolavirus, which was identified during an outbreak in Congo in 1976[1]. Among the five species, this is the most prevalent and common and has a higher fatality rate. The Sudan Ebolavirus was experienced in South Sudan in 1976 during an outbreak. It has identical symptoms to Zaire one, but its fatality rate is less. Tai forest species was isolated only once in 1994 and involved a researcher who conducted an autopsy on a chimpanzee. Luckily the researcher recovered from the disease with no much complication. Lastly, the Bundibugyo virus was identified in 2007 during an outbreak in Uganda. It has a distant relationship with the Tai forest species.

Life Cycle

The extracellular virion is the first stage of the Ebola virus when it is enveloped around the host. Upon finding a host, the virus has to make its way into the host, which usually happens via the mucosal membrane. The next stage involves the formation of glycoprotein from protein L and Cathepsin B to allow the vesicle to release the virus[2]. This stage involves the fusion of virus and vesicle membrane. In the stage that follows, the virus RNA is transcribed into viral mRNA, which later moves to the cell nucleus through the cytoplasm. VP 30 protein accompanies the mRNA strands to aid in the replication of nucleocapsids RNA and polymerase. A combination of the host cell replication mechanism and polymerase begins Ebola virus replication, and at this stage, the encapsulated virus is released by the nucleus[3]. The last stage involves the transportation of a newly formed virus to the cell’s membrane. Interaction between cells budding mechanism and nucleocapsid around the virus facilitates the release of the membrane’s encapsulated virus.

Transmission

Researchers believe that the initial human infection is when a person comes into contact with an animal, such as a bat that is infected with the Ebola virus. After the first infection, the disease keeps spreading from one person to the other; this may end many affecting people. Ebola virus spreads from one person to the other through direct touch with primates or fruit bats with the virus[4]. Contact with the semen of a man who has been a treat of the Ebola virus. The virus is capable of remaining in particular body fluids despite the absence of Ebola signs and symptoms. It has not been proven that EVD could be transmitted through sex. Humans spread the virus to one another only after the virus incubation period is over; i.e., Ebola symptoms are visible. Food is not a medium of Ebola virus transmission; however, it may spread through contact and eat wild animals’ meat having the virus.

Symptoms

The signs and symptoms of Ebola virus disease are visible after two to twenty-one days of contracting the virus. The initial signs of the disease may include some or a combination of the following.  Ebola victims have a fever, experience joint and muscle pain and headache[5]. Unusual bleeding of the victim, vomiting and diarrhea, and also fatigue. Other symptoms appear in the disease’s late stage, such as red eyes, hiccups, and skin rash. Most common diseases such as typhoid, flu, and malaria depict similar signs, and therefore, physicians ought to be cautious while identifying the illness.

Treatment

At the moment, there is no particular treatment or drug that has been proven to cure the Ebola virus. Treatments anticipated to cure the virus are still being tested; some include drug therapies, immune therapies, and blood products. One possible medication under tests is designed using monoclonal antibodies to stop the virus attachment to body cells. Also, vaccines are being developed. The Ebola virus treatment involves treating signs and symptoms through oxygen and fluids intakes and dealing with other infections. This kind of treatment help Ebola victims fight it and increase their chances of survival [6]. Four types of treatments were used during the Ebola outbreak in Congo in 2018. Two of the treatments, commonly referred to as mAb114 and Regeneron, depicted higher chances of survival. The two treatments are still in use and usually fight EVD by preventing it from replicating.

Control and Prevention

In a healthcare center, workers are expected to follow standard measures while handling patients regardless of the initial treatment. Some of these basic measures include wearing protective gear to prevent contact with infected surfaces, safe burial and injection practices, and observing hygiene [7]. The employees who handle Ebola patients or those suspected of having the Ebola virus should take extra precautions to avoid contacting patients’ body fluids, materials, and contaminated surfaces. In close contact with the victims, workers should wear protective clothing such as gloves, face protection, and a long-sleeved gown. Since Lab technicians are also at risk of EVD infection, samples to be tested should be handled by only trained and lab facilities that are well equipped.

The most appropriate way to prevent the Ebola virus is to keep off areas where the virus is commonly found. Following are also some of the precautions people should follow to prevent the Ebola virus from spreading. Avoid funeral rituals that involve touching the body of a person who died of Ebola. Do not touch body fluids and blood of persons who are ill.  It is also advisable to avoid raw meat from sources that are not known. Additionally, touching the semen of a person recovering from the Ebola virus should be avoided until the test shows the virus is of the semen. People traveling from Ebola outbreak areas should monitor their health and visit a hospital upon developing Ebola signs.

 

 

Bibliography

Khalafallah, Mahmoud Tawfik, Omar Ali Aboshady, Shaban Ahmed Moawed, and Menna Said Ramadan. “Ebola virus disease: essential clinical knowledge.” Avicenna Journal of Medicine 7, no. 3 (2017): 96.

Malvy, Denis, Anita K. McElroy, Hilde de Clerck, Stephan Günther, and Johan van Griensven. “Ebola virus disease.” The Lancet 393, no. 10174 (2019): 936-948.

Singh, Raj Kumar, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari et al. “Ebola virus–epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans–an update on its 40 year’s journey.” Veterinary Quarterly 37, no. 1 (2017): 98-135.

Subissi, Lorenzo, Mory Keita, Samuel Mesfin, Giovanni Rezza, Boubacar Diallo, Steven Van Gucht, Emmanuel Onuche Musa et al. “Ebola virus transmission caused by persistently infected survivors of the 2014–2016 outbreak in West Africa.” The Journal of infectious diseases 218, no. suppl_5 (2018): S287-S291.

Yu, Dong-Shan, Tian-Hao Weng, Xiao-Xin Wu, Frederick XC Wang, Xiang-Yun Lu, Hai-Bo Wu, Nan-Ping Wu, Lan-Juan Li, and Hang-Ping Yao. “The lifecycle of the Ebola virus in host cells.” Oncotarget 8, no. 33, (2017): 55750.

[1] Singh, Raj Kumar, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari et al. “Ebola virus–epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans–an update on its 40 year’s journey.” Veterinary Quarterly 37, no. 1 (2017): 98-135.

[2] Yu, Dong-Shan, Tian-Hao Weng, Xiao-Xin Wu, Frederick XC Wang, Xiang-Yun Lu, Hai-Bo Wu, Nan-Ping Wu, Lan-Juan Li, and Hang-Ping Yao. “The lifecycle of the Ebola virus in host cells.” Oncotarget 8, no. 33, (2017): 55750.

[3] Yu, Dong-Shan, Tian-Hao Weng, Xiao-Xin Wu, Frederick XC Wang, Xiang-Yun Lu, Hai-Bo Wu, Nan-Ping Wu, Lan-Juan Li, and Hang-Ping Yao. “The lifecycle of the Ebola virus in host cells.” Oncotarget 8, no. 33, (2017): 55750.

[4] Subissi, Lorenzo, Mory Keita, Samuel Mesfin, Giovanni Rezza, Boubacar Diallo, Steven Van Gucht, Emmanuel Onuche Musa et al. “Ebola virus transmission caused by persistently infected survivors of the 2014–2016 outbreak in West Africa.” The Journal of infectious diseases 218, no. suppl_5 (2018): S287-S291.

[5] Singh, Raj Kumar, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari et al. “Ebola virus–epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans–an update on its 40 year’s journey.” Veterinary Quarterly 37, no. 1 (2017): 98-135.

[6] Malvy, Denis, Anita K. McElroy, Hilde de Clerck, Stephan Günther, and Johan van Griensven. “Ebola virus disease.” The Lancet 393, no. 10174 (2019): 936-948.

[7] Khalafallah, Mahmoud Tawfik, Omar Ali Aboshady, Shaban Ahmed Moawed, and Menna Said Ramadan. “Ebola virus disease: essential clinical knowledge.” Avicenna Journal of Medicine 7, no. 3 (2017): 96.

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