SOURAV PANDA | Roll

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BIOLOGY
INVESTIGATORY
PROJECT
ON RECENT DISEASES - EBOLA

Ebola Proteins

 Initial symptoms are nonspecific - may

include fever, chills, myalgias, and
malaise.

Symptoms of Ebola

Patients can progress to

gastrointestinal symptoms:

develop

severe
watery
diarrhea,
vomiting, abdominal pain

nausea,

Other symptoms:
chest
pain,
shortness
of
breath,
headache or confusion, conjunctival
injection,
hiccups,
seizures,
and
cerebral edema

Bleeding not universally present but

can manifest later as petechiae,
ecchymosis/ bruising, or oozing. Frank
hemorrhage less common.

Some develop
maculopapular
desquamate.

diffuse
rash

erythematous
that
can

Source: Centers for Disease Control and Prevention.

http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html
Accessed Oct. 14, 2014

Diagonosis Of Ebola

Diagnosing Ebola can be difficult at first

since early symptoms, such as fever, are
nonspecific to Ebola infection.
However, if a person has the early
symptoms and has had contact with Ebola
they should be isolated and public health
professionals notified.

Samples from the patient can then be

collected and tested to confirm infection.

Treatment of Ebola

There are no approved treatments available for

EVD.
Clinical management focus - supportive care of
complications:
Hypovolemia , electrolyte abnormalities,
hematologic abnormalities, refractory
shock, hypoxia, hemorrhage, septic shock,
multi-organ failure, and DIC.
Recommended care includes:
volume repletion
maintenance of blood pressure (with
vasopressors if needed)
maintenance of oxygenation
pain control
nutritional support
treating secondary bacterial infections and
pre-existing comorbidities
Among patients from West Africa, large
volumes of intravenous fluids have often been
required to correct dehydration due to diarrhea
and vomiting.

Several investigational therapeutics for Ebola

virus disease are in development. There are no
approved
vaccines available for EVD. Several
Source: Centers for Disease Control and Prevention.
http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html
investigational
Ebola vaccines are in
Accessed Oct. 14, 2014

Index

Ebola: Upcoming Future Epidemic

Epidemiology

Ebola Subtypes
Molecular Structure And Characteristic Features
Transmission Of Ebola
Symptoms Of Ebola
Diagnosis Of Ebola
Treatment Of Ebola
Checklist For Infected Ebola Virus Disease(EVD)
Sequence Of Putting On Personal Protective
Equipment(PPE)

Ebola: Upcoming
Future Epidemic
The Ebola virus is a lipid
enveloped virus in the family
Filoviridae. Members of this
family also include Marburg,
Lassa, and other viruses that
cause hemorrhagic fever, a
group of illnesses that damage
the vascular system and in
severe cases, lead to bleeding
under the skin, in internal
organs or from body orifices
(e.g. mouth, eyes and ears)1.
Infection with the Ebola virus is
now referred to as: Ebola virus
disease (EVD)2. There is a
diagnostic test to determine if
the patient has EVD. There is no
current FDA approved effective
medication or treatment for
those who become infected with

Ebola other than supportive

hydration, electrolyte balancing
and oxygen. The death rate of
those infected is between 5090%. There is no vaccine or
preventative treatment.

TRANSMISSION OF
EBOLA
Person-to-person transmission occurs by very
close personal contact with an infected
individual or with their body fluids during the
late stages of infection or after their death 3,4.
During the care of an infected individual,
spread of the virus can occur through
contact with infected body fluids on the
patient, on their clothes or bedding, on
surfaces such as bedrails, side tables, the
floor, or on reused unsterilized syringes,
needles, thermometers or other viruscontaminated medical equipment. Humans
may also be infected by handling sick or dead

non-human primates and are also at risk

when handling the bodies of deceased
humans in preparation for funerals 5,6.
Virus containing body fluids from individuals
infected with the Ebola virus:
Blood
Breast milk
Organs and tissues
Saliva
Semen
Stool
Sweat
Urine
Vaginal secretions
Vomit
Amniotic fluid (possibly)

Note: Ebola virus has been isolated from

semen 61 days after the initial symptoms of
infection appear. Transmission through
semen has occurred 7 weeks after clinical
recovery
Incubation period: It requires 2 to 21 days
(more often 4-9 days) before symptoms of
infection occur. The infected individual is not
contagious until symptoms appear.

Hemorrhage begins to present 4-5 days after

general symptom onset
Survival outside the body: The virus can
survive and remain infective in liquid or dried
material at room temperature for a number of
days 10 or at 39F (4C) for several days, and is
indefinitely stable at -70C. Infectivity can be
preserved by lyophilization (freeze-drying)

How Ebola enters the body: Intact skin is a

barrier, but scratches, cuts (large or tiny),
rashes, and abrasions, ruin the barrier
integrity and become routes for viral entry.
Additionally, Ebola virus can enter the body
through mucosal tissues after being
deposited by contaminated fluids through
physical contact, splashes, splatters, sprays,
or possibly aerosols. Mucosal tissues include
the eyes, mouth, throat, lungs inside of nose,
vaginal tissues, intestines, and urinary tract

 Most common symptoms reported

during current outbreak:
fever (87%)
fatigue (76%)
vomiting (68%)
diarrhea (66%)
loss of appetite (65%)

Patients with fatal disease develop

more severe clinical signs early
during infection and die between
days 6 - 16 of complications (mean
of 7.5 days).
In non-fatal cases, patients may
have fever for several days and
improve, around day 6.
The case fatality proportion in West
Africa is about 71%

Ebola Subtypes
Ebola-Zaire

(ZEBOV)

Ebola-Zaire

(ZEBOV)

Ebola Ebola-Sudan
(SEBOV)
Sudan
Ebola Ivory(SEBOV)
Coast (ICEBOV)
Ebola
Ebola-Reston
Ivory-Coast
(REBOV)
(ICEBOV)
Ebola-Reston
(REBOV)

MOLECULAR STRUCTURE
Characterization of the
virus

Order: Mononegavirales
Family: Filoviridae
Genus: Ebolavirus
Species: Ebola-Zaire, Ebola-Sudan,

Ebola-Cote d-Ivoire, Ebola-Reston

Morphology under
electron microscope

filamentous, enveloped RNA virus

approx. 19 kb in length (1 kb =

1000 RNA

bases/nucleotides) or 60-80 nm in
diameter
single-stranded, linear, non-

segmented

negative-sense RNA (encoded in a

3 to 5 direction)

appears to have spikes due to

glycoprotein on outside membrane

Structure of Ebola
genome and proteins

Transcribed into 8 sub-genomic

mRNA proteins: 7 structural and 1

nonstructural

7 structural proteins:
nucleoprotein (NP)
4 viral/virion proteins (VP35,
VP40, VP30, VP24)
glycoprotein (GP)
RNA-dependent RNA polymerase
(L protein)
NP, VP35, VP30, L protein:
required for transcription &
replication
VP40, GP, VP24: associated
with the membrane

Epidemiol
ogy

First Known Case Of

August 26, 1976 in Yambuku,
a town in the
Ebola
north of Zare.
A 44-year-old school teacher returned from a
small hike. His went to the doctor and because
of his high fever they gave him a quinine shot
which is good against malaria.

A week later, he had uncontrolled vomiting,

bloody diarrhea, trouble breathing and then
bleeding from his nose, mouth, and anus.
It struck two countries within that year
--a. Sudan in a town called Nzara
b. Zaire, now known as the Democratic Republic
of Congo
-- In these two instances the mortality rate was
between
50 90%
-- Following those epidemics, Ebola hit Africa in
many other
instances the worst yet being in
the year 2000 when it struck Uganda infecting
--