Analysis of Ebola Virus - Essay Example

Ebola Virus Introduction: Dr. John W. King’s article (2003) on Ebola Virus gives us detailed information on the infection that takes its from the Ebola River in Zaire, Africa where its outbreak was first identified. The same year the virus was also spotted among the people living in Nzara, Sudan. Approximately 602 cases of Ebola Virus were reported that year out of which 397 died. Research was carried out on the two strains of viruses which were identified as Ebola Zaire (EBO-Z) and Ebola Sudan (EBO-S). On comparison the Zaire strain had caused more fatalities (90%) than the Sudan strain (50%). In 1990 once again a similar type of virus was spotted among monkeys in Reston, Virginia which were imported from the Philippines. The strain was named Ebola Reston (EBO Reston). The epidemic continued to emerge in the region in different countries such as in Zaire in 1995 and 2003, Gabon in 1994, 1995 and 1996 and Uganda in the year 2000. In 1994 a subtype of Ebola virus was spotted in the Ivory Coast and was identified as Ebola-CI. So far there have been 1500 identified cases of Ebola virus in the world out of which two third have died. King (2003) further states that the virus is one of the 18 least known viruses that have the capability of causing viral hemorrhage fever syndrome. The virus belongs to the family of flaviviridae. There are four subtypes of Ebola Virus. They are Ebola Zaire, Ebola Sudan, Ebola Ivory Coast and Ebola Reston. Its outbreak is in the form of an epidemic that is capable of causing 88% deaths in the patients suffering from it. Ebola Zaire is considered to be the deadliest one with greatest number of deaths attributed to it. However no deaths were reported from the four cases of Ebola Reston. The virus is quickly replicated in human and non human tissues spreading the infection rapidly. The replication is followed by severe focal necrosis. The severest form of necrosis occurs in the liver where councilman like bodies are formed like the ones formed in the yellow fever. The tissues and blood of the near death patients suffering from Ebola virus are highly infectious. King (2003) states that in 1996 members of the National Institute of Virology of South Africa carried out a research in Zaire to find out the infectivity of the virus in different species of plants, vertebrates and invertebrates. It was observed that the serum and feces of the insectivorous bats (Tadarida pumila) and fruit bats (Epomophorus wahlbergi) were found to help the virus multiply rapidly without dying. Source: Primary Source: No definite source has been identified in the case of Ebola virus. However there is a strong history of patients traveling to or working in the region where the epidemic was positive. Another common factor in the patients’ history was the exposure to the tropical African forests. In primary cases the incubation period is normally from 3-8 days. Secondary Source: Secondary source include the contact with the infected person or animal such as the care givers or the medical staff and the animal care workers. In secondary cases the incubation period is usually long. There have been reports of 19-21 days incubation period as well. Symptoms: Symptoms include fever, Pharyngitis, an expressionless face and rash on the skin and bleeding from the mucous membrane and the ultra venous puncture sites. Clinical symptoms appear quite suddenly. King (2003) has described them in great detail. These include headache (50-74%), arthralgias (50-79%), fever (95%), anorexia (45%), and asthenia (85%). Disturbance in the gastrointestinal system includes abdominal pain (65%), nausea or vomiting (68-73%) and diarrhea (85%). Other symptoms include conjunctivitis (45%), dysphagia (57%) and bleeding which may occur from any site in the gastrointestinal tract. Rash is also noted among 15% patients infected with Ebola virus. Terminally ill patients are often expressionless and are in a state of shock. Hiccups have also been observed among fatally ill patients and in most cases tachypnea was the only symptom that separated the fatally ill patients from the survivors. 15% patients have also reported ocular pain. Due to these symptoms the patient often finds it difficult to follow the normal diet pattern. Method of Dispersion: The research carried out on Ebola Virus discloses the fact that the virus is transmitted from unknown source, most likely bats, to humans and other animals. The transmission takes place when a human or an animal comes in direct contact with the saliva, blood or infected tissues of the infected host. Infection in non human primates is due to contact with mucous membrane, conjuctiva, cracks in the skin, gastrointestinal surfaces and pharynx. The virus has also been found in dogs due to contact with droplets from urine, feces or blood. Among humans those who are most likely to get infected are the medical staff or family members who have acted as attendants to the patients. Family members who have prepared the infected body for burial have also contracted the disease and many casualties have occurred due to it. Near death patients are a highly infected source of infection. There are higher risks of contracting the disease if proper precautions are not taken for the disposal of the infected dead body. Research has shown that the serum and saliva of the infected patients are highly infected with the Ebola virus. The research thus confirms that oral secretions of the infected patients have the capability of transmitting virus from one person to another. Another possible way of the spread of virus is through the hospitals. At Zaire in 1976 approximately 316 patients were reported positive with the virus. The use and reuse of contaminated medical equipment, negligence in the use of gloves and gowns and improper sanitation also contributed in spreading the virus in the form of an epidemic. Ebola virus is also transmitted through sexual intercourse between the recovering person and any other healthy sex partner. Ebola Zaire and Ebola Sudan appear to spread more rapidly through direct contact with the infected host than through respiratory tract. Ebola Reston has appeared in non human primates and seems to spread more rapidly through the respiratory route. The virus can be transmitted to other animals and humans through respiratory tract. Fortunately, the virus has not been found deadly among humans. Ebola Virus as an epidemic: According to the Oxford dictionary (2002) an epidemic is a condition in which large numbers of people belonging to the same region suffer from an infectious disease at the same time. Dr. King’s (2003) article shows that Ebola virus first appeared in Zaire and grew rapidly among the population. Those who were infected included family members who had acted as care givers or had prepared the body for burial, the medical staff and the people who were treated with unsterilized hospital equipment. In the United Stated Ebola virus did not emerge as an epidemic. Only four cases of Ebola Reston were reported which fortunately did not cause any fatalities. People and other laboratory staff working in close contact with the infected animals have higher risk of getting infected from the infected animals. Internationally Ebola virus outbreak has caused many fatalities in the African region. A look into the history of the virus shows that people who have traveled in the African region, those taking care of the infected patients and animals have suffered from the disease. Following is the list of the fatalities in the African region due to this epidemic as mentioned by King (2003). Outbreak of Ebola Virus Sudan YEAR COUNTRY CASES REPORTED FATALITIES PERCENTAGE 1976 SUDAN 284 151 53% 1979 SUDAN 34 22 65% 2000-2001 UGANDA 425 224 53% 2004 SUDAN 17 17 41% TOTAL 760 414 54.5% Outbreak of Ebola Zaire YEAR COUNTRY CASES REPORTED FATALITIES PERCENTAGE 1976 ZAIRE 318 280 88% 1977 ZAIRE 1 1 100% 1994 GABON 52 31 60% 1995 DEMOCRATIC REPUBLIC OF CONGO 315 250 81% 1996 (JAN-APR) GABON 37 21 57% 1996 S. AFRICA (got infection in Gabon) 1 1 100% 1996-1997 (JUL-JAN) GABON 60 45 74% 2001-2002 (OCT-MAR) GABON 65 53 82% 2001-2002 (OCT-MAR) DEMOCRATIC REPUBLIC OF CONGO 59 44 75% 2002-2003 (DEC-APR) DEMOCRATIC REPUBLIC OF CONGO 143 128 89% 2003-2004 (NOV-DEC) DEMOCRATIC REPUBLIC OF CONGO 35 29 83% TOTAL 1,086 883 81.3% Outbreak of Ebola Virus Ivory Coast YEAR COUNTRY CASES REPORTED FATALITIES 1994 IVORY COAST 1 0 1995 LIBERIA 1 0 TOTAL 2 0 Outbreak of Ebola Virus Reston YEAR AREA CASES REPORTED FATALITIES 1989 (OCT) RESTON, VA 4 0 1989 (NOV) PHILADELPHIA, PA NOT KNOWN NOT KNOWN 1990 RESTON, VA NOT KNOWN NOT KNOWN 1990 ALICE, TEX NOT KNOWN NOT KNOWN TOTAL 4 0 The mortality rate is very high in the case of Ebola Zaire. It is approximately 89% as compared to Ebola Sudan where the mortality rate is 41% to 65%. No sex discrimination: King (2003) states that both men and women are equally vulnerable when exposed to the virus. Women generally act as caregivers and men work in the forests and outside home due to which both sexes are at equal risk of getting the infection from any contaminated source. Age: There has been no evidence of any age preference in the case of Ebola virus. However according to Dr. King (2003) adults seem to be more exposed to the infected environment so they have more chances of getting the infection. FUNERAL PREPERATIONS FOR EBOLA VIRUS PATIENTS The book on “Emergency Sanitation” written by Harvey, Baghri and Reed (2002) describes in detail the precautions needed for the funeral preparation of the infectious bodies such as those of Ebola Virus. Ebola is a deadly virus and can cause fatalities as it is spread in the form of an epidemic. In most of the cases the disease is spread within the healthcare environment and those who prepare the infected body for burial. The disease can easily spread once a person comes in contact with the body secretions of the infected person or by using the same water source. The blood, saliva, sputum, waste and semen of the patients are highly infected. Ebola virus can live for a long time once it is outside the body. It can be cleaned with the soap or water but if any fluid remains unclean it can cause fatalities once a person or an animal comes in contact with it. High level of protection is needed for those who deal with the dead bodies of the Ebola virus patients. A general awareness about the danger of the disease is very essential. Usually dead bodies are given a bath before the burial either in mass or private ceremonies. In situations like Ebola virus, such ceremonies can actually increase the chances of spreading the disease. It is for this reason it is essential to avoid such ceremonies to prevent the spread of the disease. The burial matters of such infected persons should be given to the funeral industry that are aware of the precautions necessary for the funeral of a person suffering from an infectious disease. Mortuary service of the infected body: In many communities the dead bodies are kept at home for the relatives who keep a vigil or wish to pay last respect to it. However in situations where the dead body is infected with Ebola virus or any other infected disease, it is better to keep the body in a morgue. Body Dressing: As per the guidelines provided by the NSW Health (2004) sealed body bags are provided for epidemic victims. The body is kept in the bag to ensure public health and safety. The bags must be labeled with the “Infectious Disease” tag to prevent the people from opening the bags. Infectious bodies must not be taken out of the bag for public viewing. Disinfection: According to NSW Health (2004) the use of lime or chlorine for disinfection is a common practice. However the idea is superficial and may cause more harm than disinfecting the surrounding. The best practice is to use protective clothing to those who have the responsibility of handling the dead body. Chlorine sprays can be used by trained staff to disinfect the places that have come in contact with the infected body. Protective Clothing: According to Harvey, Baghri and Reed (2002) for health safety, it is important that the trained staff should be allowed to take care of the infected dead bodies. The infected corpse must be handled with great protection. For this purpose protective clothing such as gloves, gowns and glasses must be worn by those who handle the infected bodies. Once the body is properly buried the protective clothing must be sent for laundry as soon as possible. If the protective clothing is disposable then they must be properly disposed off as contaminated waste. Workers must be asked to disinfect themselves by washing with disinfecting soaps. Transportation: Harvey, Baghri and Reed (2002) state that the epidemic victims’ corpses must be transported to the burial site in a vehicle. The vehicle must be disinfected once the body is taken out of it. It is stated in NSW Health (2004) that in many countries such as in Australia, it is the legal right of the vehicle driver to know that the corpse that he is transporting is infectious or not so that he should be aware of the consequences. Burial: Harvey, Baghri and Reed (2002) state that proper measures should be taken for the burial of the infected dead bodies. They should be away from the ground water table to avoid the water from being contaminated. The bodies of Ebola Virus patients must not be embalmed. Embalming requires the removal of the body fluids and injection of the embalming fluids inside the body. Since the body fluids of the Ebola Virus patients are highly infectious it is not at all advisable to embalm the body. Disposal of body waste: The NSW Health (2004) states that any waste of the infected dead body and the material used for handling the body must be properly disposed off to prevent the spread of the virus. The disposal should be done under the rules and regulations followed for the contaminated clinical waste disposal. Future of Ebola Virus: Although medicine has advanced in every field it is a pity that so far no cure has been found out for the Ebola virus. Previously Ribavirin has been used without any success. Several laboratory workers were successfully treated with goat derived anti Ebola immunoglobulin and human alpha 2 interferon. Several supportive therapies with healthy nutrition have been advised to comfort the ailing patient. The recovery is slow in patients who manage to survive for two weeks (King, 2003). Till this day experiments are being carried out to find out a cure to Ebola virus. DNA vaccines are being studied for this purpose. Another approach that is being studied is the growth of neutralized antibodies in goats or horses that are exclusive for Ebola (King, 2003). Conclusion: History has shown that Ebola is a deadly virus. So far no vaccine has been found for the virus. The actual source of Ebola Virus is still not known to the medical experts. It is therefore very important to educate people about the mode of dispersion, symptoms and its prevention. Educating the care givers and the medical staff can definitely reduce the number of casualties. REFERENCES “Epidemic”, Colour Oxford English Dictionary, Oxford University Press, (2002). Pg. 233 “Guidelines For the Funeral Industry”. NSW Health. New Department of Health, Sydney, Australia. (2004). Pg. 9- 17 Harvey P., Baghri S., Reed B. “Disposal of the Dead Bodies”, Emergency Sanitation, WEDC Publications, (2002) pg. 135-140 King. J. W. “Ebola virus”. Emedicine. November 2003. Retrieved on April 9, 2007 from http://www.emedicine.com/MED/topic626.htm Read More