How to prevent the spread of the deadly Ebola disease.

Patients are contagious as long as their blood and bodily fluids contain the virus. The Ebola virus was isolated from the semen of an infected male in a laboratory 61 days after the onset of the disease.

Ebola first appeared in 1976 in two simultaneous outbreaks in Nzara, Sudan, and Yambuku, Democratic Republic of Congo. The second outbreak was in a village located near the Ebola River and was named after the river.

Ebolavirus is one of three genera of viruses belonging to the Filoviridae family (filovirus), the same family as Marburgvirus and Cuevavirus. Ebolavirus comprises five different species:

- Bundibugyo ebolavirus (BDBV)

- Zaire ebolavirus (EBOV)

- Reston Ebolavirus (RESTV)

- Sudan Ebola virus (SUDV)

- Tai Forest ebolavirus (TAFV).

BDBV, EBOV, and SUDV are all associated with major Ebola outbreaks in Africa, while RESTV and TAFV are not.

The RESTV species, which has been detected in the Philippines and China, can infect humans, but so far there have been no reports of illness or death in humans due to this species.

Transmission

Ebola is transmitted to humans through close contact with the blood, secretions, organs, or other bodily fluids of infected animals. In Africa, infections have been reported due to the transport of sick or dead chimpanzees, orangutans, fruit bats, monkeys, forest antelopes, and porcupines, or through tropical forests.

Ebola then spreads in the community through person-to-person transmission, with infection resulting from direct contact (via open wounds on the skin or mucous membranes) with the blood, secretions, organs, or other bodily fluids of an infected person, and through indirect contact with environments contaminated with these fluids.

Funerals in which attendees have direct contact with the deceased's body also play a role in the transmission of Ebola.

Men who have recovered from the illness can still transmit the virus through semen for up to 7 weeks after recovery.

Healthcare workers are highly susceptible to infection while treating patients suspected of or confirmed to have Ebola. Infection occurs through direct contact with patients when preventative measures are not strictly followed.

Signs and symptoms

Ebola is a severe acute viral illness typically characterized by a sudden onset of high fever, extreme fatigue, muscle aches, headache, and sore throat. This is followed by vomiting, diarrhea, renal and hepatic dysfunction, and in some cases, internal and external bleeding. Laboratory findings include leukopenia and thrombocytopenia and elevated liver enzymes.

Patients are contagious as long as their blood and bodily fluids contain the virus. The Ebola virus was isolated from the semen of an infected male in a laboratory 61 days after the onset of the disease.

The incubation period, which is the time from infection with the virus to the appearance of symptoms, is 2 to 21 days.

Diagnose

Other diseases that need to be ruled out before making a diagnosis of Ebola include: malaria, typhoid, bacillary dysentery, cholera, leptospira disease, herplague, rickettsial disease, relapsing fever, meningitis, hepatitis, and other viral hemorrhagic fevers.

Ebola virus infection can be definitively diagnosed in the laboratory through various tests such as enzyme-linked immunosorbent assay (ELISA); antigen detection tests; serum neutralization tests; reverse transcriptase polymerase chain reaction (RT-PCR); electron microscopy; and virus isolation by cell culture.

Patient samples pose an extremely high biological risk; testing must be conducted under conditions of maximum biosafety.

Vaccines and treatments

Currently, there is no vaccine for Ebola. Many vaccines are being tested, but none have yet been used in clinical trials.

Severely ill patients require intensive supportive care. Patients often become dehydrated and need oral rehydration with electrolyte solutions or intravenous fluid replacement.

There is currently no specific cure for the disease. Several new drug regimens are being evaluated.

The natural host of the Ebola virus.

In Africa, fruit bats, especially those belonging to the genera Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata, are considered natural hosts of the Ebola virus. Consequently, the geographical distribution of the Ebola virus may overlap with the bats' range of activity.

Prevention

Reducing the risk of Ebola infection in humans.

In the absence of an effective treatment and vaccine for humans, raising awareness about risk factors for Ebola infection and personal protective measures is the only way to reduce infection and mortality.

In Ebola outbreak areas, community education messages to reduce risk focus on the following elements:

- Reduce the risk of disease transmission from wild animals to humans through contact with infected fruit bats or monkeys/primates and consuming their raw meat. When handling animals, wear appropriate gloves and protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.

- Reduce the risk of person-to-person transmission in the community due to direct or close contact with sick individuals, especially through their bodily fluids.

Close physical contact with Ebola patients should be avoided.

Gloves and appropriate personal protective equipment should be worn when caring for a sick person at home.

Wash your hands frequently after visiting patients in the hospital, as well as after caring for sick people at home.

-Communities affected by Ebola need to inform people about the nature of the disease and about measures to contain the outbreak, including burial procedures. Those who die from Ebola need to be buried promptly and safely.

African pig farms may contribute to the escalation of disease outbreaks due to the presence of fruit bats on these farms. Appropriate biosecurity measures should be implemented to limit infection.

For RESTV, the focus is on reducing the risk of disease transmission from pigs to humans due to unsafe animal husbandry and slaughter practices, as well as the unsafe consumption of raw blood products, raw milk, or animal meat. Appropriate gloves and protective clothing should be worn when handling sick animals or animal tissue and when slaughtering animals. In areas where RESTV has been reported in pigs, all animal products (blood, meat, and milk) must be cooked thoroughly before consumption.

Infection control in healthcare facilities

Transmission of the Ebola virus from person to person is primarily associated with direct contact with blood and bodily fluids. Infection has been reported among healthcare workers when adequate precautions are not in place.

Early identification of Ebola patients is not always possible because initial symptoms are often nonspecific. Therefore, healthcare workers need to apply preventative measures to all patients – regardless of diagnosis – at all times and in all places.

These measures include hand hygiene, respiratory hygiene, use of personal protective equipment (depending on the risk of dispersal or other contact with contaminated material), safe injection practices, and safe burial practices.

In addition to the basic measures mentioned above, healthcare workers caring for patients suspected or confirmed to be infected with the Ebola virus need to implement further infection control measures to avoid any exposure to the patient's blood and bodily fluids and unprotected direct contact with contaminated environments. When in close contact (within 1 meter) with an Ebola patient, healthcare workers should wear face protection (face shield or medical mask and safety glasses), a clean, non-sterile gown, and gloves (sterile gloves for certain procedures).

Laboratory personnel are also at risk. Samples taken from animals and people suspected of having Ebola need to be transported by trained personnel and processed in a properly equipped laboratory.

According to Hanoimoi