Summary/Outline of Ebola Virus Presentation By Stephanie Cheng and Jenny Hsieh What is the Ebola virus?

Background (description and history) Biological Basis Where its found Transmission/Contacts Symptoms Diagnosis Containment Therapy Ebola in the news/article Questions/issues raised in the news II. III. Picture of the virus Background - One of the most virulent viral diseases known to humankind - Most cases result in death - First identified in 1976 in Sudan and a region formerly known as Zaire now called Democratic Republic of the Congo - June-November 1976: 284 people infected in Sudan, 117 died - September and October: 318 cases in Zaire resulting in 280 deaths - Second outbreak in Sudan in 1979 - Viral hemorrhagic fevers are caused by viruses from four families: filoviruses, arenaviruses, flaviviruses, and bunyaviruses - Ebola is one of two types of filoviruses - There are four subtypes of Ebola virus: Ebola-Zaire, Ebola-Sudan, and Ebola-Ivory Coast which all caused disease in humans. The fourth subtype, Ebola-Reston, has only caused disease in nonhuman primates

Biological basis (see bottom of page)

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Where it is found - Exact origin, natural habitat (natural reservoir), and locations are unknown - Believed to be zoonotic (animal born) a disease communicable from animals to humans under natural conditions - Maintained in an animal host that is native to Africa Transmission - Transmitted by direct contact with blood, secretions, organs or semen of infected persons - Re-use of contaminated syringes and needles, as was the case in the 1976 epidemic in Zaire - Still possibility of infection for a short time after recovery, so the virus can be spread through sexual activity

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Symptoms (*put chart from CDC handout here*) - Incubation period is 2-21 days
Symptoms that occur in most Ebola patients high fever, headache, muscle aches, stomach pain, fatigue, diarrhea chest pain, shock, and death Symptoms that occur in some Ebola patients sore throat, hiccups, rash, red and itchy eyes, vomiting blood, bloody diarrhea blindness, bleeding

Time Frame Within a few days of becoming infected with the virus: Within one week of becoming infected with the virus:

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Containment - Infected persons are quarantined - Doctors and nurses use extreme care when treating patients - Patients who die from the disease should be buried or cremated immediately - Limiting the import of monkeys - Goal to rely on domestic breeding of monkeys to prevent the potential importation of monkeys that are carrying the disease - Burying ppl; pore bleach on bodies, take coffins and bury them in restricted areas - When leaving, people spray themselves with bleach Therapy - No treatment or vaccine exists - However, experiments are being performed on filovirus vaccines - Using drugs to treat viruses similar to Ebola Ebola in the news - Outbreak officially declared/confirmed Oct. 14th, 2000 in Uganda - Lasted 3 months, killed 162 ppl

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Cure-treatment high- titered hyperimmune horse anti-Ebola serum has been produced and been found protective in baboons challenged w/ the ebola virus; confirmed efficacious in guinea pigs, not as useful in rhesus monkeys or the mouse model of ebola virus infection production of monoclonal (forming or derived from a single clone) antibodies against ebola virus surface protein from mRNA extracted from bone marrow of Kikwit survivors raises the possibility that an improved, standardized, safe, and replenishable source of therapeutic antibodies could be developed. vaccines show to protect mice and guinea pigs from Ebola-like viruses (SA) new vaccine, works against the strain that infects humans (SA)

Doctor dies - Dr. Matthew Lukwiya - First to identify recent outbreak in Uganda in October, medical superintendent of Lacor Hospital

Biological basis Cytokine??? Necrosis, endothelial Evidence of mRNA activation of multiple cytokines- which are believed to play a part in causing several forms of shock and specific defects in vascular permeability in Filovirus infections (studied in vitro) Glycoprotein: a macromolecule consisting of one or more polypeptides linked to short chains of sugars In specific infections of humans and primates, the soluble glycoprotein which shares ~300 amino acids with the viral glycoprotein. The viral glycoprotein is produced through transcriptional editing of the same gene This protein is said to serve as a immunologic decoy, preventing an effective immune response. Necrosis? Other things prevent immune system from working, including extensive necrosis of spleen and lymph nodes from fatal human and nonhuman primate cases Extensive infection co-localized necrosis found in many organs what kills a person is the immune system does not work; infection and necrotic lesions are so fatal that nothing seems to be able to fight it Virus appears relatively refractory to the antiviral effects of interferon virus cannot be stopped by our immune systeminterferon is a defense protein which our body produces to fight viruses. Dunno how viruses defend themselves from attacks of the body Recent studies, virus inhibits gene induction (during embryonic development, the influence of one group of cells on another group of cells) by interferons and double-stranded RNA in endothelial cells, effects that could be relevant to pathogenesis