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EBOLA and MARBURG Viral Infections
Dr.T.V.Rao MD
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Viral Hemorrhagic fevers The term v ira l hem orrh agic fever refers to a c l in ical
syn dro m e ch aracter ized by acute ons et of fever acco m panied by n on spec i f ic find ing s of malaise,pro st ra t ion, d iarrhea,and headach e. Pat ients f requent ly
sho w s igns of inc reased vascular permeabi l i ty, and m any develop bleeding d iatheses . The hem orrh agic fever vi rus es represent po tent ial agents fo r biolo gic w arfare because of capabi l i ty of aeroso l t rans m iss io n,h igh m orbid i ty,and m or ta li ty asso c iated w i th infec t ion ,
and abi l i ty to repl icate in cel l cul tu re in h igh co nc entra t ions . , The im po rtant infect ing agents are Ebola and Marbu rg
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Ebola and Marburg Virus
Ebola and Marburg viruses are highly virulent inhumans and non human primates, ends indeath.
Both the viruses are identified to cause Africanhemorrhagic fevers
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FilovirusFilo is Latin for Thread
Marburg and Ebolaare members of theFiloviridae
Appear as longthreads,
Can be U shaped, Genome 19 kb long Enveloped viruses. A single stranded,
unregimented, -Helical, ve senseRNA genome
80 nm Diameter
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Events on Ebola Ebola virus were discovered in 1976 with
occurance of two severe epidemics of hemorrhagic fever in Sudan and Zaire.
The Epidemic invloved > 500 persons and killed >400 infected individual.
The importance of epidemic lies with in eachoutbreak hospital staff become infected throughclose contact with patients, their blood and
excreta. The mean time of death from onset to symptomsis 7 8 days.
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Events on Marburg
Marburg Viruses were discovered in 1967 First identified in Laboratory workers
exposed to tissues of African greenMonkeys imported to Germany andYugoslavia.
Transmission from patients to Medical
personal occurred with highly mortality. Marburg virus can infect Guinea pigs, Mice,
Hamsters, Monkeys
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Epidemic Outbreaks of Marburg
Out breaks occured inKenya, South Africa,Democratic Republicof Congo.
Recent outbreak in Angola in 2005
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Ebola Patient
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Reservoir Hosts Reservoirs can be a
Rodent or Bat Humans infected
accidentally
Monkeys are not provedas reservoirs as die withinfection early
Infected humans are richsource of infections toothers.
By direct contact withblood and body fluids of infected persons canspread the disease
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Spread of Infections
Transmission appears to be associated withcontamination of Blood, Blood stained bodyfluids or tissues.
Nosocomial spread is common mode of spread, Doctors and Nurses at risk whenattending the patients.
Transmission by sexual intercourse has beenon record from a case of man infecting hiswife 83 days after initial infection.
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Viral Replication
The viruses are grownin variety of cell lines
includingVeroM A 104
S W 13 cellsFiloviruses replicates in
the cytoplasam
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Pathology and Pathogenesis
The viruses belong togroup of Filoviruses
The viruses havetropism for
Cells of macrophage systemDendritic cells
Interstitial fibroblastsEndothelial cells
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Mode of Spread
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Virus infect several Organs
High titer of viruses are foundinLiver Spleen,LungsKidneysBloodOther Body fluids
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How the Illness is Presented inMarburg and Ebola
Fever Head ache Sore throat
Muscle pain Abdominal pain, Vomitting Diarrhea Incubation period 3 -9
days in Marburg In Ebola 2 21 days.
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Serious manifestation of Ebola and Marburg
Internal andExternalbleeding,
Shock,Death
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Diagnosis
Viruses are isolatedfrom Blood by cellculture on Vero
cells ( Vero E 6 ) ELISA for antigen
detection
ELISA for IgM RT - PCR
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Control of Infection
Isolation facilitieswithin the Hospitalremain the most
important effectivemeasure. Barrier nursing
remain the basicneed in control of infection spread
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The health care workers should
Avoid
InfectedBlood,secretions,
Tissues,Wastes
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Treatment of Ebola and Marburg
Antiviral drugs are not available
Interferons are not effective To date no Vaccine Electrolyte corrections
Dealing with hemorrhagic complications .
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Barrier Nursing remains the onlybest option in Prevention
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Created for Health
awarness on Filoviruses Dr.T.V.Rao MD
Email [email protected]