Ebola Virus Infection: General Overview, Statistics, Diagnosis, and Treatment

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Introduction

Origin and the discovery of the disease

The Ebola disease is a fatal infection that affects human beings and other primates. It is believed that the Ebola virus got its name from where it was first discovered. The virus causing the fever was first reported along the Ebola River Valley in Zaire, Africa. In 1976, there was an immense outbreak in Zaire, which is believed to be the first outbreak. In the Zaire outbreak, 381 cases were reported and they resulted in 280 deaths. In the same year, a concurrent outbreak was reported in Sudan. In Sudan, the Ebola cases in the initial outbreak were 284 with 151 deaths (Laupland & Valiquette, 2014).

A young Belgian scientist, Peter Piot, discovered the Ebola virus in 1976. This was after the Zaire outbreak. A Belgian nun who was working in Zaire had contracted the virus and her blood sample taken to Belgium. Dr. Piot received the sample in his Antwerp from the nun who had fallen ill with an unknown sickness. Piot was required to screen the sample for yellow fever but the results were negative. Tests for other pathogens were done but they all turned negative. After several tests and thorough research, it became apparent that the virus in the sample was strange and deadly (Vandenbruaene, 2007). Later, Piot and his team traveled to Zaire where they discovered that direct contact was vital in the virus transmission.

Statistics

Ebola fever is relatively rare and contributes to a small percentage of global disease burden even in African. Nonetheless, Ebola has an extremely high case-fatality rate, especially in West Africa. For instance, the first outbreak in Zaire had an 88% case-fatality rate (Laupland & Valiquette, 2014).

The 2014 outbreak in West Africa is probably the most extensive. During the outbreak, more than 4500 cases were reported. Among the reported cases, 2296 were fatal. The outbreak affected five countries, including Guinea, Liberia, Nigeria, Senegal, and Sierra Leone (WHO Ebola Response Team, 2014).

Pathogen

The Ebola viruses belong to the Filovirus family whose major characteristic is the negative-sense ribonucleic acid. The viruses family has a genome organization comparable to paramyxoviridae. The viruses can be grouped into four subcategories, including the Zaire, Ivory Coast, Sudan and the Reston strains. It is imperative to note that the Zaire strain is the most dangerous among the four and is attributed to the highest number of deaths. Moreover, it is worth noting that the Reston strain has only affected nonhuman primates in the US with no reported human fatalities.

The virus has a 19 kb long and 80 nm diameter genome that has seven open reading frames encoding structural proteins.

Transmission

It is worth noting that the natural reservoir host is yet to be discovered. Therefore, the initial appearance of the virus at the onset of an outbreak is not known. Nevertheless, researchers and scientists hold the belief that animal to human spreading is facilitated by physical contacts. Human beings are likely to be infected from animals like nonhuman primates and the fruit bat. The virus spreads from animals to human beings through a process commonly referred to as spillover. Spillovers occur during hunting or butchering of infected animals (Jin, 2014).

The virus spreads at a higher rate in person-to-person transmissions than from animals to human beings. Person-to-person infections of the Ebola viruses are facilitated by direct physical contact with infected persons. The pathogens movement and infection are facilitated by direct contact with fluids of an infected person. Some of the body fluids that transmit the viruses include saliva, sweat, stool, and blood (Jin, 2014).

The viruses move into a new host through noses, mouth, eyes, and other openings. It is worth noting that objects such as needles and syringes facilitate the spread of the Ebola viruses.

The viruses enter the human body, especially with the aid of mucous membranes. The viruses penetrate through the skin and end up affecting various cells. The first cells to be affected are the Macrophages after which the Ebola viruses replicate rapidly. More cells are affected leading to tissues and organs damage. Organs and tissues that are mostly affected include the liver and the spleen. Apparently, organ damage is what results in death.

Signs/symptoms and diagnosis

Early diagnosis of Ebola is made difficult by the fact that early symptoms are nonspecific/not limited to Ebola. For instance, it would be inaccurate to say that a patient with a high fever is suffering from Ebola. Other diseases such as malaria and typhoid also have similar symptoms.

For an accurate diagnosis, therefore, samples from patients should be collected for laboratory tests (Laupland & Valiquette, 2014). Diagnosis can be done through three stages of the disease, as summarized in the following table.

Timeline of Infection Diagnostic tests available
Within a few days after symptoms begin
  • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
  • IgM ELISA
  • Polymerase chain reaction (PCR)
  • Virus isolation
Later in disease course or after recovery IgM and IgG antibodies
Retrospectively in deceased patients
  • Immunohistochemistry testing
  • PCR
  • Virus isolation

The incubation period for the disease oftentimes lasts for a minimum two days to a maximum period of three weeks. Key symptoms include high fever, severe headache, anorexia, nausea/vomiting, myalgias and gastrointestinal infections. At advanced stages, patients of Ebola manifest with organs malfunctioning and severe internal/external bleeding (Jin, 2014).

Treatment/or management

According to the Center for Disease Control and Prevention (CDC), FDA-approved vaccines for Ebola are yet to be discovered. Nonetheless, the fever can be treated categorically with the degree of complications and symptoms manifestation. Some of the interventions that can augment patient outcomes include providing intravenous fluids (IV); balancing body salts; proper ventilation to maintain relevant oxygen status and blood pressure; and prompt treating of associated infections.

It is imperative for patients to be given proper and the best supportive care since care is vital in the recovery processes. Additionally, it is worth noting that patients with strong immunity have higher survival rates if proper care is given and early interventions made.

Summary

The Ebola virus was discovered approximately fifty years ago by a Belgian infectious diseases researcher. The discovery was prompted by an outbreak in Zaire, Africa. Consequent research revealed the characteristics of the virus. The disease has some symptoms that can be mistaken for the symptoms of other diseases such as malaria or typhoid. Therefore, lab tests are the most accurate form of Ebola virus diagnoses.

Notably, the disease contributes to a small percentage of deaths in Africa but has a very high case-fatality ratio. More than 50% of reported cases result in deaths. The virus is transmitted by direct contact with infected human (body fluids) and nonhuman primates. Additionally, bats have been linked to the transmission of the virus. In the human body, the Ebola viruses affect numerous cells starting with Macrophages cells. The viruses then replicate rapidly leading to further damaging of body cells and eventually damaging body organs. The damaging of organs and tissues is what leads to death.

Research for a vaccine is ongoing but the diseases can be managed/treated to avoid deaths. Extra care should be provided during treatment for augmented results. In addition, caregivers should protect themselves from infections.

References

Centers for Disease Control and Prevention. (2015). Diagnosis. Web.

Jin, J. (2014). Ebola Virus Disease. The Journal of the American Medical Association, 312(18), 1942. Web.

Laupland, K. B., & Valiquette, L. (2014). Ebola Virus Disease. Canadian Journal of Infectious Diseases and Medical Microbiology, 25(3), 128-129.

Vandenbruaene, M. (2007). Interview with Peter Piot. Sexualy Transmitted Infections, 83(6), 436440. Web.

WHO Ebola Response Team. (2014). Ebola Virus Disease in West Africa  The First 9 Months of the Epidemic and Forward Projections. The New England Journal of Medicine, 371(16), 1481-1495. Web.

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