Ebola virus disease (EVD), earlier referred to as Ebola haemorrhagic fever, caused by the Ebola virus, one of the most virulent pathogens, is a rare, deadly disease and often fatal illness in humans and other primates. The transmission of the virus to people is from wild animals such as chimpanzees, fruit bats, and forest antelope which then infect humans through direct contact with blood, body fluids, feces, and tissues of affected patients and with surfaces and materials contaminated with these fluids. Ebola is caused by a virus of the Filoviridae family, genus Ebolavirus. Within this genus, five species have been identified, including four that cause EVD in humans. According to the World Health Organization (WHO), currently, there is no existing data to prove airborne and droplet transmission of the Ebola virus in humans. As the virus spreads through the body, it causes necrosis of the liver and damages the immune system, ultimately activating the clotting cascade further leading to severe and uncontrollable bleeding. The average EVD case mortality rate depends on the strain. EVD first occurred in 1976 in 2 concurrent outbreaks, in southern Sudan and the Democratic Republic of Congo. The 2014 outbreak of EVD in West Africa has a historic mortality rate of up to 90%. Primary symptoms of Ebola show up after an incubation period of 2 to 21 days often includes-
- Severe headache
- Muscle and joint pain
- Weakness and fatigue
- Diarrhea and vomiting
- Abdominal pain
- Unwanted bleeding or bruising
- High fever
- Sore throat
- Lack of appetite
The clinical features can be divided into the following four main phases such as influenza-like syndrome, acute, pseudo-remission, and aggravation. Ebola haemorrhagic fever can be early diagnosed through polymerase chain reaction detection and virus isolation on Vero cells. Moreover, enzyme-linked immunosorbent assays (ELISAs), antigen-capture detection tests, serum neutralization tests, electron microscopy, and IgM antibody are the additional laboratory diagnostic tests for the detection of antigens. Presently, there is no proven treatment for the disease and there is no process to neutralize the virus but there are measures such as a variety of blood, immunological, and drug therapies that are under development. Early supportive care with fluids and electrolytes, blood pressure medication, maintaining oxygen status, and treatment of other infections can improve survival rate. Pregnant and breastfeeding women with Ebola should be offered early supportive care. Good outbreak control is to interrupt the viral transmission chain which relies on applying some preventive measures including isolation of patients, barrier precautions, identification and tracking of all contacts, ideal research laboratory service, safe and dignified burials, and social mobilization. Experimental vaccines and treatments should be offered to improve the chances of recovery and they also have been used to help control the spread of Ebola outbreaks worldwide. In October 2014, WHO licensed two favorable Ebola vaccines namely cAd3-ZEBOV and rVSV-ZEBOV. Ebola haemorrhagic fever has become a public health concern, therefore, there is an urgent need for an effective vaccine that would especially benefit doctors, nurses, veterinarians, and field epidemiologists working in endemic countries.
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