Video:Western African Ebola virus epidemic

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Definition 1

The Western African Ebola virus epidemic 2013 to 2016 was the most widespread outbreak of Ebola virus disease in history, causing major loss of life and socioeconomic disruption in the region, mainly in Guinea, Liberia and Sierra Leone. The first cases were recorded in Guinea in December 2013; later, the disease spread to neighbouring Liberia and Sierra Leone,[1] with minor outbreaks occurring elsewhere. It caused significant mortality, with the case fatality rate reported which was initially considerable.[1][2][3]

Definition 2

On 8 August 2014, a Public Health Emergency of International Concern was declared[4] and on 29 March 2016, the WHO terminated the Public Health Emergency of International Concern status of the outbreak.[5][6] Subsequent flare-ups occurred, the epidemic was finally declared over on 9 June 2016, 42 days after the last case tested negative on 28 April 2016 in Monrovia. In the end there were 28, 646 cases and 11, 323 people lost their lives to the virus[7]

Epidemiology

The virus spread from Guinea, Liberia and Sierra Leone to other countries on the African continent and internationally. This included Nigeria, Mali, United States, United Kingdom, Spain, Italy and Senegal.[8]

Virology

Ebola virus disease is caused by four of six viruses classified in the genus Ebolavirus. Of the four disease-causing viruses, Ebola virus formerly and often still called the Zaire Ebola virus is dangerous and is the virus responsible for the epidemic in Western Africa.[9][10]

Transmission 1

The initial infection is believed to occur after an Ebola virus is transmitted to a human by contact with an infected animal's body fluids. Evidence strongly implicates bats as the reservoir hosts for ebolaviruses however, despite considerable research, infectious ebolaviruses have never been recovered from bats.[11][12] Bats drop partially eaten fruit and pulp, then land mammals such as gorillas and duikers feed on this fallen fruit. This chain of events forms a possible indirect means of transmission from the natural host to animal populations.[13]

Transmission 2

As primates in the area were not found to be infected and fruit bats do not live near the location of the initial zoonotic transmission event in Meliandou, Guinea, it is suspected that the index case occurred after a child had contact with an insectivorous bat from a colony of Angolan free-tailed bats near the village.[14]On 12 January, the journal Nature reported that the virus emergence could be found by studying how bush-meat hunters interacted with the ecosystem.[15]

Prevention

Recombinant vesicular stomatitis virus–Zaire Ebola virus, also known as Ebola Zaire vaccine live and sold under the brand name Ervebo, is an Ebola vaccine for adults that prevents Ebola caused by the Zaire ebolavirus.[16][17][18] When used in ring vaccination, rVSV-EBOV has shown a high level of protection.[19]Around half the people given the vaccine have mild to moderate adverse effects that include headache, fatigue, and muscle pain,[19] the vaccine was not available during the outbreak because it had not been created until later.

Treatment 1

Initially there was no cure or specific treatment for the Ebola virus disease that was currently approved for market, although various experimental treatments were being developed.[20] For past Ebola epidemics, treatment had been primarily supportive in nature.[21]

Treatment 2

In October 2020, the U.S. Food and Drug Administration approved atoltivimab maftivimab odesivimab with an indication for the treatment of infection caused by Zaire ebolavirus.[22]

Prognosis

Post-Ebola virus syndrome is a post-viral syndrome affecting those who have recovered from infection with Ebola. Symptoms include joint and muscle pain, eye problems, including blindness, various neurological problems, and other ailments, sometimes so severe that the person is unable to work.[23] Although similar symptoms had been reported following previous outbreaks in the last 20 years, health professionals began using the term in 2014 when referring to a constellation of symptoms seen in people who had recovered from an acute attack of Ebola disease.[24]

References

  1. ↑ 1.0 1.1 WHO Ebola Response Team (23 September 2014). "Ebola virus disease in West Africa – the first 9 months of the epidemic and forward projections". New England Journal of Medicine. 371 (16): 1481–1495. doi:10.1056/NEJMoa1411100. PMC 4235004. PMID 25244186. ... we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection.
  2. ↑ "Case Fatality Rate for ebolavirus". University of Edinburgh. 2015. Archived from the original on 29 August 2014. Retrieved 28 January 2015.
  3. ↑ Ebola response roadmap situation report (PDF) (Report). WHO. 31 December 2014. Retrieved 1 January 2015. The reported case fatality rate in the three intense-transmission countries among all cases for whom a definitive outcome is known is 71%.
  4. ↑ Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa (Report). WHO. Retrieved 13 January 2019.
  5. ↑ Interim advice on the sexual transmission of the Ebola virus disease (Report). WHO. Retrieved 28 October 2016.
  6. ↑ WHO Director-General addresses the Executive Board (Report). WHO. Retrieved 27 January 2016.
  7. ↑ WHO (10 June 2016). Situation Report Ebola (PDF) (Report). WHO. Retrieved 11 November 2016.
  8. ↑ "2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC". www.cdc.gov. 2020-03-17. Retrieved 16 June 2021.
  9. ↑ Gire, S. K.; Goba, A.; Andersen, K. G.; Sealfon, R. S. G.; Park, D. J.; Kanneh, L.; Jalloh, S.; Momoh, M.; Fullah, M.; Dudas, G.; Wohl, S.; Moses, L. M.; Yozwiak, N. L.; Winnicki, S.; Matranga, C. B.; Malboeuf, C. M.; Qu, J.; Gladden, A. D.; Schaffner, S. F.; Yang, X.; Jiang, P.-P.; Nekoui, M.; Colubri, A.; Coomber, M. R.; Fonnie, M.; Moigboi, A.; Gbakie, M.; Kamara, F. K.; Tucker, V.; Konuwa, E.; Saffa, S.; Sellu, J.; Jalloh, A. A.; Kovoma, A.; Koninga, J.; Mustapha, I.; Kargbo, K.; Foday, M.; Yillah, M.; Kanneh, F.; Robert, W.; Massally, J. L. B.; Chapman, S. B.; Bochicchio, J.; Murphy, C.; Nusbaum, C.; Young, S.; Birren, B. W.; Grant, D. S.; Scheiffelin, J. S.; Lander, E. S.; Happi, C.; Gevao, S. M.; Gnirke, A.; Rambaut, A.; Garry, R. F.; Khan, S. H.; Sabeti, P. C. (28 August 2014). "Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak". Science. 345 (6202): 1369–1372. Bibcode:2014Sci...345.1369G. doi:10.1126/science.1259657. PMC 4431643. PMID 25214632.
  10. ↑ Kuhn, Jens H.; Becker, Stephan; Ebihara, Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka, Yoshihiro; Lipkin, W. Ian; Negredo, Ana I.; Netesov, Sergey V.; Nichol, Stuart T.; Palacios, Gustavo; Peters, Clarence J.; Tenorio, Antonio; Volchkov, Viktor E.; Jahrling, Peter B. (30 October 2010). "Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations". Archives of Virology. 155 (12): 2083–2103. doi:10.1007/s00705-010-0814-x. PMC 3074192. PMID 21046175.
  11. ↑ Griensven, Johan van; Günther, Stephan; Clerck, Hilde de; McElroy, Anita K.; Malvy, Denis (2 March 2019). "Ebola virus disease". The Lancet. 393 (10174): 936–948. doi:10.1016/S0140-6736(18)33132-5. PMID 30777297.
  12. ↑ Ng, Melinda; Ndungo, Esther; Kaczmarek, Maria E; Herbert, Andrew S; Binger, Tabea; Kuehne, Ana I; Jangra, Rohit K; Hawkins, John A; Gifford, Robert J (23 December 2015). "Filovirus receptor NPC1 contributes to species-specific patterns of ebolavirus susceptibility in bats". eLife. 4: e11785. doi:10.7554/eLife.11785. PMC 4709267. PMID 26698106.
  13. ↑ Gonzalez, J. P.; Pourrut, X.; Leroy, E. (2007). "Ebolavirus and Other Filoviruses". In Childs, J. E.; Mackenzie, J. S.; Richt, J. A. (eds.). Wildlife and Emerging Zoonotic Diseases: The Biology, Circumstances and Consequences of Cross-Species Transmission. Current Topics in Microbiology and Immunology. Vol. 315. pp. 363–387. doi:10.1007/978-3-540-70962-6_15. ISBN 978-3-540-70961-9. PMC 7121322. PMID 17848072.
  14. ↑ Mari Saez, A.; Weiss, S.; Nowak, K.; Lapeyre, V.; Zimmermann, F.; Dux, A.; Kuhl, H. S.; Kaba, M.; Regnaut, S.; Merkel, K.; Sachse, A.; Thiesen, U.; Villanyi, L.; Boesch, C.; Dabrowski, P. W.; Radonic, A.; Nitsche, A.; Leendertz, S. A. J.; Petterson, S.; Becker, S.; Krahling, V.; Couacy-Hymann, E.; Akoua-Koffi, C.; Weber, N.; Schaade, L.; Fahr, J.; Borchert, M.; Gogarten, J. F.; Calvignac-Spencer, S.; Leendertz, F. H. (30 December 2014). "Investigating the zoonotic origin of the West African Ebola epidemic". EMBO Molecular Medicine. 7 (1): 17–23. doi:10.15252/emmm.201404792. PMC 4309665. PMID 25550396. The severe Ebola virus disease epidemic occurring in West Africa likely stems from a single zoonotic transmission event involving a 2‐year‐old boy in Meliandou, Guinea, who might have been infected by hunting or playing with insectivorous free‐tailed bats living in a nearby hollow tree
  15. ↑ Callaway, Ewen (2016). "Hunt for Ebola's wild hideout takes off as epidemic wanes". Nature. Nature News & Comment. 529 (7585): 138–139. Bibcode:2016Natur.529..138C. doi:10.1038/529138a. PMID 26762436.
  16. ↑ "Ervebo (Ebola Zaire Vaccine, Live) Suspension for intramuscular injection" (PDF). Merck Sharp & Dohme.
  17. ↑ Trad MA, Naughton W, Yeung A, et al. (January 2017). "Ebola virus disease: An update on current prevention and management strategies". Journal of Clinical Virology. 86: 5–13. doi:10.1016/j.jcv.2016.11.005. hdl:10144/618818. PMID 27893999.
  18. ↑ Pavot V (December 2016). "Ebola virus vaccines: Where do we stand?". Clinical Immunology. 173: 44–49. doi:10.1016/j.clim.2016.10.016. PMID 27910805.
  19. ↑ 19.0 19.1 Medaglini, D; Siegrist, CA (April 2017). "Immunomonitoring of human responses to the rVSV-ZEBOV Ebola vaccine". Current Opinion in Virology. 23: 88–94. doi:10.1016/j.coviro.2017.03.008. PMID 28460340.
  20. ↑ Choi JH, Croyle MA (December 2013). "Emerging targets and novel approaches to Ebola virus prophylaxis and treatment". BioDrugs. 27 (6): 565–83. doi:10.1007/s40259-013-0046-1. PMC 3833964. PMID 23813435.
  21. ↑ Clark DV, Jahrling PB, Lawler JV (September 2012). "Clinical management of filovirus-infected patients". Viruses. 4 (9): 1668–86. doi:10.3390/v4091668. PMC 3499825. PMID 23170178.
  22. ↑ "FDA Approves First Treatment for Ebola Virus". U.S. Food and Drug Administration (FDA) (Press release). 14 October 2020. Retrieved 14 October 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  23. ↑ Burki TK (July 2016). "Post-Ebola syndrome". The Lancet. Infectious Diseases. 16 (7): 780–781. doi:10.1016/S1473-3099(15)00259-5. PMID 27352759.
  24. ↑ Yasmin S. "Why Ebola Survivors Struggle with New Symptoms". Scientific American. Retrieved 2020-05-27.
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