Notes

My Genius Hour Project Notes Audrey Pham
Signs and Symptom:
Fever
Severe headache
Muscle pain
Weakness
Fatigue
Diarrhea
Vomiting
Abdominal (stomach) pain
Unexplained hemorrhage (bleeding or bruising)
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

Transmission:
Because the natural reservoir host of Ebola viruses has not yet been identified, the way in which the virus first appears in a human at the start of an outbreak is unknown. However, scientists believe that the first patient becomes infected through contact with an infected animal, such as a fruit bat or primate (apes and monkeys), which is called a spillover event. Person-to-person transmission follows and can lead to large numbers of affected people. In some past Ebola outbreaks, primates were also affected by Ebola and multiple spillover events occurred when people touched or ate infected primates.

When an infection occurs in humans, the virus can be spread to others through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with or has died from Ebola, objects (like needles and syringe)s that have been contaminated with body fluids from a person who is sick with Ebola or the body of a person who has died from Ebola, infected fruit bats or primates (apes and monkeys), and possibly from contact with semen from a man who has recovered from Ebola (for example, by having oral, vaginal, or anal sex) Ebola is not spread through the air, by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bush meat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitoes or other insects can transmit Ebola virus. Only a few species of mammals (e.g., humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.

Healthcare providers caring for Ebola patients and family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids.

During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate personal protective equipment.

Dedicated medical equipment (preferably disposable, when possible) should be used by healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as needles and syringes, also are important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of instruments, virus transmission can continue and amplify an outbreak.

Ebola virus has been found in the semen of some men who have recovered from Ebola. It is possible that Ebola could be spread through sex or other contact with semen. It is not known how long Ebola might be found in the semen of male Ebola survivors. The time it takes for Ebola to leave the semen is different for each man. Based on the results from limited studies conducted to date, it appears that the amount of virus decreases over time and eventually leaves the semen. Until more information is known, avoid contact with semen from a man who has had Ebola. It is not known if Ebola can be spread through sex or other contact with vaginal fluids from a woman who has had Ebola.

Prevention:
There is no FDA-approved vaccine available for Ebola.

If you travel to or are in an area affected by an Ebola outbreak, make sure to do the following:

Practice careful hygiene. For example, wash your hands with soap and water or an alcohol-based hand sanitizer and avoid contact with blood and body fluids (such as urine, feces, saliva, sweat, urine, vomit, breast milk, semen, and vaginal fluids).
Do not handle items that may have come in contact with an infected person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).
Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.
Avoid facilities in West Africa where Ebola patients are being treated. The U.S. embassy or consulate is often able to provide advice on facilities.
Avoid contact with semen from a man who has had Ebola until you know Ebola is gone from his semen.
After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms of Ebola.
Healthcare workers who may be exposed to people with Ebola should follow these steps:

Wear appropriate personal protective equipment (PPE).
Practice proper infection control and sterilization measures. For more information, see U.S. Healthcare Workers and Settings.
Isolate patients with Ebola from other patients.
Avoid direct, unprotected contact with the bodies of people who have died from Ebola.
Notify health officials if you have had direct contact with the blood or body fluids, such as but not limited to, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola. The virus can enter the body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth.


Did Scientists Just Discover a Cure for Ebola?:
Ebola by Frederick Murphy CDC
Scientists in Canada announced the successful treatment of Ebola viral infection in monkeys. The encouraging results were published in the journal Science Translational Medicine on June 13.

Researchers from the National Microbiology Laboratory in Winnipeg, Manitoba identified a number of antibodies that corresponded to proteins on the shell of the Ebola virus. They combined the antibodies into a specific cocktail and administered it to four macaques within 24 hours of infection. All four macaques survived. When the cocktail was administered within 48 hours of infection, two of four macaques survived.

Why is the survival of a few monkeys such big news? Ebola hemorrhagic fever, a disease caused by infection with the Ebola virus, is one of the most deadly and little-understood diseases in the world. There is no vaccine, no standard treatment, and the origin of the virus remains unknown.

Your cheat sheet on Ebola virus

Ebola virus was first recognized in 1976 in Zaire (now the Democratic Republic of Congo) in an outbreak that affected 318 people and resulted in 280 deaths. The virus and its five subtypes belong to a family of viruses called Filoviridae; only four of the five subtypes have caused disease in humans. The virus affects humans and non-human primates, but the natural reservoir of Ebola remains unknown. This means the exact origin and natural habitat of the virus are a mystery, with significant implications for treatment and prevention.

Scientists believe Ebola spreads through zoonotic transmission- that is, coming from an animal. The first patient of an Ebola outbreak is thought to be infected through contact with an infected animal. From there, the virus can spread to other humans through direct contact with blood or body fluids. Outbreaks often occur in healthcare settings (known as nosocomial transmission), as patients seek treatment in facilities where appropriate infection-control may not be practiced. The symptoms of Ebola are somewhat nonspecific at first. Within 2-21 days of exposure, patients usually experience fever, headache, joint and muscle aches, sore throat, and weakness, later followed by diarrhea, vomiting and stomach pain. Some patients also experience rash, red eyes, hiccups and bleeding. From the onset of symptoms, Ebola can kill a patient within a matter of days.

There is no known treatment for Ebola in humans. Doctors can offer supportive therapy, such as hydration, oxygen and treatment of complicating infections, but mortality rates are still very high. Because the natural reservoir and origin of transmission remains unknown, there are no established methods of primary prevention. Instead, prevention efforts focus on outbreak control in healthcare settings.

There have been 28 documented outbreaks, with 2,288 human cases and 1,331 deaths. The most recent Ebola outbreak, according to the CDC, was a single case in Luwero district, Uganda in May 2011.

A cure for human Ebola infection? Not just yet.

What does this recent advance mean? Can we expect a post-exposure treatment for humans? Or better yet, a vaccine? Scientists caution this is certainly a big step forward, but many challenges remain before the treatment can be applied to an outbreak in humans. For example, the amount of antibodies needed to treat a larger group of people would be difficult to manufacture.

For a first-person account of the initial detection of the Ebola virus, listen to this interview from NPR’s Talk of the Nation with Peter Piot, a member of the 1976 team who first identified Ebola, as he discusses his memories of the discovery and his long career in virology