International Medical Journal, Vol. 20., Iss. 4, 2014, P. 62−67.
EBOLA VIRUS DISEASE: PRESENTATION, DIAGNOSIS, AND PREVENTION
Kharkiv Medical Academy of Postgraduate Education, Ukraine
In 2014 West African countries experience an outbreak of Ebola virus disease (EVD), which is rapidly spreading, but not out of the region, while cases of imported Ebola to other countries have already been registered. The pathogen of this infection is a very dangerous virus from the family of Filoviridae. The virus genome contains a single strain RNA. Replication of the genome undergoes with low accuracy that leads to a high RNA mutation rate thus leading to formation of new virus variants with altered antigenic structure and virulence. Epidemiologically EVD is a natural focal infection. Natural hosts of the virus are infected bats, rodents, primates, antelopes, porcupines, and others. The virus is transmitted from these animals during the contact with them, or their blood or body fluids, organs or discharge, autopsies as well as through contact with contaminated objects, or by food, as example, eating the monkey's brain. There is a possibility of accidental transmission from patients to others through secretions of the nasal mucosa, eyes, damaged skin of healthy people. Frequently health care workers are infected because of their professional activities. Clinically a latent period (incubation) ranges from 2 to 21 days (usually 8−10). The signs and symptoms are characterized by onset of high fever, signs of intoxication, sore throat later joined by abdominal pain, vomiting, melena. At the peak of EVD intoxication symptoms, abdominal pain and melena get worse. Polymorphic rash, hemorrhagic syndrome, conjunctival hyperemia, dehydration and /or toxic shock, join on the 5th−7th day. Various complications associated with bleeding can occur, while mortality reaches 90 %. A specific diagnosis is developed, using the PCR method. Symptomatic treatment must be provided; specific treatment has not been developed yet. The efficacy of ZMapp (monoclonal antibody) has recently been reported. Preventive measures are the same as in other dangerous infections. No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.
Key words: Ebola virus disease, Ebola hemorrhagic fever, Filoviridae, Democratic Republic of Congo (former Zair), ZMapp.