Post on 02-Jun-2018
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advanced stage, both internal and external bleeding. Laboratory findings include
leukopenia, thrombocytopenia, and elevated liver enzymes.
Historically, several cases of hemorrhagic fever have been diagnosed after long
journeys, but none developed symptoms during international travel. The long-
distance travelers (eg intercontinental) infected with virus circulation areas might
get incubating the disease and develop symptoms consistent with EVE after
arrival.
Search for contacts
Anyone who has had contact with the Ebola virus in the 21 days preceding the
onset of symptoms in at least one of the following forms is defined as a contact:
Having slept in the same house.
Having had direct physical contact with the patient (dead or alive) for the
disease.
Having had direct physical contact with the patient (dead) at the funeral.
Having had contact with blood or body fluids during illness.
Having touched the clothing or bedding.
Having been breastfed by the patient (baby).
When individuals with clinical and epidemiological support EVE history or
unexplained deaths travelers with clinical history compatible with EVE and
epidemiological history are identified, should proceed to the identification and
monitoring of contacts (although confirmatory diagnosis is pending). Monitoring
contacts must be made in 21 days (after the last known exposure to EVE).
If the patient with illness compatible with EVE developed symptoms on the plane,
the contact must be performed according to the Risk Assessment Protocol for Air-
borne transport (RAGIDA1, for its acronym in English) which indicates that
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diseases should track contact all those passengers seated 4 rows and 4 rows back
later, and the crew on board. If cleaning of the aircraft is performed by personnel
without protection, should also be considered as a contact.
When contacts between international travelers in transit, national authorities should
determine the most acceptable and least disruptive way to track contact. If the
traveler continuous journey, should inform the authorities of the host country on the
arrival of these travelers that monitoring should be done for 21 days. Information to
the authorities of the country where the traveler is directed can be done directly or
through WHO / PAHO.
Both health personnel involved in direct patient care under investigation or
confirmed case of EVE, and laboratory personnel should be registered as contacts
being monitored and maintained until 21 days after the last chance of exposure to
contaminated material.
As a follow-up contact, it is suggested to collect the following information: name,
address, relationship to the patient, the date of last exposure, contact type.
Countries should have tools for the efficient management of monitoring contacts.
For countries that do not have such PAHO / WHO tool offers what is known as
information management system in the field (FIMS, for its acronym in English) tool.
For training on this tool, contact your Country Office WHO / PAHO.
Individuals identified as contacts, while they remain asymptomatic, not requiring
the use of personal protective equipment, may remain in their daily activities and
must remain available for monitoring by health staff, reporting to health personnel
on any shift that you can imply a lack of daily monitoring. For operational reasons,
non-essential travel is discouraged contacts during the monitoring period.
Diagnostic Laboratory
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Once an individual with disease compatible with EVE is identified, it must be
sampled (whole blood and / or serum) for the diagnosis. The sample shall be taken
by trained health personnel, taking extreme biosecurity measures, and additional
protective equipment (gloves, masks, eye protection, preferably with anti-fog visor).
This sample should ideally be taken at the hospital designated to handle cases
compatible with EVE and sent to the national reference laboratory.
In the case of a deceased with clinical and epidemiological history compatible with
EVE patient, we suggest taking an oral swab. In these situations, the autopsy is
contraindicated.
The Ebola virus is classified as Risk Group 4 pathogen, so it needs to be handled
in an equivalent level of biosecurity.
Recognizing that patients with symptoms compatible EVE can be detected at
different levels of health care system or entry points, which must be handled using
standard precautions for infection control, the following are recommended:
The patient should be transferred and operated in a designated health facility
which must comply with the following features:
Conditions for contact isolation,
Providing appropriate personal protective equipment, and
trained health personnel in prevention and control of infections.
Use of personal protective equipment during transport:
The direct care staff of patient must wear gloves, impermeable gowns,
surgical masks, eye protection (preferably with anti-fog visor) and closed
shoes.
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The driver does not need to use personal protective equipment unless it
provided a possible direct contact with the patient.
Precautions in direct contact with the patient
Restrict the number of staff dedicated to patient care.
Limit the number of visits.
Keep a log book of both the staff in charge of patient care and visits.
Use of PPE by both health personnel and visitors.
Hand wash.
Use of surgical masks, protective eye-preferably with anti-fog visor,
waterproof apron, gloves and closed shoes before entering the patient's
room.
Remove PPE before leaving the isolation area. Special care should be
taken when removing PPE to avoid contact with eyes and mucous
membranes.
Designate personnel dedicated to monitoring the correct use of PPE both
health personnel and visitors.
In general, we recommend using disposable personal protective equipment.
When you can not get or do not count on old equipment, the following items
can be reused after disinfection Proceed:
Eyewear: must first be washed with soap and water and then disinfected
with 70% alcohol.
waterproof gowns or aprons that can not be sent to the hospital laundry
should be disinfected with hypochlorite 0.05%.
Safe disposal of corpses
The body should remain intact and should be limited handling.
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Recognizing the existence of rituals and burial practices deeply rooted in
different cultural and religious contexts, is crucial to ensure the safe disposal of
carcasses to limit the spread of EVD. The body must not be embalmed. The
same should be disinfected with hypochlorite solution 0.5%, placed in resistant
liquid filtration body bags, which must be properly closed and placed in a closed
casket before burial. The staff for the handling and disposal of bodies should be
appointed, equipped, trained and supervised by the national public health
authorities to implement the management of bodies under biosafety conditions.
clinical Management
Currently, there is no specific treatment that has shown efficacy in the treatment
of EVE.
The overall clinical support is critical. Severe cases require intensive care
nursing, with strict isolation. Patients often are dehydrated and require oral
rehydration solutions containing electrolytes or intravenously.
Shall be limited invasive procedures confirmed both EVE and EVE patients
under investigation for cases.
Criteria for patient isolation suspension:
The duration of patient isolation precautions must determine on a case, once
the symptoms disappear, and considering the laboratory information.
special Considerations
Breastfeeding: Because the virus is transmitted through breastfeeding is
recommended that you do not breast symptomatic women under
investigation for EVE EVE or confirmed cases.
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Since Ebola virus can be transmitted through the semen for up to seven
weeks after the patient's recovery, health authorities recommend that
nursing should men abstain from sexual activity or to use condoms.
Personal Health
All institutions, at different levels of the health care system, as well as all health
care workers (clinicians, public health professionals, laboratory, cleaning staff
etc.) must be constantly informed about:
The EVE outbreak in West Africa, as well as the recommendations
issued internationally. Evolution
On the characteristics and patterns of disease transmission.
on any type of protocol that the country has developed, is developing or
is changing for all types of response or request.
Based on its analysis of health personnel should be trained to respond to the
situation in priority to the implementation of prevention and control of infections
and the systematic and comprehensive collection of comprehensive travel
history of the patient.
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(2)Thrombocytopenia: is any situation of decreasing the number
of circulating platelets in the blood below normal levels, that is, with a
latelet count below 100,000 / mm.
(3)Hypovolemic: is a decrease in circulating blood volume or
any other body fluid due to multiple factors such as hemorrhage,
deh dration burns amon others.
(4)Hematocrit: A blood test that measures the percentage of
whole blood volume that consists of red blood cells. This measurement
de ends on the number of red blood cells and their size.
(5)Fomites: is any lifeless object or substance that is capable
of transporting infectious organisms such as bacteria, viruses, fungi or
parasites from one individual to another. Skin cells, hair, clothes, and sheets
are common sources of contamination in hospitals.
(6)Mortality: Number of people who die in a place and a certain
time period in relation to the total population.
(1)Ebola: Virus ribonucleic acid in humans produces fever,
muscle aches, vomiting, diarrhea, bleeding and destruction of internal
tissues.
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(10)Leukopenia: Decrease in number of leukocytes in the blood
below 4000 per cubic millimeter.
(7)Outbreaks: The emergence of a disease problem or health
risk in an area previously free of it.
(8)fluids: a set of substances where there is little between
molecules attractive force, changing its shape, which causes the molecules
take their position varies to a force applied to them, because just flowed.
(9)Autopsy: Study and examination of organs, tissues or
bones of a corpse to find out or investigate the cause of his death.
(11)urticaria: They are red welts, raised, often itchy appearing
on the surface of the skin and are usually an allergic reaction to food or
medicine.
(12)Purple: The presence of patches and purplish spots on the
skin and mucous membranes, including the lining of the mouth.
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(13) Fever: Increased body temperature above normal, which is
accompanied by an increased heart rate and breathing, and expresses the
reaction of the body against disease.
(14)Gravis: Muscle weakness or fatigue, which impairs or
prevents the muscles to perform tasks that normally are easily made.
(15)Headache: Severe and persistent headache that is
accompanied by a feeling of heaviness.
(16)Vomiting: Vomiting (violent expulsion from the mouth
of what is contained in the stomach).
(17)Diarrhea: intestinal disorder characterized by the higher
frequency, fluidity and often stool volume.
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24 specificity of a test is the probability that a healthy person has a negative
test result.
25 PCR: "Polymerase chain reaction" is a biomedical technique for obtaining
large amounts of molecular sequence of DNA or RNA replicated from samplesin very small amounts of these DNA or RNA.
26 emerging: that experiences a high rate of economic growth and rapid
industrialization, accompanied by a predisposition to international trade.
27 zoonoses: is said to own any animal disease that may incidentally reach
people.
28 isolation: it is the quality that has an item, alive or not, which is separated
without contact with others.
29 Pandemic: Epidemic disease that extends to many countries or attacks
almost all individuals in a locality or region.
30 influenza: infectious, acute contagious disease caused by a virus that
attacks the respiratory system and causes fever, headache and a feeling of
malaise.
31 tuberculosis: Infectious disease caused by a bacillus which is transmittedthrough the air and is characterized by the formation of tubers or nodules in
the infected tissues; can affect different organs of the body, especially the
lungs, causing a dry cough, fever, bloody sputum, and weight loss.
32 contingency: For one thing happens or does not happen.
33 locus: is also locus) is fixed on a chromosome, such as the position of a gene
or a marker (genetic marker) position.
34 Hemic: What is blood-borne.
35 Disinfection: its main purpose cleaning surfaces or spaces in which humans
and animals are living or who have contact with
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36 hiplocorito: Prepared chemical for domestic, industrial or medical
application that acts as an antiseptic, oxidizer and disinfectant bleach. Upon
contact with the skin causes skin lesions, but if swallowed can cause death.
37 Handwashing: is the vigorous rubbing of hands beforehand soapy followedby rinsing with water, in order to remove dirt, organic matter, normal and
transient flora and thus avoid transmission of these organisms from person to
person.
38 Prevention: Measure or provision that is taken in advance to prevent it
from happening considered a negative thing.
39corporeal: what you can see and touch, possessing matter or material,
consistency and volume
40 invasive: the one that uses one or more medical techniques that invade the
body, with a diagnostic or therapeutic purpose.
41 Mortality: Number of people who die in a place and a certain time period in
relation to the total population.
42 Morbidity: Number of people falling ill in a place and a certain time period
in relation to the total population.
43 Nosocomial: What shrinks during the stay in a hospital environment.
44 mask: Object or piece of cloth or paper is placed over the nose and mouth
and secured with a rubber band or headband to prevent or facilitate the
inhalation of certain gases or substances.
45 Immunity: is associated with the state of resistance to the pathogenic
action of microorganisms or foreign substances.
46 hemograma: Description and number of the different kinds of cells found
in a given amount of blood and the ratios between them.
47 IgG: one of the five classes of humoral antibodies produced by the
organism
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48 IgM: is one of the five immunoglobulin isotypes (G, A, M, E, D) present in
mammals, constituting 6% of the population present in blood.
49 ELISA TEST: a blood test for detecting HIV.
50 cetaminofn: analgesic and antipyretic Drug prescribed to treat mild to
moderate pain and for the treatment of fever.
51 BLISTER: Lump appearing on the skin as a small bag of fluid, because of
sunburn, chafing or illness.
52 Itching: Tightness felt in a body part that causes the need to scratch.
53 FLASH: A reaction that is triggered by a body part or tissue of an organ,
characterized by redness in the area, increasing its volume, pain, warmth andfunctional disorders, which can be caused by pathogens or irritants; It can
also occur from a blow.
54 DEHYDRATION: Removal of water that contains a substance, organism or
living tissue.
55 Homeopathy: Healing Method of certain diseases based on the application
of small amounts of substances that, if implemented on a large scale to a
healthy person, would produce the same symptoms that are intended tocombat.
56 Antiviral: It fights viruses.
57 Septic: What is or has been contaminated by germs. Of or pertaining to
sepsis.
58 retina: inside the eye membrane in which the luminous impressions are
transmitted to the brain is receiving; covers the choroid to the iris and
consists essentially of expansion of the optic nerve.
59 Blindness: Lack of sense of sight; can be complete or very pronounced and
affect one eye or both.
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60 anemia: syndrome characterized by abnormal decrease in the number or
size of red blood cells containing blood or hemoglobin level.
61 hypovolemia: Decrease the total volume of blood circulating through the
body.
62 convulsions: presents as involuntary twitching of a muscle, a group muscle
or set of muscles throughout the body.
63 hemostatic: Containing or stops bleeding.
64 Amenorrhea: Absence of menstruation..
65 epistaxis: Nosebleed.
66 Hemolysis: Destruction of red blood cells or red blood cells that is
accompanied by release of hemoglobin.
67 mane: is expelling stool (feces) black, sticky, smelly due to the presence of
blood from the digestive tract degraded upper.
68Hematemesis: Vomiting of blood from the digestive system.
69 uterine bleeding: uterine bleeding outside the menstrual period
70 Hemophilia: A hereditary disease characterized by defective blood clotting
due to lack of one of the factors involved in it and that is manifested by a
persistent bleeding.
71 petechiae: are small red lesions formed by leakage of a small number of
erythrocytes is damaged when a capillary.
72 mucosa: is a layer formed by epithelium and loose connective tissue
underlying (lamina propria) lining the inner walls of the organs in contact withthe outside of the body.
73 vein: a duct or blood vessel responsible for carrying blood from the
capillaries toward the heart.
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74 Artery: A blood vessel that carries blood from the heart to the various
parts of the body.
75 pore: the one that is used to refer to all small air gaps can be found in an
area.
76 Gum: mucosa with fibrous tissue, pale reddish color that surrounds the
neck of the teeth
77 Stomach: Widening the digestive tract of man and other animals located
between the esophagus and intestine, whose walls are the glands that secrete
gastric juices involved in digestion.
78 Esophageal gastrointestinal muscular duct that connects the pharynx to
the stomach.
79 tachycardia: Excessive speed the pace of the heartbeat.
80 ear: The ear shaped organs of balance and hearing. Also called
vestibulocochlear organ within the study of medicine.
81 Eye Gaze, expression of eyes to look or how.
82 Nose: Outgoing Part of the human face between the eyes and mouth, with
two holes in the bottom and used to breathing and smelling.
83 body: functional unit of a multicellular organism is a structural unit and
performs a particular function
84 uterus: Internal Organ female reproduction in viviparous animals in which
the fetus develops.
85 ureter is retroperitoneal urinary shaped tube that carries urine from the
kidney to the urinary bladder mucosal lining which is of mesodermal origin
86 Lung: respiratory system organ located in the thoracic cavity, formed by a
pink connective tissue and soft, elastic and fluffy.
87 Coagulation Action coagulate or clot
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88Putrid: Rotten, rotten, stinking
89 ulcer: sore or lesion appears on the skin or mucosal tissue due to a loss of
substance and does not tend to scarring.
90 Neuron: Cell nervous system consists of a core and a number of extensions,
one of which is longer than the other
91 thrombus: blood clot that forms inside a blood vessel.
92 viscera: internal organ of the body of humans or animals, cranial contents
into the abdominal cavity, or chest.
93 shock: state of profound nervous and circulatory depression without loss of
consciousness that occurs after experiencing a shock or a strong shock, asblunt trauma or surgery.
94 stasis: Stopping progression or stagnation of blood or other substance in a
body organ.
95 Trauma: Injury or damage to body tissues or bones caused by some
external violence, as a blow, a twist or otherwise.
96 hyperthermia: increased body temperature above normal.
97bradycardia: Drop in heart contraction frequency of 60 beats per minute.
98 sweating: Sweating heavily.
99 Anasarca: is a medical term that describes a form of edema or
accumulation of massive and widespread throughout the body fluids
100 thrombocytopenia: decrease in platelet count of less than 100, 000.