Ebola Fix Presentasi

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    EbolaThe Deadly African Virus

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    Ebola Virus Introduction

    First appeared in Africa 1976

    African Hemorrhagic Fever

    acute,mostly fatal disease causes blood vessel bursting

    systemic (all organs/tissues)

    humans and nonhuman primates

    Excluding 2000 outbreak

    1,500 cases

    over 1,000 deaths

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    Ebola Epidemiology

    Reservoirs in Nature largely unknown

    possibly infected animals (primates?)

    Transmission

    direct contact blood/secretions of infected person

    possible airborne(Reston primate facility)

    Onset of illness abrupt

    incubation period: 2 to 21 days

    infections are acute and mostly deadly

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    Latest Morbidity and Mortality Reports

    Ebola-Reston Virus Infection Among QuarantinedNonhuman Primates -- Texas, 1996

    report describes death and blood testing of cynomolgusmonkey imported from the Philippines held in a private

    quarantine facility in Texas

    Outbreak of Ebola Hemorrhagic Fever ---Uganda,August 2000--January 2001

    report describes surveillance and control activitiesrelated to the EHF outbreak

    presents preliminary clinical and epidemiologic findings

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    Ebola Taxonomy

    Scientific Classification

    Order: Mononegavirales

    Family: Fi lovir idae

    Genus: Ebola l ike viruses

    Species: Ebola

    Subtypes Ebola-Zaire, Ebola-Sudan,Ebola-Ivory Coast

    disease in humans

    Ebola-Reston disease in nonhuman primates

    Copyrighted

    Dr. Fre:derick A. Murphy, D.V.M., Ph.D. 1976.

    http://www.geocities.com/CapeCanaveral/Lab/5738/images/Ebola1.jpg
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    Filoviridae orFiloviruses

    Most mysterious virus group

    Pathogenesis poorly understood

    Ebola

    natural history/reservoirs unknown

    exist throughout the world

    endemic to Africa

    filamentous ssRNA-(antisense) viruses

    Image courtesy of the Centers for Disease Control

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    Ebola Pathogenesis

    Enters Bloodstream skin, membranes,open wounds

    Cell Level

    docks with cell membrane

    Viral RNA

    released into cytoplasm

    production new viral proteins/ genetic material

    New viral genomes

    rapidly coated in protein

    create cores

    Copyright: Russell Kightley Media, Australia

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    Ebola Pathogenesis, cont

    Viral cores stack up in cell

    migrate to the cell surface

    produce trans-membrane proteins

    push through cell surface

    become enveloped by cell membrane

    ssRNA-Genome Mutations

    capable of rapid mutation

    very adaptable to evade host defenses and environmental change

    Theory

    virus evolved to occupy special niches in the wild

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    Symptoms and Diagnostic Tests

    Early symptoms muscle aches, fever, vomiting

    red eyes, skin rash, diarrhea, stomach pain

    Acute symptoms

    bleeding/hemorrhaging from skin, orifices, internal organs

    Early Diagnosis

    very difficult

    signs & symptoms very similar to other infections

    Laboratory Test PCR detection

    ELISA (enzyme-linked immuno-absorbant) assay

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    Laboratical finding

    Leucopenia Trombocytopenia (

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    Treatment

    No Standard Treatment available

    Patients receive supportive therapy

    treating complicating infections

    balancing patients fluids and electrolytes

    maintaining oxygen status and blood pressure

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    The most risk

    Health workers Family member

    Mourner who have direct contact with dead

    body Hunter who contact with dead animals

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    Prevention

    No vaccines!

    Patients are isolated

    Medical Staff Training western sanitation practices

    intake

    care during stay

    after patient dies

    Infection-control Measures complete equipment and area sterilization

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    Prevention

    After DeathVirus contagious in fluids for days

    Burial use extreme caution

    handling and transport

    cultural practices/ religious belief

    incinerate all waste !!!!

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    References Reemergence of Ebola Virus in Africa; Anthony Sanchez et al,EID Volume 1 * Number 3 July-September 1995

    http://www.cdc.gov/ncidod/EID/vol1no3/sanchez.htm

    Viral Hemorrhagic Fever, Healthlink, Medical College of Wisconsin, 2000

    http://healthlink.mcw.edu/article/955159073.html

    Isolation and Phylogenetic Characterization of Ebola Viruses Causing Different Outbreaks in Gabon

    Emerging Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention ,February 5, 1997

    http://www.cdc.gov/ncidod/EID/vol3no1/courbot2.htm

    Hemorrhagic fevers; Julia Barrett, Gale Encyclopedia of Medicine, Gale Research, 1999

    http://www.findarticles.com/cf_dls/g2601/0006/2601000652/p1/article.jhtm

    l

    Key Issues in the Prevention and Control of Viral Hemorrhagic Fevers Clarence J.Peters, MD, Special Pathogens Branch/Division of Viral andRickettsial Diseases, National Center for Infectious Diseases/Centers for Disease Control and Prevention, 1997

    http://www.cdc.gov/od/ohs/sympsium/symp43.htm

    Scientific Stock Images Library; Russell Kightley Media,Australia

    http://www.rkm.com.au/imagelibrary/index.html

    Outbreak of Ebola Hemorrhagic Fever ---Uganda, August 2000--January 2001,

    Morbidity and Mortality Weekly Report, Vol 50, No 05;73, 02/09/2001 / 50(05);73-7

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5005a1.htm

    Ebola-Reston Virus Infection Among Quarantined Nonhuman Primates -- Texas, 1996

    Morbidity and Mortality Weekly Report, Vol 45, No 15;314 ,April 19, 1996 / 45(15);314-316

    http://www.cdc.gov/mmwr/preview/mmwrhtml/00040920.htm

    The assembly of Ebola virus nucleocapsid requires virion-associated proteins 35 and 24 and posttranslational modification of nucleoprotein, HuangYet al, Mol Cell. 2002 Aug;10(2):307-16. PMID: 12191476 [PubMed - indexed for MEDLINE]

    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12191476&dopt=Abstract

    Detection of antibodies against the four subtypes of ebola virus in sera from any species using a novel antibody-phage indicator assay.; Meissner F

    et al , PMID: 1235035

    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12350354&dopt=Abstract

    http://www.cdc.gov/ncidod/EID/vol1no3/sanchez.htmhttp://healthlink.mcw.edu/article/955159073.htmlhttp://www.cdc.gov/ncidod/EID/vol3no1/courbot2.htmhttp://www.findarticles.com/cf_dls/g2601/0006/2601000652/p1/article.jhtmhttp://www.cdc.gov/od/ohs/sympsium/symp43.htmhttp://www.rkm.com.au/imagelibrary/index.htmlhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5005a1.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/00040920.htmhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12191476&dopt=Abstracthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12350354&dopt=Abstracthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12350354&dopt=Abstracthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12191476&dopt=Abstracthttp://www.cdc.gov/mmwr/preview/mmwrhtml/00040920.htmhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5005a1.htmhttp://www.rkm.com.au/imagelibrary/index.htmlhttp://www.cdc.gov/od/ohs/sympsium/symp43.htmhttp://www.findarticles.com/cf_dls/g2601/0006/2601000652/p1/article.jhtmhttp://www.cdc.gov/ncidod/EID/vol3no1/courbot2.htmhttp://healthlink.mcw.edu/article/955159073.htmlhttp://www.cdc.gov/ncidod/EID/vol1no3/sanchez.htm