EBOLA VIRUS UPDATE OCTOBER 18 2014

1.WHAT IS EBOLA–It is a Filovirus similar to Marburg Virus. These viruses cause a Hemorrhagic fever syndrome with a high mortality. Ebola was first recognized in 1976 during 2 epidemics in Zaire and with 602 cases and an 88% mortality. There was a recurrence in the Sudan 1n 1979 but then no outbreaks for the next 20 years

2.MODE OF SPREAD—Household contacts with close contact with blood , body ffluids and or wastes. Health care workers spread appears to be similar to household contacts. Monkeys have an element of aerosol particle spread but how important this is in humans is not known.

3.CLINICAL MANIFESTATIONS-Inculbation 2-19 days most commonly 5-10 days.Initial symptoms are nonspecific -fever, headache,muscle aches, nausea and vomiting —  often followed by bleeding manifestations.

4.TREATMENT–Primarily supportive. Several of the health care workers treated in the U.S. have received either an experimental vaccine or plasma transfusions from recovered  Ebola patients. Of the health care workers treated in the USA none have died from the disease  in this recent epidemic.Described mortality in resource limited African countries has been 50-90%.

5.CURRENT EPIDEMIC-West Africa–Guinea, Liberia,Nigeria,Senegal,Sierrra Leone.  6,574 cases.Highest number of cases(thru Oct 3 was in Liberia 3,458 cases.This is the largest outbread ever reported.

6.EFFORTS TO CONTROL THE OUTBREAK–Being led by the involved countries. CDC, WHO, Medicine sans Frontieres, UN Red Cross and many other organizations.

7.KNOWN US CASES—ACQUIRED IN USA FROM INFECTED PATIENTS. 2 Texas Nurses who cared for the patient and had prolonged and intensive exposure to the patients blood, body fluid and waste products.No US cases from non medical non household contact.

8.CHANCES THAT EBOLA MIGHT SPREAD TO THE GENERAL POPULATION-SLIM TO NONE. All evidence still points to prolonged and intense contact with the patient as being necessary for spread.Several family members stayed with the index Texas patient in  a small motel room and none have become infected as of this date.

If you have further questions the following sources are excellent. CDC, Mississippi Department of Health– Epidemiology Section. Center of Infectious Disease Excellence—Use the e mail listed on the web site and or call with questions.

David L. Smith M.D.