Ebola virus
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The document summarizes information about Ebola virus and the use of blood transfusion as a potential treatment. It discusses: 1) Ebola virus was first identified in 1976 and causes viral hemorrhagic fever. The 2013-2014 outbreak in West Africa was the largest in history. 2) With no vaccine or reliable drug treatment, symptomatic care including blood transfusion from recovered patients has been used. 3) For blood transfusion to be effective and safe as a treatment, donors must be properly screened and blood must be type-matched to the recipient to avoid complications.
Ebola virus
- 1. Centre for Biotechnology Siksha ‘O’ Anusandhan ( Deemed to be University ) Ebola and blood transfusion: existing challenges and emerging opportunities S. ABDULLAH, K. KARUNAMOORTHI. European Review for Medical and Pharmacological Sciences YEAR:- 2015 Subham Preetam Regd No: 1861621001 3rd Semester
- 2. ABSRACT:- • The deadly Ebola virus has been first known to mankind since 1976. • In the past decades Ebola outbreaks has often been ignored or neglected as erupted in the rural isolated area of Africa. • The recent 2013-2014 epidemic is the most wide spread with high incidence rates, morbidity and mortality in the Ebola history. • Eventually the World Health Organization(WHO) has declared it as a “Public Health Concern of the International Community”. • This community was conducted to initiate blood transfusion as an empirical therapeutic method.
- 3. Introduction:- What is Ebola? • EBOLA virus is a member of a family of viruses:- Filoviridae. • Ebola virus particles form long filaments with a 19kb non- segmented, single stranded RNA genome surrounded by a lipid (fatty) membrane. • Ebola disease is a viral haemorrhagic (bleeding) illness. • Has high fatality rate. • Discovered in 1976, near Ebola river Democratic republic of Congo.
- 4. Structure of Ebola virus:-
- 5. There are 5 strains or subspecies of the Ebola virus. These are: o Tai forest ebolavirus o Sudan ebolavirus o Bundibugyo ebolavirus o Zaire ebolavirus o Reston ebolavirus
- 8. How Ebola enter in to the cell:-
- 9. How Ebola infect our body and how our body fight against it:-
- 10. Mechanism of action:- • Every tissues are affected mostly the immune system except bones. • Level of white blood cells and platelets be elevated. • The virus creates blood clots. • Clots goes towards internal organs like lungs, liver, kidney, spleen & also brain. • It prevents oxygen to rise tissues. • The virus also destroys all connective tissues.
- 11. Case study on Ebola virus:- • Ebola virus was first identified in Southern Sudan in1976 but most likely occurred in 1972 in Tandala, DRC(democratic republic of Congo), Uganda. • The recent out break erupted in GUINEA in December 2013 but soon it spread into neighboring LIBERIA and SIERRA LEONE with a reported 70% of the case fatality rate. • There after soon the WORLD HEALTH ORGANIZATION (WHO) declared Ebola as a “public health emergency of international concern” on 8th august 2014. Through ever since the mid of 1970s there are several sporadic outbreaks reported, but 2014 epidemic has broken down the entire civic society by killing thousands of people, destroying families and threatening the whole world. ** after 2014 the west Africa Ebola out break is the largest in history with 28,652 reported case and 11,325 deaths as per April 2016.
- 15. Pathophysiology:- • It can be diagnosed by performing standard serological diagnostic tests like:- • Antibody capture enzyme linked immunosorbent assay (ELISA), • antigen capture detection, • serum neutralization, • reverse transcriptase polymerase chain reaction (RT-PCR) assay, • electron microscopy and virus isolation by cell culture. Since, samples are potential biohazard risks, diagnosis should be performed under highest-level of biosafety containment conditions.
- 16. Ebola virus Infection Treatment and Management:- Prior EVD outbreaks have been controlled by implementation of integrated strategies like identification of cases, contact tracing, quarantine, early diagnosis, supportive care, infection control, and safe burial practices. Importance of Blood Transfusion to Treat EVD cases :- • Due to the absence of effective vaccine and reliable drugs to neutralize the Ebola virus, the treatment or management of Ebola patients have been mainly focused on symptomatic treatments with available antiviral agents and blood transfusion method.
- 18. Ebola and Blood Transfusions Mode of Mechanism The survivors of Ebola infection typically produce effective antibodies against the virus, the transfusions of their blood into a newly Ebola infected individual could save life. – The convalescent whole blood (CWB) and serum could serve as therapeutic agents against Ebola virus. – Indeed, it has to be transfused safely with careful screening, or else mismatched blood type and infected blood could cause a few severe reactions that may be life threatening too. Key phases for the Blood Transfusion Identification:- The EVD recovered patients (those have been discharged from the recognized Ebola treatment centers or units) could serve as potential donors (after 28 days of discharge) for CWB/CP. 1. Screening/Pre-Donation Tests (WHO 2014) • Estimation of donors hemoglobin concentration • ABO (A, B, AB and O) grouping and RhD type screening tests for blood borne infectious diseases like human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis co-infections and other locally transmitted infections like malaria, as applicable.
- 19. 2.Review of Pre-Donation Tests :- It is one of the critical phases in empirical blood transfusion treatment. Results of the predonation tests must be carefully reviewed. Donors, those are shown negative for all tests and fulfilling the remaining all other criteria should be chosen for CWD/CP donations 3.Selection of EVD Patients and Blood Sample :- Collection Only EVD confirmed patients in the early stages should be selected for CWB/CP transfusion. 4.Selection of Convalescent Whole Blood or Plasma :- Units ABO and RhD matched blood or plasma units need to be chosen for transfusion. • RhD-ve units should be transfused to RhD-ve women of childbearing age (if possible).
- 20. 5.Transfusion of Convalescent Whole Blood or Plasma :- CWB/CP units should be transfused to the EVD patients. 6.Patient Monitoring:- Transfused EVD patients must be closely monitored in order to assess the patient improvement in terms of clinical conditions and the concomitant decline of virus load detected in plasma, as well as to evaluate the effectiveness of the treatment. In addition to clinical monitoring, Ebola antibody levels and other tests are also extremely important.
- 21. Existing Major Challenges and Emerging Opportunities:- Till now there is no vaccines or drugs to neutralize and prevent the Ebola virus disease the treatment of Ebola patients have been mainly focused on symptomatic treatments with available antiviral agents and experimental therapy like blood transfusion method. • Necessities of Adequate Healthcare, Professionals & facilities. • Sharing knowledge and resources; a key to save lives. • Maximum Use of Supportive Therapy (MUST) • Formulation of Effective Chemotherapy . • Ebola Vaccine Development . chimpanzee adenovirus serotype 3 (ChAD3-ZEBOV) and recombinant vesicular stomatitis virus (rVSV- ZEBOV) are currently being tested in humans. • Cost-free Ebola Vaccination WHO Director-General (Dr. Margaret Chan) has indicated that developing Ebola vaccine is not a profit- driven industry, as the victims are poorest people to procure vaccine. At least in the humanity ground the international stake holders and concerned authorities must initiate to develop low-cost potential vaccine and all people must be vaccinated at least in the Ebola-prone African countries.
- 22. Conclusion EVD remains one of the most dreadful infectious diseases and the recent 2014 outbreak is the most devastating in terms of fatality rate in recorded Ebola history. At the moment, there is no effective curative agents to fight against our common enemy. WHO scientists and a group of key public health experts endorse the blood transfusion as an empirical modality by considering various existing therapeutic options to contain this deadliest outbreak. Until acquiring reliable therapeutic agents, we can adopt blood transfusion as therapeutic modality by strictly following the WHO standard protocol in order to avoid any undesirable effects. Furthermore, strong regional, national and international multilayered collaborations by bringing all the stakeholders is extremely important to address the existing challenges to build a Ebola-free healthiest society in the near future.
- 23. Thank You