Ebola Hemorrhagic Fever

Ebola Virus Hemorrhagic Fever



Ebola Hemorrhagic Fever


Virus Hemorrhagic Fever


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Ebola Hemorrhagic Fever

Ebola Hemorrhagic Fever Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees). Ebola HF is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. When infection occurs, symptoms usually begin abruptly. The first Ebolavirus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Since then, outbreaks have appeared sporadically. There are five identified subspecies of Ebolavirus. Four of the five have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d'Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans. The natural reservoir host of ebolaviruses remains unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne) with bats being the most likely reservoir. Four of the five subtypes occur in an animal host native to Africa. A host of similar species is probably associated with Reston virus, which was isolated from infected cynomolgous monkeys imported to the United States and Italy from the Philippines. Several workers in the Philippines and in US holding facility outbreaks became infected with the virus, but did not become ill.

Rapid Health Assessment in Outbreaks of

Viral Haemorrhagic Fever (VHF)

This information provided here could be used particularly by occupational health doctors and nurses managing health of an office building, estate, remote population, etc.
We advise adjustments are made as you see fit.

Conducting The Rapid Assessment

The rapid assessment consists of confirming an outbreak of VHF and estimating its geographic distribution, assessing the impact on health, assessing the existing response capacity and immediate needs.

1- Confirming An Outbreak Of VHF And Estimating Its Geographic Distribution
Initial Case-Definition

As for all potential epidemics, this is best determined in advance, as part of emergency preparedness. Simple, workable case-definitions should be defined for suspect, probable and confirmed cases of VHF.

Examples of case-definitions for VHF are:

Suspect Case
“acute fever with either jaundice, or cutaneous and internal bleeding, accompanied by shock”; in the case of dengue the rash should also be mentioned.

Probable Case
“a suspect case with at least two of the following signs: severe myalgia and headache, conjunctivitis, rash, shock, proteinuria, death, where the case has had contact with a possible source of transmission”.

Confirmed case
“a suspect or probable case with one of the following: virus isolation from blood or tissue; detection of viral antigen or genome in blood, tissue or other body fluid; presence of specific IgM antibody in titer high enough to indicate recent infection”.

2- Assessing Existing Response Capacity And Immediate Needs
Assess Local Response Capacity

Local epidemic surveillance:
Are there sufficient trained personnel, vehicles and communications support to maintain adequate surveillance? Is outside technical help needed?
Is there a need for animal studies (e.g. sentinel herd surveillance) or further entomological investigations?

Response capacity of existing health services:
What steps have local health officials taken to organize epidemic response? Is there a plan of action, standardized reporting procedures, trained staff?
Are hospitals equipped to carry out safe barrier nursing measures? (Check bed nets, gloves, disinfectants, masks, gowns.)
What is local cold chain capacity? Trained vaccinators? Jet injectors? Vehicles? Stocks of syringes? Yellow fever vaccine stocks in country?
Do medical, nursing and laboratory personnel need further training on case-detection and safe patient management?
What links have been established with key community members (e.g. for allaying panic, health education and improved case-detection)?
What vector control equipment, pesticides and larvicides are available?
Has a strategy been developed for dealing with press inquiries?

3- Deciding On Immediate Needs

To decide on immediate needs, ask:
is there an outbreak of VHF which has or could lead to a large number of cases?
if so, are external resources needed to contain it?
If the answer to both questions is “yes”, then an emergency response is needed.

State the following:
Is there an outbreak of some type of VHF?
If so, how many cases and deaths so far?
What is the geographic distribution?
Does it appear to be spreading?
What are the trends?
What is the clinical presentation?

I hope you find this information usefull.
We can be contacted for further advise on ebola@ohprime.co.uk

This document contains extracts from a much larger webpage managed by the European Network for Diagnostics of “Imported” Viral Diseases (ENIVD). (A projected funded by the European Centre for Disease Prevention and Control): ENIVD

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