Definition:
Ebola virus, well known for its hemorrhagic effects produced inside as well as outside of body. This virus progresses with bleeding, which leads to organ failure and if not treated properly can also cause death. ("Ebola virus and Marburg virus - Mayo Clinic", 2016). Ebola is also termed as Ebola Hemorrhagic fever because of its hemorrhagic property and it is also known to cause the death of 90% effected people ("Ebola Virus: Symptoms, Treatment, and Prevention", 2016). There are 5 strains of this virus and four of them are known to cause deadly symptoms like hemorrhage. Ebola have its most periodic breakout usually in Africa and has its roots spreading in rural and urban areas effecting a large population. ("How to identify and treat patients suffering from Ebola Virus in Dental Clinics", 2014).
The major outbreak occurred most recently was in March 2016. There were 13 patients reported who had Ebola virus and it was also reported that more than 1200 other people were affected from just these 13 cases. The most common mode of transmission that was suspected was through sexual means. Prior to that in January 2016, 2 cases of Ebola were reported to have effected more than 150 people in ("Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE)| Ebola Hemorrhagic Fever | CDC", 2016). This was not all this virus was once considered as a global threat because of its fast mode of transmission and no proper vaccination.
Mode of Transmission:
Ebola virus basically survives in animal host cell from where it can be transferred to humans through entering into food chain. Ebola virus has been found into African monkeys and chimps. Some traces of Ebola strains are also found in monkeys and chimps of Philippines. Once the virus is entered into the food chain of humans it has multiple ways on transmission from one human to others.
Body Fluids: one of the common modes of transmission from human to human is through body fluids. The virus is transmitted through exchange of body fluids. This is most common in sexual practices. And that is one of the most important factor by which this virus spreads so easily and rapidly. Other mode of body secretion includes blood transfusion, saliva, secretions and breast milk.
Skin contact: Ebola can also spread through contact of skin. Like if a person gets in contact with infected animals like monkeys and fruit bats they can also get affected easily. But there are no signs that Ebola virus spreads through insect bite.
Contaminated needles: there is a very common practice, that is unethical and illegal too but still it is highly practiced and is a major cause of many lethal disease, use of contaminated needles. Ebola easily spreads through contaminated needles or surfaces. It can also spread through contact to infected wounds.
Waste products: people in Africa who work in mines are most prone to get infected with Ebola because they have more contact from the feces and urine of animals.
Symptoms:
Now to understand any disease it is important to know the symptoms of that disease. Symptoms are those marks that a patient experience after getting effected to any certain disease. Symptoms can be divided into two categories first is the initial symptoms and later appears the long term symptoms. The initial symptoms include; Chills, Severe headaches, Joint and muscle pain, Weakness and Fever (greater than 101.5)
("All about Ebola Virus: Symptoms, Treatment, and Prevention - WorthvieW", 2014)
And the long term symptoms include; Severe weight loss, Diarrhea, Red eyes, Chest pain, Raised rashes, Nausea vomiting, and Internal bleeding and bleeding from eyes and bruising ("Ebola virus and Marburg virus Symptoms - Mayo Clinic", 2016)
These symptoms occur periodically and in the end patient have multiple problems.
Risk Factors:
Risk factors are those factors that can be very supportive to the disease. If a person acquire risk factor for certain disease they become prone to that disease. Likewise, Ebola have certain risk factors that can support the virus to grow and cause its lethal effects;
Protection while medical procedures: it is quite great significance that no matter what kind of medical procedure is being performed the medical personal should take precaution so that he can protect him from acquiring that disease. So if a person is assisting or taking medical care of patient affected with Ebola, he should take precautions or else he might get affected too.
Preparing the dead body of Ebola: if someone is preparing a body for burial who have died due to Ebola should take measures in order to protect him from acquiring this virus.
Visiting Africa: since Africa is the most common place for the outbreak of Ebola so a person should take care if he or she is planning to visit Africa.
Researcher: if a person is researching on animals specifically monkeys and chimps, they should take adequate measures to protect them from this virus "Ebola virus and Marburg virus Risk factors - Mayo Clinic", 2016)
Complications:
Complications are usually those problems that are caused because of the disease. These complications can be lethal and it can be non lethal too. Usually these complications are treatable. Since people who are effected with Ebola usually die after lot of complications. Complications occurring in Ebola are; Jaundice, Delirium, Shock, Coma, Seizures and Severe bleeding leading to organ failure.
But in very few cases people do survive when they get early diagnose and treatment. So they might have to suffers complication too because the virus still stays in a body and makes the recovery slow; Weakness, Fatigue, Testicular inflammation, Hair loss, Sensory changes, Liver inflammation, Eye inflammation and Headaches ("Ebola virus and Marburg virus Complications - Mayo Clinic", 2016)
Test:
The initial symptoms that occur in Ebola Fever are usually confused with other diseases like malaria and typhoid. Ebola virus is diagnosed after three days of the appearance of symptoms. The laboratory test used to diagnose are divided into three stages first is test which are done in early weeks on the appearance of symptoms these are; Antigen capture enzyme linked immunosorbent assay (ELISA) testing, IgM ELISA, Polymerase Chain Reaction (PCR) and Virus Isolation
Test which are performed as the disease progress or after recovery test include; IgM antibody and Ig G antibody
And test performed in patients who died with Ebola virus are; PCR Polymerase Chain Reaction, Virus Isolation and Immunohistochemistry testing ("Diagnosis| Ebola Hemorrhagic Fever | CDC", 2016)
Treatment:
Since there is no FDA approved anti viral medication or vaccine available for the treatment of Ebola. The only treatment done in Ebola virus condition is treating the symptoms and complications. There are certain initial and immediate procedures that need to be followed so that the symptoms and complications can be treated and death can be prevented. These measures include; Administration of immediate intravenous (IV) fluids to balance the electrolyte loss from the body, Since there is blood loss so recover the loss blood through blood transfusion, If there are other infections along with this, treatment for that infection should also be carried out immediately, Oxygen depletion is to be prevented with the supply of pure oxygen, Blood pressure should be well maintained
This immediate measure can save the life of patient. But it is totally dependent on the immune response of the patient. If the patient’s immune is strong it can fight the virus, patient will survive but with many complications. It is of high significance that patient who recover from Ebola will have anti body for that specific strain of Ebola for at least 10 years. But it is not known that whether other strains will effect or will they be rejected because of previous acquired immunity. Though the person might recover but this recovering will not be complete as the virus may still be found in body fluid. So even after recovery the person needs to take precaution so that others might not get affected.
There is no approved anti viral drug for the treatment. Still work is going on so that soon some anti viral medication can be made for treatment of Ebola. But recently the college of medicine and Allied Health Sciences (COMAHS) along with the collaboration of university of Sierra Leone, health ministry of Sierra Leone and Centre of Disease control and prevention (CDC) has made trails of a vaccine of Ebola in the state of Sierra Leone in April 2015. This program is named as STRIVE. This program had some success as it had long lasting effects as it prevented the spread of this disease and it also gave protection from Ebola. But some patients experienced joint pain but rest this proved quite beneficial for the state of Sierra Leone. ("Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE)| Ebola Hemorrhagic Fever | CDC", 2016).
Prevention:
Though no vaccine is available so prevention is still an unanswered question but there are still certain preventive measures can be taken so that certain barrier can protect, these measure include care of hygiene; keep your sanitizers and alcohol based soaps, do not make any contact with objects that have blood stains or fluid spilled, be careful while using needles or surgical instruments, always keep your proper medical record and check up, Healthcare workers should wear proper protective equipments, Ebola patients should be kept separately, Make proper arrangements for sterilization ("Prevention| Ebola Hemorrhagic Fever | CDC", 2016).
(uscreen GmbH, 2016)
Ebola virus outbreak has been quite depressing because the case for Ebola are increasing year by year one main reason is lack of development of vaccine or any anti viral medication against it and second major factor is lack of awareness has also created a rise in Ebola patients. In 1976 when Ebola break out there were around 500 cases with Ebola an out of them 100 patients survived hardly. The figure dropped the following years until 2000 when it again grew up and there were 400 patients and out of them 200 patients made it safe home rest died. Then again there was a downfall in cases in coming years but in 2014 the figure raised to such a shocking level that there were around 700 reported patients out of them 250 patients survived.
("MDHealth.com", 2016)
Impact in Dental hygiene
If there is a patient who has arrived from an area affected from Ebola virus so it is quite essential that you delay the dental procedure of that patient for 21 days because dental procedure requires contact of fluids that can cause transmission of Ebola virus. If the patient had been diagnosed as Ebola affected patient then others at the hospital should be protected and preventive measures should be made. All the equipments that serve as barrier between patient and doctor should be used essentially so that Ebola spread can be controlled. Make sure proper departments and hospitals are informed about such patients so that they can take this patient in proper care ("How to identify and treat patients suffering from Ebola Virus in Dental Clinics", 2014).
Key Features:
There are certain facts about Ebola virus that can be very shocking and they are very important as well. Since Ebola within such a short period of time has created a panic in the whole world. It was regarded as a global threat. These facts have changed the opinion about Ebola; The average mortality rate caused by Ebola Virus is around 50%. The very first outbreak of Ebola took place in central Africa and that is why Africa is the place where Ebola is commonest. During the first outbreak that occurred in Sudan and Zaire there were around 248 people affected. The second outbreak was just few months after the first outbreak and it was even more dangerous as it took lives of 318 people and had a mortality rate of 88%. One of the most devastating break occurred in 2003 in Congo which had a mortality of nearly 90%. Though there are many researches going on this virus but still the main natural reservoir of Ebola is still undiscovered. But still it is believed that fruit bat is the natural reservoir of Ebola virus. The last known strain of Ebola was found in the skin of dead chimpanzee in 1994. The word Ebola is coined from a river Ebola where the first outbreak of Ebola took place. The outbreak that occurred in 2014 was considered as the largest and most epidemic break. The reason is this break was not only limited to Africa but it also travelled to different countries like USA, Senegal, Nigeria and even to Mali. This spread was with the help of travelers who traveled from Africa to other places. The most effected countries were those who had no proper medical and healthcare systems. Among the five strains of Ebola virus the most potent outbreak occurred belonged to Zaire family.
WHO is working to fight against this virus. They are setting up awareness campaigns so that people can be made aware of the threat of Ebola virus and along with such campaigns they are also supporting those countries which do not have enough medical facility to fight Ebola. Whenever there is an outbreak of Ebola, WHO sends their health workers, community engagements, logistic support ad teaching and assistance with proper burial techniques, laboratory services, infection control, supporting surveillance, case management and also give contact tracing.
Ebola virus has turned out to be one of the common diseases. It has gone from ends to ends spreading and taking lives of many. Modern day medical sciences have considered this threat as a major issue and many researches and studies are being conducted all around the globe just in order to try to cure it or make proper vaccines so that this spread can be brought to a halt. This disease is not effected just the poor, it is effecting everyone. Who so ever comes into contact with effected one they get affected too. But it is quite high significance that only those patients are cured who get proper care on proper time.
Ebola virus enters into body and attacks those cells which are responsible for blood clotting. These cells are known as Platelets. This is the reason why Ebola Hemorrhagic Fever is confused with Malaria and Typhoid. In all these three diseases the platelet count drops rapidly. Drop in platelet counts can leads to internal bleeding and this is really crucial. Drop in platelet count also disturbs other body functions such as blood pressure. Drop in blood pressure is crucial as blood is unable to reach important organs due to which the later stage of Ebola Virus Disease is characterized by organ failure. This is one of the most common complication and this is why is a patient recovers from Ebola Virus Disease, complications like organ failure becomes a hurdle in their normal life. Ebola virus is systemic, it means that it affects all the organs or human body but it does not have any effect on bones. Ebola virus also affects the collagen, which is responsible to keep the organs in their places. Since Ebola virus is not airborne or waterborne it has low mode of transportation. Ebola virus has amazing reproducing capability as it can reproduce itself in approximate 8 hours and there will be numerous copies of it.
References
Ebola virus and Marburg virus - Mayo Clinic. (2016). Mayoclinic.org. Retrieved 26 June 2016, from http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/definition/con-20031241
Ebola Virus: Symptoms, Treatment, and Prevention. (2016). WebMD. Retrieved 26 June 2016, from http://www.webmd.com/a-to-z-guides/ebola-fever-virus-infection
How to identify and treat patients suffering from Ebola Virus in Dental Clinics. (2014).Juniordentist.com. Retrieved 26 June 2016, from http://www.juniordentist.com/how-to-identify-and-treat-patients-suffering-from-ebola-virus-in-dental-clinics.html
Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE)| Ebola Hemorrhagic Fever | CDC. (2016). Cdc.gov. Retrieved 26 June 2016, from https://www.cdc.gov/vhf/ebola/strive/index.html
All about Ebola Virus: Symptoms, Treatment, and Prevention - WorthvieW. (2014). WorthvieW. Retrieved 26 June 2016, from http://www.worthview.com/ebola-virus-symptoms-treatment-prevention/
Ebola virus and Marburg virus Symptoms - Mayo Clinic. (2016). Mayoclinic.org. Retrieved 26 June 2016, from http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/symptoms/con-20031241
Ebola virus and Marburg virus Risk factors - Mayo Clinic. (2016). Mayoclinic.org. Retrieved 26 June 2016, from http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/risk-factors/con-20031241
Ebola virus and Marburg virus Complications - Mayo Clinic. (2016). Mayoclinic.org. Retrieved 26 June 2016, from http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/complications/con-20031241
Diagnosis| Ebola Hemorrhagic Fever | CDC. (2016). Cdc.gov. Retrieved 26 June 2016, from https://www.cdc.gov/vhf/ebola/diagnosis/index.html
Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) Q&A| Ebola Hemorrhagic Fever | CDC. (2016). Cdc.gov. Retrieved 26 June 2016, from https://www.cdc.gov/vhf/ebola/strive/qa.html
Prevention| Ebola Hemorrhagic Fever | CDC. (2016). Cdc.gov. Retrieved 26 June 2016, from https://www.cdc.gov/vhf/ebola/prevention/index.html
uscreen GmbH, M. (2016). 6 ways to prevent Ebola | medbox.org. Medbox.org. Retrieved 26 June 2016, from https://www.medbox.org/ebola-iec-material-englisch/6-ways-to-prevent-ebola/preview?q=
MDHealth.com. (2016). M.md-health.com. Retrieved 26 June 2016, from http://m.md-health.com/Ebola-Virus-Disease-Pictures.html
