Summary on Ebola Virus Infection: Outbreak, Treatment, and Prevention

This report provides a comprehensive summary of the Ebola virus infection, focusing on the 2014-2015 outbreak in West Africa. It reviews the virology, epidemiology, and clinical features of the disease, including its transmission, symptoms, and pathophysiology. The report highlights diagnostic methods such as ELISA and RT-PCR, along with various treatment approaches, including supportive care, antiviral agents (like Favipiravir), immunotherapies, and the development of Ebola vaccines. It also discusses the importance of public health infrastructure, contact tracing, and precautionary measures to control the spread of the virus. The study emphasizes the need for new tools and strategies to manage and prevent future Ebola outbreaks, drawing on literature searches from databases like PubMed, CINAHL, and Medline. The report concludes that microorganisms play an important role in human health and the need to control outbreaks.

Running head: SUMMARY ON EBOLA VIRUS INFECTION
Summary on Ebola virus infection
Name of the Student
Name of the University
Author Note

1SUMMARY ON EBOLA VIRUS INFECTION
Title: Ebola Virus Infection: Overview and Update on Prevention and
Treatment
Authors name and affiliation:
M. J. Martı´nez J. C. Hurtado Department of Clinical Microbiology, Hospital Clinic,
Universitat de Barcelona, Barcelona, Spain
M. J. Martı´nez ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
A. M. Salim P. E. Kilgore (&) Department of Pharmacy Practice, Eugene Applebaum
College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA e-mail:
[e-mail]
P. E. Kilgore Department of Family Medicine and Public Health Sciences, Wayne State
University, Detroit, MI, USA
Summary:
Martínez et al. studied on the outbreak of Ebola virus infection specially in West
Africa and provided an update regarding epidemic and recent progress of the disease, its
treatment options and prevention. The authors conducted a comprehensive literature study
through various search engines by using appropriate keywords and finding out cases within a
particular period. They have also discussed about new therapies and vaccines created for
Ebola virus disease (EVD) and which are still under evaluation for human use. To control the
spread of infection new drugs and vaccines can be supplied to various countries affected by
EVD and focussing on the establishment of public health infrastructure will prove beneficial.
Therefore new tools for controlling Ebola in outbreak prone countries should be made
available in future.

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The authors introduced review with the incidence of EVD outbreak, virology of the
diseasd causing organism and epidemiology of the disease. EBV outbreak was first observed
in Ebola river which is situated in democratic republic of Congo. However it could not be
confined to a single country with the help of health agencies therefore occurred in several
West African countries due to factors related to practices of funeral and burial of decedents.
Upon searching of various peer-reviewd articles from reliable sources such as PubMed,
CINAHL and Medline, around 156 studies were recognized under inclusion criteria. The
inclusion criteria were literature that were published in English language, had full-text,
published within 1993-2015, focussed on Ebola virus epidemiology, its virology, diagnosis
and management. The rest of the articles not meeting the inclusion criteria were excluded.
Virology revealed that Ebolavirus(EBOV) fall under the filovirus family that were
identified for causing serious diseases in human and it’specific characters include envelop,
non-segmented, linear and negative single strand of RNA. There are five viruses under genus
Ebolavirus each representing a virus species that causes outbreaks at different locations. The
recent virus that causes outbreak in West Africa is the Zaire ebolavirus that has close to 97%
similarity with EBOV strain and comprises of 7 genes in their genome, each encoding for
viral structural protein- nucleoprotein (NP), glycoprotein (GP), L protein, virion protein (VP)
24. However these viruses can have mutation in their genome as a result of which they evade
the efficiency of diagnostic tests and treatments.
Ebola virus has caused outbreaks in six African countries where control was made
effective by isolation and contact tracing although EVD was identified every year from 2000
where the morbidity and fatality rates varied ranging from 24-81% with increasing rate in
Zaire and Sudan. In 2015, WHO declared that EVD burden was high in Guinea and Sierra
Leone. However evidences were found on transmission of the virus through different bat
species who carried antibodies against the virus were examined. Clinical syndrome were

3SUMMARY ON EBOLA VIRUS INFECTION
identified and different body fluids were detected of virus in many studies, that included
breast milk, saliva, urine, stool, semen, sweat, and tears. The clinical symptoms and
transmission are similar in current outbreak in West Africa and previous pandemics of EBOV
where transmission occurred fom person-to-person and had incubation period ranging from
either 8-11 days or in some cases less than 2 days. Initial phase symptoms include tropical
fever and progresses with gastrointestinal symptoms along with late sign of bleeding or
haemorrhage. Susceptible individuals are pregnant women and children under 5 years and
elderly. Pathophysiology of the symptoms include suppression of immune system due to
inflammatory response resulting in secretion of proinflammatory mediators. As a result of
which multiorgan failure and septic shock occurs with huge fluid loss and severe
lymphopenia. WHO and CDC has recommended to follow precautionary measures while
handling cases of EBOV since it is a contagious disease.
Diagnosis of EBO include laboratory test for detecting genome of EBOV or measure
specific antibodies against virus or antigens of the virus. Antigen can be detected using
Enzyme linked immunosorbent assay (ELISA) which is considered a gold standard in some
outbreaks with a high sensistivity of 93% at acute phase of the disease. ELISA can also detect
antibodies specifically IgM for EBOV during the onset of symptoms in first week and 2nd
week having low sensitivity in settings of Intensive care unit. RT-PCR or reverse
transcriptase polymerase chain reaction is considered a gold standard technique for detecting
viral genome of Ebola having 100% sensitivity and 97% specificity. Quantitative RT-PCR
can be used for monitoring viral load. For diagnosing Ebola with 1005 sensitivity and 90%
specifity during the outbreak in West Africa, rapid point-of-care diagnostic test are suggested
for use.
Therapies and treatments include care and drugs of different types. Supportive care
manages EVD patients by rehydration, analgesics, blood transfusion and nutrition. In caase

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of high fatality rate, antiviral agents are given to inhibit, eliminate or reduce EBOV from the
infected body. Small interefering RNA (TKM-Ebola) administered will cleave the mRNA of
EBOV preventing production of key viral proteins however it has limitations with patient
safety therefore is under trial phase. Favipiravir inhibits viral polymerase, therefore is
efficient in clearing virus rapidly out of infected body with completed trial in Guinea. Other
inhbitors of viral RNA polymerase activity include BCX4430 which has a broad spectrum,
minimum side effects and administered orally. Immunotherapies such as convalescent whole
blood and plasma (CWB) and monoclonal antibodies can be used as alternative therapies.
Many studies showed the use of CWB with no benefits against EBOV however post-
exposure treatments with antibodies such as IgG was regarded as an option for using in
human. Monoclonal antibodies is based on targeting epitopes of EBOV antigens with
antibodies generated during natural infection. However it is only useful in treating the
infection in human once the clinical symptoms has been manifested to reduce the viral load.
Non-specifc agents such as interferon and recombinant nematode anticoagulant protein c2
along with recombinant human activated protein c having low efficacy when used alone, can
be used in combination with other treatment measures for increasing survival time. Ebola
vaccines were developed using virus-like proteins or recombinant proteins and tested in
animals for its efficacy and is useful in contributing for protecting immune system against
EBOV however no licensed vaccines are available for human trial.
From this study it can be concluded that microorganisms play an important role in
lives of human such as causing a disease. Disease can become an outbreak with need for
control to ensure improved public health. Various startegies for management and prevention
were discussed in the paper such as therapies and drugs. These interventions along with the
diagnostic tools are useful in examining and controlling trigger factors for similar outbreaks
in future.

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References:
Martínez, Miguel J., et al. "Ebola virus infection: overview and update on prevention and
treatment." Infectious diseases and therapy 4.4 (2015): 365-390.