Overview of Ebola Virus, diagnosis, symptoms, treatment and prevention Precautions and Dangers Prognosis and Prevalence

1. EBOLA
What You Need To
Know
By
Barry Miskin, MD, FACS

2. Ebola Virus
Named After Ebola River In Africa
That Runs Through Zaire & The Congo

3. Cases of Ebola
1979 to 2008.

4. Ebola 2014

5. Only 7 Cases In US

7. Transmitted By Food

8. Transmission
• Nearly two thirds of the cases of Ebola infections in
Guinea during the 2014 outbreak contracted via
unprotected contact with infected corpses during
"Guinean burial rituals”
• No Air Transmission
• infected fruit bats drop partially eaten fruits or fruit
pulp, then land mammals such as gorillas and duikers
may feed on these fallen fruits.
• This chain of events forms indirect means of
transmission from the natural host species to other
animal species viral shedding in the saliva of fruit bats.

9. Cane Rat, Giant Pouched Rat, Red-
Flanked Duiker

10. Transmission
• Human-to-human transmission occurs only via direct
contact with blood or body fluid from an infected person
(including embalming of an infected dead body)
• Contact objects contaminated by the virus, needles &
syringes
• Other body fluids that transmit ebolaviruses saliva, mucus,
vomit, feces, sweat, tears, breast milk, urine, and semen
• Entry points include the nose, mouth, eyes, or open
wounds, cuts and abrasions.
• Transmission from other animals to humans occurs only via
contact with, or consumption of, an infected mammal, such
as a fruit bat, or ape

11. Virus Can Live On Contaminated
Surfaces for Up to 3 Hours

12. CDC Worker Incinerates Medical Waste
To Prevent Spread

13. How Does It Spread
• Contact With Blood or Other Bodily Fluids of
Infected Humans Or Other Mammals
• Fruit Bats May Spread Ebola Without Having
Symptoms
• Male Survivors Can Transmit Ebola Through
Semen for up to 2 Months

14. Biosafety Level 4 Hazmat Suit
Protects

16. Mortality Rate 25-90%, Avg 50%
Best To Dispose of Bodies Quickly

17. Symptoms
• Starts 2 days to 3 Weeks after Exposure
• Fever
• Sore Throat
• Muscle Pain
• Headaches

18. Next Stage
• Nausea
• Vomiting
• Diarrhea
• Rash
• Progress to Uncontrolled Hemorrhage 5-7
days after first Symptoms
• Kidney & Liver Failure 7-16 days if no Recovery

19. Symptoms 2 Days-3 Weeks

20. Diagnosis
• R/O Maleria & Cholera & other Hemorrhagic
Fevers
• Blood Samples Test for Viral Ab, Viral RNA, or
Virus itself

21. Diagnostic Test Blood
Viral Ab, Viral RNA, Ebola Virus

22. Ebola Outbreak in Gulu Municipal
Hospital, Uganda, Tx Supportive

23. Treatment
• No Specific Treatment
• Oral or IV Hydration
• Supportive Care Improves Recovery
• No Vaccine

24. As of 10/10/2014 8,376 Cases
Resulting in 4,024 Deaths Worldwide
RNA Virus Infects Cells

25. Education for Prevention

26. Prevention
• Decrease Spread from Infected Animal to
Human by Handling Potentially infected Meat
with Protective Gear and Fully Cooking It
• Proper Protective Clothing & Washing Hands
around Potentially Infected Patients
• Specimens of Bodily Fluids & Blood Handled
with special precautions

27. Mass Screening

28. Fever Scan At Airports

29. Prevention
• Rapid Detection & Contact Tracing
• Quick Access to Lab Services
• Proper Management of Those Infected
• Proper Disposal of Dead through Cremation or
Burial

30. Prognosis
• High Risk of Death 25-90% of those infected
• Avg 50% die from contracting Ebola
• 1976 – 2013 first detected 1716 cases
reported
• As of 10 October 2014, 8,376 suspected cases
resulting in the deaths of 4,024 have been
reported

31. Precautions
• if caring for a symptomatic suspect/confirmed case
Gloves, gown (fluid resistant or impermeable), eye
protection (goggles or face shield), and a facemask
• If copious amounts of blood, other body fluids, vomit,
or feces present in the environment: double gloving,
disposable shoe covers, and leg coverings
• if monitoring an asymptomatic contact Gloves (as long
as there is no potential for exposure to blood/body
fluids)
• Bring extra PPE when monitoring contacts in case
contact becomes symptomatic

32. Exposure Risk Levels
• High risk exposures:
• –Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids of EVD
patient
• –Direct skin contact with, or exposure to blood or body fluids of, an EVD patient without
appropriate personal protective equipment (PPE)
• –Processing blood or body fluids of a confirmed EVD patient without appropriate PPE or standard
biosafety precautions
• –Direct contact with decedent remains without appropriate PPE in a country where an EVD
outbreak is occurring
• Low risk exposures:
• –Household contact with an EVD patient
• –Other close contact with EVD patients in health care facilities or community settings
• –Brief interactions, such as walking by a person or moving through a hospital, do not constitute
close contact
• No known exposure:
• –Having been in a country in which an EVD outbreak occurred within the past 21 days and having
had no high or low risk exposures

33. Take Home Message
• Only Get Ebola From Touching Bodily Fluids of
Person Who is Sick With or Has Died From
Ebola
• Or From Exposure to Contaminated Objects,
Such As Needles
• Ebola Poses No Significant Risk In US

34. Depends On What You See

35. Light The Way