General Information on (1) Ebola. and (2) Enterovirus 068
For information on Ebola (or Ebola Hemorrhagic Fever). see
the Centers of Disease Control and Prevention website at
With regard to Enterovirus D68, also see the following fact
sheet.
Fact Sheet on Enterovirus D68
With regard to Enterovirus D68, also see the following fact
sheet.
Fact Sheet on Enterovirus D68
What are enteroviruses?
• Enteroviruses are very common viruses.
There are over 100 different
enteroviruses
• In the United
States, people are more likely to get infected with enteroviruses in the summer
and fall.
Cases are likely to decline later
in the fall.
• These are often
what cause "summer" colds and "back to school" colds.
What is enterovirus D68?
• Enterovirus D68 (EV-D68) is one of more than 100
enteroviruses.
This virus (EV-D68) was first
identified in California in 1962.
What are the symptoms?
• Just like any other viral upper respiratory illness,
EV-D68 can cause mild to severe respiratory illness.
• Mild symptoms may include fever, runny nose, sneezing,
cough, and body and muscle aches. • Severe symptoms may include wheezing and
difficulty breathing.
• Anyone with
respiratory illness should contact their doctor if they are having difficulty
breathing or if their symptoms are getting worse.
How is it transmitted?
• Since EV-D68 causes respiratory illness, the virus can be
found in an infected person's respiratory secretions, such as saliva, nasal
mucus, or sputum.
• EV-D68 likely spreads from person to person when an
infected person coughs, sneezes, or touches a surface that is then touched by
others.
How do I protect myself?
You can help prevent yourself from getting and spreading
EV-D68 and other respiratory illnesses by following these steps:
• Wash hands often
with soap and water for 20 seconds.
• Avoid touching
eyes, nose and mouth with unwashed hands.
• Avoid close contact such as kissing, hugging, and sharing
cups or eating utensils with people who are sick.
• Cover your coughs
and sneezes with a tissue or shirt sleeve, not your hands.
• Clean and disinfect
frequently touched surfaces, such as toys and doorknobs, especially if someone
is sick.
• Stay home when you are sick.
How is it treated?
• There is no
specific treatment for people with respiratory illness caused by EV-D68.
• For mild respiratory illness, you can help relieve
symptoms by taking over-the-counter medications for pain and fever. Aspirin
should not be given to children.
• Some people with
severe respiratory illness may need to be hospitalized.
• There are no
antiviral medications currently available for people who become infected with
EV-D68.
What should people with asthma and children suffering from reactive
airway disease do?
Children with asthma are at risk for severe symptoms from
EV-D68 and other respiratory illnesses. They should follow CDC's guidance to
maintain control of their illness during this time.
CDC recommends:
• Discuss and update your asthma action plan with your
primary care provider.
• Take all your
prescribed asthma medications as directed, especially long term control
medication(s).
• Be sure to keep your reliever medication with you.
• Get a flu vaccine
when available.
• If you develop new
or worsening asthma symptoms, follow the steps of your asthma action plan. If
your symptoms do not go away, call your doctor right away.
• Parents should make sure the child's caregiver and/or
teacher is aware of his/her condition, and that they know how to help if the
child experiences any symptoms related to asthma.
For additional information on Enterovirus 068, see the
Centers of Disease Control and Prevention website at
http://www.cdc.gov/non-polio-enterovirus!aboutlEV-D68.html
Ebola, previously known as Ebola hemorrhagic fever, is a
severe, often fatal disease in humans and nonhuman primates (such as monkeys,
gorillas, and chimpanzees).
Ebola is a rare and deadly disease caused by infection with
a virus of the family Filoviridae, genus Ebolavirus.
There are five identified Ebola virus species, four of which
have caused disease in humans:
Ø Zaire
ebola virus;
Ø Sudan
ebola virus;
Ø Tar
Forest ebola virus, formerly Cote d'lvoire ebola virus; and
Ø Bundibugyo
ebola virus.
Ø The
fifth, Reston ebola virus, has caused disease in nonhuman primates but not in
humans.
Ebola is found in several African countries.
The first Ebola species was discovered in 1976 near the
Ebola River in what is now the Democratic Republic of the Congo.
Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola remains unknown.
However, on the basis of available evidence and the nature
of similar viruses, researchers believe that the virus is animal-borne with
bats being the most likely reservoir.
Four of the five subtypes occur in an animal host native to
Africa.
Transmission Because the natural reservoir host of Ebola has
not yet been identified, the manner by which the virus first appears in a human
at the start of an outbreak is unknown. However, researchers believe that the
first patient becomes infected through contact with an infected animal.
When an infection does occur in
humans, there are several ways the virus can be spread to others.
These include:
• direct contact with the blood or body fluids (including
but not limited to feces, saliva, urine, vomit and semen) of a person who is
sick with Ebola
• contact with objects (like needles and syringes) that have
been contaminated with the blood or body fluids of an infected person or with
infected animals
The virus in the blood and body fluids can enter another
person's body through broken skin or unprotected mucous membranes in, for
example, the eyes, nose, or mouth.
The viruses that cause Ebola are often spread among families
and friends, because they come in close contact with blood or body fluids when
caring for ill persons.
During outbreaks of Ebola, the disease can spread quickly
within healthcare settings, such as clinics or hospitals.
Exposure to Ebola can occur in healthcare settings where
hospital staff are not wearing appropriate protective clothing including masks,
gowns, gloves, and eye protection.
Dedicated medical equipment (preferably disposable, when
possible) should be used by healthcare personnel providing care for someone
sick with Ebola.
Proper cleaning and disposal of instruments, such as needles
and syringes, is also important. If instruments are not disposable, they must
be sterilized before being used again.
Without adequate instrument sterilization, virus
transmission can continue and amplify an outbreak.
Signs and Symptoms A
person infected with Ebola is not contagious until symptoms appear.
Signs and Symptoms of Ebola typically include:
• Fever (greater than 38.6°C or 101.5°F)
• Severe headache
• Muscle pain
• Vomiting
• Diarrhea
• Stomach pain
• Unexplained
bleeding or bruising
Symptoms may appear anywhere from 2
to 21 days after exposure to Ebola but the average
is 8 to 10 days.
Recovery from Ebola depends on the patient's immune
response.
People who recover from Ebola
infection develop antibodies that last for at least 10
years.
Risk of Exposure
Ebola is found in several African countries. Since 1976,
Ebola outbreaks have occurred in the following countries:
• Democratic Republic of the Congo (DRC)
• South Africa
(imported)
• Gabon
• Guinea
• South Sudan
• Liberia
• Ivory Coast
• Sierra Leone
• Uganda
• Senegal
• Republic of the Congo (ROC)
• Nigeria
Because the natural reservoir host of Ebola, and the manner
in which transmission of the virus to humans remain unknown, risk assessment in
endemic areas is difficult.
During outbreaks of Ebola, those at highest risk include
healthcare workers and the family and friends of a person infected with Ebola.
Healthcare workers in Africa should consult the Infection
Control for Viral Hemorrhagic Fevers In the African Health Care Setting to
learn how to prevent and control infections in these settings.
Medical professionals
in the United States should consult the Infection Prevention and Control
Recommendations for Hospitalized Patients with Known or Suspected Ebola
Hemorrhagic Fever in U.S. Hospitals.
Diagnosis
Diagnosing Ebola in a person who has been infected for only
a few days is difficult because the early symptoms, such as fever, are not
specific to Ebola infection and are seen often in patients with more commonly
occurring diseases, such as malaria and typhoid fever.
However, if a person has symptoms of Ebola and had contact
with blood or body fluids of a person sick with Ebola, contact with objects
that have been contaminated with blood or body fluids of a person sick with
Ebola or contact with infected animals, the patient should be isolated and
public health professionals notified.
Samples from the patient can then be collected and tested to
confirm infection.
Laboratory tests used in diagnosis include
Timeline of Infection Diagnostic tests available
Within a few days after symptoms begin
- Antigen-capture enzyme-linked
immunosorbent assay (ELISA) testing
-lgM ELISA
- Polymerase chain reaction (PCR) - Virus isolation
Later in disease course or after
recovery
- IgM and IgG antibodies
Retrospectively in deceased patients
- Immunohistochemistry testing
-PCR
- Virus isolation
Treatment
Currently there are no specific vaccines or medicines (such
as antiviral drug) that have been proven to be effective against Ebola.
Symptoms of Ebola are treated as they appear.
The following basic interventions, when used early, can
significantly improve the chances of survival:
• Providing intravenous(IV) fluids and balancing
electrolytes (body salts)
• Maintaining oxygen
status and blood pressure
• Treating other infections if they occur
Timely treatment of Ebola is important but challenging since
the disease is difficult to diagnose clinically in the early stages of
infection.
Because early
symptoms such as headache and fever are not specific to Ebola viruses, cases of
Ebola may be initially misdiagnosed.
However, if a person has symptoms of Ebola and had contact
with blood or body fluids of a person sick with Ebola, contact with objects
that have been contaminated with blood or body fluids of a person sick with
Ebola, or contact with an infected animal, the patient should be isolated and
public health professionals notified.
Supportive therapy can continue with proper protective
clothing until samples from the patient are tested to confirm infection.
Experimental treatment has been tested and proven effective
in some animals but has not yet been evaluated in humans.
Prevention
When cases of the disease do appear, there is increased risk
of transmission within healthcare settings.
Therefore, healthcare workers must be able to recognize a
case of Ebola and be ready to use appropriate infection control measures.
The aim of these techniques is to avoid contact with the
blood or body fluids of an infected patient.
Appropriate procedures include:
• isolation of patients with Ebola from contact with
unprotected persons
• wearing of protective clothing (including masks, gloves,
impermeable gowns, and goggles or face shields) by persons caring for Ebola
patients
• the use of other infection-control measures (such as
complete equipment sterilization and routine use of disinfectant)
• Avoid touching the
bodies of patients who have died from Ebola
Healthcare workers should also have the capability to
request diagnostic tests or prepare samples for shipping and testing elsewhere.
CDC, in conjunction with the World Health Organization, has
developed a set of guidelines to help prevent and control the spread of Ebola.
Entitled Infection Control for Viral Hemorrhagic Fevers In
the African Health Care Setting, the manual describes how to:
• recognize cases of viral hemorrhagic fever
• prevent further transmission
in health care setting by using locally available materials and minimal
financial resources.
Provided courtesy of Mr. Frank Ossai and Dr.
Anthony Esumei ( Adapted from the Centers of Disease Control and
Prevention website at
Ndoni National Association USA thank and congratulate Nigeria for containing the Ebola
menace in Nigeria. What an achievement in the fragile Nigerian Health sector. Should we say
hope restored. May it continue to be so.
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