Ebola virus infection: what should be known?

Evaluation of viral haemorrhagic fever surveillance system with focus on Ebola virus disease, Bawku municipality- Upper East Region, Ghana, 2011-2015

Background

We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015 in the Bawku Municipality, Upper East region, Ghana to determine whether the goals of the surveillance system are being met and to assess the performance of the system attributes.

Design

Descriptive secondary data analysis.

Setting

Bawku Municipality

Data Source

Review VHF surveillance records, interviewed community-based surveillance volunteers (CBSVs) and reviewed vital events registers. We also assessed the system attributes by reviewing records and interviewing key stakeholders involved in VHF surveillance system with focus on Ebola using checklist and semi structured questionnaire developed based on the Centers for Disease Control and Prevention (CDC) guidelines.

Main outcome measure

System attributes of the VHF surveillance system

Results

Population under surveillance was 105,849. The system required detail information about suspected cases. However, it had a simple and clear standard case definitions, and was well integrated with the IDSR. There is a regular and timely flow of information. The system captured 155 suspected cases nationwide from 2011 to 2015 and all tested negative. Of these, Upper East Region reported 10 suspected cases including 4 suspected cases from Bawku Municipality.

Conclusion

The VHF surveillance system achieved its objectives. However, poor data quality, inadequately trained surveillance officers, and inadequate financial support are threats to the effectiveness of the system.

Funding

This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana

Ebola Hemorrhagic Shock Syndrome-on-a-Chip

Ebola virus, for which we lack effective countermeasures, causes hemorrhagic fever in humans, with significant case fatality rates. Lack of experimental human models for Ebola hemorrhagic fever is a major obstacle that hinders the development of treatment strategies. Here, we model the Ebola hemorrhagic syndrome in a microvessel-on-a-chip system and demonstrate its applicability to drug studies. Luminal infusion of Ebola virus-like particles leads to albumin leakage from the engineered vessels. The process is mediated by the Rho/ROCK pathway and is associated with cytoskeleton remodeling. Infusion of Ebola glycoprotein (GP_1,2) generates a similar phenotype, indicating the key role of GP_1,2 in this process. Finally, we measured the potency of a recently developed experimental drug FX06 and a novel drug candidate, melatonin, in phenotypic rescue. Our study confirms the effects of FX06 and identifies melatonin as an effective, safe, inexpensive therapeutic option that is worth investigating in animal models and human trials.

Ebola virus: A global public health menace: A narrative review

Ebola virus disease (EVD), a fatal viral hemorrhagic illness, is due to infection with the Ebola virus of the Filoviridae family. The disease has evolved as a global public health menace due to a large immigrant population. Initially, the patients present with nonspecific influenza-like symptoms and eventually terminate into shock and multiorgan failure. There exists no specific treatment protocol for EVD and only supportive and symptomatic therapy is the line of treatment. This review article provides a detailed overview of the Ebola virus; it's clinical and oral manifestations, diagnostic aids, differential diagnosis, preventive aspects, and management protocol.

Knowledge, risk perception and mitigation measures towards Ebola virus disease by potentially exposed bushmeat handlers in north-central Nigeria: Any critical gap?

The bushmeat industry has been a topic of increasing importance among public health officials for its influence on zoonotic diseases transmission, such as Ebola virus disease (EVD), a rare and severe infectious disease of humans and non-human primates. This survey assessed knowledge/awareness, risk perceptions and mitigation practices towards EVD among bushmeat handlers in north-central Nigeria. These characteristics are premise to level of preparedness against appropriate risk prevention and control. A questionnaire-based cross-sectional study was conducted between January and December 2015 on 395 bushmeat handlers. Descriptive and analytical statistical analyses were performed using Epi-Info 3.5.3 software, and p < 0.05 was considered statistical significance in all analyses. Mean age of respondents was 40.9 ± 10.7 years, and most (30.4%) of them were in the age group 40-49 years. Majority (82.8%) of them were males, while most (47.9%) do not possess formal education. Bushmeat hunters, vendors and consumers constituted 17.2%, 28.1% and 54.7% of the respondents, respectively. A majority (85.6%) of the participants had heard about EVD. Bushmeat vendors were more likely (OR 1.96; 95% CI: 1.05-3.65) to have satisfactory knowledge than the hunters. Handlers with tertiary education were more likely (OR 3.22; 95% CI: 1.56-6.67) to possess significant satisfactory knowledge/awareness about EVD. Also, vendors were more likely (OR 1.85; 95% CI: 1.01-3.42) to practice satisfactory mitigation measures than the hunters. Only handlers with tertiary education were more likely (OR 2.48; 95% CI: 1.26-4.89) to significantly practice satisfactory mitigation measures against EVD. Although most of the handlers possessed significant knowledge/awareness about EVD, few applied mitigation measures against its infection, which is the challenging gap. There is a need for collaborations between the public health, veterinary and wildlife authorities in the provision of health information to bushmeat handlers on better management of emerging and re-emerging zoonotic viral diseases of wildlife origin.

The Understanding of Ebola Virus Disease (EVD) Among Medical Practitioners of Karachi, Pakistan

The World Health Organization (WHO) has acknowledged the large West African Ebola virus disease (EVD) outbreak to be a community health disaster of global concern, and the spread of disease demands a synchronized response. Medical practitioners have an increased risk of contracting the disease as compared to others as they are directly exposed to patients’ blood or fluids. This study evaluated the knowledge of medical practitioners in Karachi regarding EVD. It was descriptive and exploratory in nature and took place over a period of 4 months, i.e., August 2016 to November 2016. The respondents were randomly selected by convenience sampling and surveyed with a 20-item questionnaire. Overall, 403 questionnaires were included in the study and a response rate of 80.6% was achieved. The majority (56.3%) considered themselves to be somewhat knowledgeable; females had more knowledge as compared to male (p < 0.003). More than 80% knew about the 2014 Ebola outbreak in West Africa. Interestingly, the findings revealed that respondents’ knowledge about diagnosis and identification of EVD is good. Respondents considered EVD a severe disease and emphasized on the need for protective measures when contacting affected patients. Interventions should be tailored to focus on areas where respondents showed a lack of knowledge about the disease.