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The emergence of ebola as a global health security threat: from 'lessons learned' to coordinated multilateral containment efforts.

Kalra S, Kelkar D, Galwankar SC, Papadimos TJ, Stawicki SP, Arquilla B, Hoey BA, Sharpe RP, Sabol D, Jahre JA - J Glob Infect Dis (2014)

Bottom Line: Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities.The treatment involves early, aggressive supportive care with rehydration.These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat.

View Article: PubMed Central - PubMed

Affiliation: St Luke's University Health Network, Bethlehem, Pennsylvania, USA.

ABSTRACT
First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat. Here we present a review of EBOV infection in an effort to further educate medical and political communities on what the Ebolavirus disease entails, and what efforts are recommended to treat, isolate, and eventually eliminate it.

No MeSH data available.


Related in: MedlinePlus

A number of miscellaneous symptoms — including difficulty breathing, chest pain, cough, and sore throat — were more frequently seen among non-survivors. Source: WHO Ebola Response Team. Ebola virus disease in West Africa — The first nine months of the epidemic and forward projections. New Engl J Med 2014;371: 1481-1495.
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Figure 5: A number of miscellaneous symptoms — including difficulty breathing, chest pain, cough, and sore throat — were more frequently seen among non-survivors. Source: WHO Ebola Response Team. Ebola virus disease in West Africa — The first nine months of the epidemic and forward projections. New Engl J Med 2014;371: 1481-1495.

Mentions: As the disease progresses, gastrointestinal symptoms such as diarrhea, nausea, vomiting, and abdominal pain begin to develop.[78] Although bleeding is not seen in the early phase, there may be a gradual appearance of petechiae, ecchymoses, prolonged bleeding from the venipuncture sites, and mucosal hemorrhage, as the disease progresses. Patients who recover from Ebola infection have been reported to show clinical improvement by the middle of the second week. As outlined in Figure 2a-d, the clinical outcomes may depend on the appearance and the subsequent management of the symptoms and signs associated with increased mortality (i.e., impending septic shock, hemorrhagic manifestations, and multiorgan failure).[72]


The emergence of ebola as a global health security threat: from 'lessons learned' to coordinated multilateral containment efforts.

Kalra S, Kelkar D, Galwankar SC, Papadimos TJ, Stawicki SP, Arquilla B, Hoey BA, Sharpe RP, Sabol D, Jahre JA - J Glob Infect Dis (2014)

A number of miscellaneous symptoms — including difficulty breathing, chest pain, cough, and sore throat — were more frequently seen among non-survivors. Source: WHO Ebola Response Team. Ebola virus disease in West Africa — The first nine months of the epidemic and forward projections. New Engl J Med 2014;371: 1481-1495.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265832&req=5

Figure 5: A number of miscellaneous symptoms — including difficulty breathing, chest pain, cough, and sore throat — were more frequently seen among non-survivors. Source: WHO Ebola Response Team. Ebola virus disease in West Africa — The first nine months of the epidemic and forward projections. New Engl J Med 2014;371: 1481-1495.
Mentions: As the disease progresses, gastrointestinal symptoms such as diarrhea, nausea, vomiting, and abdominal pain begin to develop.[78] Although bleeding is not seen in the early phase, there may be a gradual appearance of petechiae, ecchymoses, prolonged bleeding from the venipuncture sites, and mucosal hemorrhage, as the disease progresses. Patients who recover from Ebola infection have been reported to show clinical improvement by the middle of the second week. As outlined in Figure 2a-d, the clinical outcomes may depend on the appearance and the subsequent management of the symptoms and signs associated with increased mortality (i.e., impending septic shock, hemorrhagic manifestations, and multiorgan failure).[72]

Bottom Line: Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities.The treatment involves early, aggressive supportive care with rehydration.These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat.

View Article: PubMed Central - PubMed

Affiliation: St Luke's University Health Network, Bethlehem, Pennsylvania, USA.

ABSTRACT
First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat. Here we present a review of EBOV infection in an effort to further educate medical and political communities on what the Ebolavirus disease entails, and what efforts are recommended to treat, isolate, and eventually eliminate it.

No MeSH data available.


Related in: MedlinePlus