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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| | {{Ebola}}{{About1|Ebola virus}} |
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| {{Taxobox
| | '''For patient information, click [[{{PAGENAME}} (patient information)|here]].''' |
| | name = Ebola virus
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| | image = Ebola_virus.jpg
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| | image_width = 200px
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| | caption = An [[electron microscope|electron micrograph]] of an Ebola virus
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| | virus_group = V
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| | ordo = ''[[Mononegavirales]]''
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| | familia = ''[[Filovirus]]''
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| | genus = ''Ebolavirus''
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| | type_species = ''Zaïre Ebolavirus'' | |
| | subdivision_ranks = Species
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| | subdivision = ''[[Ebola Reston|Reston Ebolavirus]]''<br />''Sudan Ebolavirus''<br />''Ivory Coast Ebolavirus''<br />''Bundibugyo Ebolavirus''
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| }}
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| {{Infobox_Disease
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| | Name = Ebola
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| | Image =
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| | Caption =
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| | DiseasesDB = 18043
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| | ICD10 = {{ICD10|A|98|4|a|90}}
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| | ICD9 = {{ICD9|065.8}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus = 001339
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| | MeshName = Ebola
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| | MeshNumber = C02.782.417.415
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| }}
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| {{CMG}} | | {{CMG}}; {{AE}} {{MJM}}, {{GRN}}, {{Marjan}} {{HK}} |
| {{Ebola}} | |
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| | {{SK}} Ebola hemorrhagic fever, Ebola haemorrhagic fever, Ebola HF, EHF, Zaire virus, Zaire Ebolavirus, ZEBOV, Sudan Ebolavirus, SEBOV, Reston Ebolavirus, REBOV, Cote d'Ivoire Ebolavirus, CIEBOV, Bundibugyo ebolavirus, Tai Forest ebolavirus |
| ==[[Ebola overview|Overview]]== | | ==[[Ebola overview|Overview]]== |
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| | ==[[Ebola historical perspective|Historical Perspective]]== |
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| ==[[Ebola classification|Classification]]== | | ==[[Ebola classification|Classification]]== |
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| ==[[Ebola historical perspective|Historical Perspective]]==
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| ==[[Ebola pathophysiology|Pathophysiology]]== | | ==[[Ebola pathophysiology|Pathophysiology]]== |
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| ==[[Ebola epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Ebola risk factors|Risk Factors]]==
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| ==[[Ebola causes|Causes]]== | | ==[[Ebola causes|Causes]]== |
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| ==[[Ebola differential diagnosis|Differentiating Ebola]]== | | ==[[Ebola differential diagnosis|Differentiating Ebola from other Diseases]]== |
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| ==[[Ebola natural history|Natural history, Complications, and Prognosis]]== | | ==[[Ebola epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Diagnosis== | | ==[[Ebola risk factors|Risk Factors]]== |
| [[Ebola history and symptoms|History and Symptoms]] | [[Ebola physical examination|Physical Examination]] | [[Ebola laboratory tests|Laboratory tests]] | [[Ebola case studies|Case Studies]] | |
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| ==Treatment== | | ==[[Ebola screening|Screening]]== |
| [[Ebola medical therapy|Medical therapy]] | [[Ebola primary prevention|Primary prevention]] | [[Ebola secondary prevention|Secondary prevention]] | [[Ebola cost-effectiveness of therapy|Financial costs]] | [[Ebola future or investigational therapies|Future therapies]] | |
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| | ==[[Ebola natural history|Natural History, Complications and Prognosis]]== |
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| ==Etymology== | | ==Diagnosis== |
| The virus is named after the [[Ebola River]] Valley in the [[Democratic Republic of the Congo]] (formerly [[Zaire|Zaïre]]), near the site of the first recognized outbreak in [[1976]], in a mission run by Flemish nuns.<ref>{{cite journal |last=Bardi |first=Jason Socrates |authorlink= |coauthors= |year=2002 |month= |title=Death Called a River |journal=Scribbs Research Institute |volume=2 |issue=1 |pages= |id= |url=http://www.scripps.edu/newsandviews/e_20020114/ebola1.html |accessdate=2006-12-08 |quote= }}</ref>
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| ==Ebola hemorrhagic fever ==
| | [[Ebola algorithm for the evaluation of the returned traveler|Algorithm for the Evaluation of the Returned Traveler]] | [[Ebola emergency department evaluation|Emergency Department Evaluation]] | [[Ebola case definition|Case Definition]] | [[Ebola history and symptoms|History and Symptoms]] | [[Ebola physical examination|Physical Examination]] | [[Ebola laboratory tests|Laboratory Findings]] | [[Ebola other diagnostic studies|Other Diagnostic Studies]] |
| ==Viral reservoirs==
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| Despite numerous studies, the wildlife reservoir of ''Ebolavirus'' has not been identified. Between 1976 and 1998, from 30,000 mammals, birds, reptiles, amphibians, and arthropods sampled from outbreak regions, no ''Ebolavirus'' was detected <ref name="Pourrut2005">{{cite journal |last=Pourrut |first=Xavier |authorlink= |coauthors=''et al.'' |year=2005 |month= |title=The natural history of Ebola virus in Africa |journal=Microbes and Infection |volume=7 |issue=7-8 |pages=1005-1014 |doi=10.1016/j.micinf.2005.04.006 |url= |accessdate= |quote= }}</ref> apart from some genetic material found in six rodents (''Mus setulosus'' and ''Praomys'' species) and a [[shrew]] (''Sylvisorex ollula'') collected from the [[Central African Republic]] in 1998.<ref name="Morvan1999">{{cite journal |last=Morvan |first=Jaques |authorlink= |coauthors=''et al.'' |year=1999 |month= |title=Identification of Ebola virus sequences present as RNA or DNA in organs of terrestrial small mammals of the Central African Republic |journal=Microbes and Infection |volume=1 |issue=14 |pages=1193-1201 |doi=10.1016/S1286-4579(99)00242-7 |url= |accessdate= |quote= }}</ref> ''Ebolavirus'' was detected in the carcasses of [[gorilla]]s, chimpanzees and [[duiker]]s during outbreaks in 2001 and 2003 (the carcasses were the source of the initial human infections) but the high mortality from infection in these species precludes them from acting as reservoirs.<ref name="Pourrut2005" />
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| [[Plant]]s, [[arthropods]], and birds have also been considered as reservoirs, however bats are considered the most likely candidate<ref>{{cite news |first= |last= |authorlink= |coauthors= |title=Fruit bats may carry Ebola virus |url=http://news.bbc.co.uk/2/hi/health/4484494.stm |work=BBC News |publisher= |date=2005-12-11 |accessdate=2008-02-25 }}</ref>. Bats were known to reside in the cotton factory in which the index cases for the 1976 and 1979 outbreaks were employed and have also been implicated in Marburg infections in 1975 and 1980.<ref name="Pourrut2005" /> Of 24 plant species and 19 vertebrate species experimentally inoculated with ''Ebolavirus'', only bats became infected.<ref>{{cite journal |last=Swanepoel |first=R |authorlink= |coauthors=''et al.'' |year=1996 |month= |title=Experimental inoculation of plants and animals with Ebola virus |journal=Emerging Infectious Diseases |volume=2 |issue= |pages=321-325 |doi= |url=http://www.cdc.gov/ncidod/eid/vol2no4/swanepo2.htm |accessdate= |quote= }}</ref> The absence of clinical signs in these bats is characteristic of a reservoir species. In 2002-03, a survey of 1,030 animals from [[Gabon]] and the [[Republic of the Congo]] including 679 bats found ''Ebolavirus'' RNA in 13 [[fruit bats]] (''Hyspignathus monstrosus, Epomops franquetti and Myonycteris torquata'').<ref>{{cite journal |last=Leroy |first=Eric |authorlink= |coauthors=''et al.'' |year=2005 |month= |title=Fruit bats as reservoirs of Ebola virus |journal=Nature |volume=438 |issue= |pages=575-576 |doi=10.1038/438575a |url= |accessdate= |quote= }}</ref> Bats are also known to be the reservoirs for a number of related viruses including [[Nipah virus]], [[Hendra virus]] and [[lyssavirus]]es.
| | ==Treatment== |
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| ==Weaponization==
| | [[Ebola medical therapy|Medical Therapy]] | [[Ebola air medical transport|Air Medical Transport]] | [[Ebola monitoring and movement of persons following exposure|Monitoring and Movement Following Exposure]] | [[Ebola primary prevention|Primary Prevention]] | [[Ebola future or investigational therapies|Future or Investigational Therapies]] |
| Because Ebola is lethal and since no approved [[vaccine]] or treatment is available, Ebola is classified as a [[Biosafety Level 4]] agent, as well as a Category A [[bioterrorism]] agent<ref>{{cite journal |last=Hoenen |first=Thomas |authorlink= |coauthors=''et al.'' |year=2006 |month= |title=Ebola virus: unravelling pathogenesis to combat a deadly disease |journal=Trends in Molecular Medicine |volume=12 |issue=5 |pages=206-215 |doi=10.1016/j.molmed.2006.03.006 |url= |accessdate= |quote= }}</ref> and a [[select agent]] by the [[Centers for Disease Control and Prevention|CDC]].
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| Ebola shows potential as a biological weapon because of its lethality but due to its relatively short incubation period it may be more difficult to spread since it may kill its victim before it has a chance to be transmitted, meaning that it would be hard to spread amongst small populations. However, if an outbreak occurred in a city the effects would likely be devastating.
| | ==Postmortem Care== |
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| As a terrorist weapon, Ebola has been considered by members of [[Japan]]'s [[Aum Shinrikyo]] [[cult]], whose leader, [[Shoko Asahara]] led about 40 members to Zaire in 1992 under the guise of offering medical aid to Ebola victims in what was presumably an attempt to acquire a sample of the virus.<ref>{{cite paper |last= |first= |author= |authorlink= |coauthors= |title=Chronology of Aum Shinrikyo's CBW Activities |version= |publisher=Monterey Institute for International Studies |date= |url=http://cns.miis.edu/pubs/reports/pdfs/aum_chrn.pdf |format= |id= |accessdate= }}</ref>
| | [[Ebola postmortem care|Postmortem Care]] |
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| ==Recent outbreaks==
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| As of [[August 30]], [[2007]], 103 people (100 adults and three children) were infected by a suspected hemorrhagic fever outbreak in the village of [[Mweka, Democratic Republic of the Congo]] (DRC). The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill. The [[World Health Organization]] sent a team to take blood samples for analysis and confirmed that many of the cases are the result of the Ebola virus <ref>{{cite news |first= |last= |authorlink= |coauthors= |title=Ebola Outbreak Confirmed in Congo |url=http://www.newscientist.com/article/dn12624-ebola-outbreak-confirmed-in-congo.html |work=NewScientist.com |publisher= |date=2007-09-11 |accessdate=2008-02-25 }}</ref>. The Congo's last major Ebola epidemic killed 245 people in 1995 in [[Kikwit]], about 200 [[mile]]s from the source of the Aug. 2007 outbreak.<ref>{{cite news |first= |last= |authorlink= |coauthors= |title=Mystery DR Congo fever kills 100 |url=http://news.bbc.co.uk/2/hi/africa/6973013.stm |work= BBC News |publisher= |date=2007-08-31 |accessdate=2008-02-25 }}</ref>
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| On [[November 30]], [[2007]], the [[Uganda]] Ministry of Health confirmed an outbreak of Ebola in the [[Bundibugyo District]]. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of the Ebola virus.<ref>{{cite news |first= |last= |authorlink= |coauthors= |title=Uganda: Deadly Ebola Outbreak Confirmed - UN |url=http://allafrica.com/stories/200711301070.html |work=UN News Service |publisher= |date=2007-11-30 |accessdate=2008-02-25 }}</ref> The epidemic came to an official end on February 20, 2008. 149 cases of this new strain were reported and 37 of those led to deaths.
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| ==Life Cycle==
| | [[Category:Biological weapons]] |
| * Virus attaches to host receptors through the GP (glycoprotein) surface [[peplomer]] and is endocytosed into vesicles in the host cell.
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| * Fusion of virus membrane with the vesicle membrane occurs; nucleocapsid is released into the cytoplasm.
| | [[Category:Hemorrhagic fevers]] |
| * The encapsidated, negative-sense genomic ssRNA is used as a template for the synthesis ( 3' - 5') of polyadenylated, monocistronic mRNAs.
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| * Translation of the mRNA into viral proteins occurs using the host cell's machinery.
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| * Post-translational processing of viral proteins occurs. GP0 (glycoprotein precursor) is cleaved to GP1 and GP2, which are heavily glycosylated. These two molecules assemble, first into heterodimers, and then into trimers to give the surface peplomers. SGP (secreted glycoprotein) precursor is cleaved to SGP and delta peptide, both of which are released from the cell.
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| * As viral protein levels rise, a switch occurs from translation to replication. Using the negative-sense genomic RNA as a template, a complementary +ssRNA is synthesized; this is then used as a template for the synthesis of new genomic (-)ssRNA, which is rapidly encapsidated.
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| * The newly-formed nucleocapsides and envelope proteins associate at the host cell's plasma membrane; budding occurs, and the virions are released.
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| ==Cultural impact==
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| [[Image:Stuffed ebola.jpg|thumb|An Ebola virus cuddly toy]]
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| Ebola and Marburg have served as a rich source of ideas and plotlines for many forms of entertainment. The infatuation with the virus is likely due to the high mortality rate of its victims, its mysterious nature, and its tendency to cause gruesome bleeding from bodily orifices.
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| In the movie ''[[Outbreak (film)|Outbreak]]'', the virus looks the same as the Ebola virus.{{Or|date=March 2008}} In fact, the entire movie's made up virus "Motaba" is based very closely on Ebola.{{Or|date=March 2008}} The symptoms and area of infection had relevance.
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| The Rage Virus from the movies [[28 Days Later]] and [[28 Weeks Later]] is a modified version of the Ebola virus.
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| In the book ''[[Outbreak (novel)|Outbreak]]'', by [[Robin Cook (novelist)| Robin Cook]], the Ebola virus is used in name as a possible weapon, with criminal intent. This book is different from the movie ''[[Outbreak (film)|Outbreak]]'' of the same name
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| Biological warfare using airborne modifications of the Ebola virus was a main theme in [[Tom Clancy]]'s novels ''[[Executive Orders]]'' and ''[[Rainbow Six (novel)|Rainbow Six]]''.
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| In ''[[Resident Evil]]'', the T-Virus is a modified version of the Progenitor Virus, created by inserting it with Ebola genes.<ref>{{cite web |url=http://www3.capcom.co.jp/bio/weskars/index.html |title=Capcom.co.jp "Wesker's Report II" |accessdate=2008-04-12}}</ref>
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| [[Tomb Raider: The Cradle of Life]] features a biological weapon<ref>{{cite web |url=http://www.jesusfreakhideout.com/movies/TombRaider2.asp |title=Jesusfreakhideout.com "Lara Croft Tomb Raider: The Cradle of Life" Movie Review |accessdate=2008-03-11 |format= |work= }}</ref> consisting of a greatly accelerated form of Ebola, capable of causing death within minutes.
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| Much of the representation of the Ebola virus in fiction and the media is considered [[apocryphal|exaggerated or myth]].{{Fact|date=June 2007}} One pervasive myth follows that the virus kills so fast that it has little time to spread. Victims die very soon after contact with the virus. In reality, the incubation time is usually about a week. The average time from onset of early symptoms to death varies in the range 3-21 days, with a mean of 10.1. Although this would prevent the transmission of the virus to many people, it is still enough time for some people to catch the disease.
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| Another myth states that the virus causes patients to melt, liquefy, or bleed profusely. In depictions of this type, victims of Ebola suffer from squirting blood, liquefying flesh, [[zombie]]-like faces and dramatic projectile bloody vomiting, at times, from even recently deceased. In actual fact, only a fraction of Ebola victims have severe bleeding, and most accounts of the course of the disease describe patients as dull and lethargic. Approximately 10% of patients suffer some bleeding, but this is often internal or subtle, such as bleeding from the gums. Ebola symptoms are usually limited to extreme exhaustion, vomiting, diarrhea, abdominal pain, a high fever, headaches and other body pains.
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| The following is an excerpt from an interview with Philippe Calain, M.D. Chief Epidemiologist, CDC Special Pathogens Branch, Kikwit 1996:
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| {{cquote|''At the end of the disease the patient does not look, from the outside, as horrible as you can read in some books. They are not melting. They are not full of blood. They're in shock, muscular shock. They are not unconscious, but you would say 'obtunded', dull, quiet, very tired. Very few were hemorrhaging. Hemorrhage is not the main symptom. Less than half of the patients had some kind of hemorrhage. But the ones that had bled, died.''}}
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| ==See also==
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| <div style="-moz-column-count:3; column-count:3;">
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| *Dr. [[Ngoy Mushola]]
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| *[[Needle remover]]
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| *[[Sharps waste]]
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| *[[Bolivian haemorrhagic fever]]
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| *[[Crimean-Congo haemorrhagic fever|Crimean Congo hemorrhagic fever (CCHF)]]
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| *[[Marburg virus|Marburg haemorrhagic fever]], the first known disease caused by a [[filovirus]]
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| *Dr. [[Matthew Lukwiya]] (1957-[[Dec 5]], [[2000]]), A [[Uganda]]n doctor at the forefront of the 2000 outbreak.
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| *Dr. [[Jonah Kule]], (-[[Dec 4]], [[2007]])
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| *[[VHFs]]
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| *[[Epidemiology]]
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| *[[Bushmeat]]
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| </div>
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| ==References==
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| {{reflist|2}}
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| ==External links==
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| <div class="references-small">
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| '''Overviews'''
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| *[http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/01.025.0.02.htm Database entry on genus ''Ebolavirus''] - [[ICTVdB]]
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| *[http://www.itg.be/ebola/ Ebola Virus Haemorrhagic Fever] - Proceedings of an International Colloquium on Ebola Virus Infection and Other Haemorrhagic Fevers held in Antwerp, Belgium, 6-8 December, 1977
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| *[http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola/qa.htm Questions and Answers about Ebola Hemorrhagic Fever] - Center for Disease Control (CDC), retrieved 10 July 2006
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| *[http://www.who.int/mediacentre/factsheets/fs103/en/index.html WHO Factsheet] - retrieved 10 July 2006
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| * [http://www.vrc.nih.gov/scientificupdates_ebola.htm Vaccine Research Center (VRC)] - Information concerning Ebola vaccine research studies
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| '''Outbreaks'''
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| *[http://www.cbc.ca/health/story/2007/09/12/ebola-outbreak.html Ebola outbreak in Congo] - CBC News, 12 September 2007. Retrieved [[2007-09-13]].
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| *[http://news.bbc.co.uk/2/hi/science/nature/6220122.stm Ebola 'kills over 5,000 gorillas'] - BBC News, 8 December 2006. Retrieved [[2006-12-08]].
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| * [http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebotabl.htm History of Ebola Outbreaks] - Centers for Disease Control Special Pathogens Branch, retrieved [[2006-07-10]].
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| *[http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual/entire.pdf Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting] - Center for Disease Control and Prevention, Atlanta, [[December]] [[1998]].
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| *[http://www.ird.fr/filomeeting2008/ Filovirus Global Symposium] - Filomeeting 2008
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| '''Life Cycle'''
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| *[http://biomarker.cdc.go.kr:8080/pathogen/pathogen_view_en.jsp?pclass=2&id=44 Biomarker Database] - information on Ebola
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| '''Infectivity'''
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| *[http://www.usamriid.army.mil/press%20releases/warfield_press_release.pdf U.S. Army Medical Research Institute of Infectious Diseases: Gene-Specific Ebola Therapies Protect Nonhuman Primates from Lethal Disease]
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| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8712894&query_hl=12 Lethal experimental infection of rhesus monkeys with Ebola-Zaire (Mayinga) virus by the oral and conjunctival route of exposure] PubMed, February 1996, Jaax et al.
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| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7547435&query_hl=12 Lethal experimental infections of rhesus monkeys by aerosolized Ebola and marburg virus] PubMed, August 1995
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| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15588056&query_hl=12 Marburg and Ebola viruses as aerosol threats] PubMed, 2004, [[USAMRIID]]
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| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15207310&query_hl=12 Other viral bioweapons: Ebola and Marburg hemorrhag fever] PubMed, 2004
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| * [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8551825&query_hl=12 Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory] PubMed, December 1993
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| * [http://www.brettrussell.com/personal/what_are_the_chances_.html What is the probability of a dangerous strain of Ebola mutating and becoming airborne?] Brett Russel, retrieved [[2006-07-10]].
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| </div>
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| {{Viral diseases}}
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| [[Category:Ebola| ]]
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| [[Category:Mononegavirales]] | | [[Category:Mononegavirales]] |
| [[Category:Viral diseases]] | | [[Category:Viral diseases]] |
| [[Category:Biological weapons]]
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| [[Category:Zoonoses]] | | [[Category:Zoonoses]] |
| [[Category:Hemorrhagic fevers]]
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| [[Category:Mature chapter]]
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| [[Category:Overview complete]]
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| [[es:Virus Ébola]]
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| [[pl:Gorączka krwotoczna Ebola]]
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| [[ru:Геморрагическая лихорадка Эбола]]
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