Tuesday, April 08, 2014

Ebola Virus Outbreak in Guinea

Ebola outbreak 'most challenging' as Guinea deaths pass 100


Staff of the "Doctors without Borders" ("Medecins Sans Frontieres") medical aid organisation carry the body of a person killed by viral haemorrhagic fever, at a centre for victims of the Ebola virus in Guekedou, on 1 April 2014

There is no known cure or vaccine for Ebola

The number of people believed to have been killed by the Ebola virus in Guinea has passed 100, the UN World Health Organization says. It was "one of the most challenging Ebola outbreaks we have ever dealt with" and could take another four months to contain, the WHO said. The virus had now killed 101 people in Guinea and 10 in Liberia, it said. Ebola is spread by close contact and kills between 25% and 90% of its victims.

Many West African states have porous borders, and people travel frequently between countries.
Southern Guinea is at the epicentre of the outbreak, with the first case reported last month. The geographical spread of the outbreak is continuing to make it particularly challenging to contain - past outbreaks have involved much smaller areas.
"We fully expect to be engaged in this outbreak for the next two to three to four months before we are comfortable that we are through it," Keija Fukuda, WHO's assistant director-general, said at a news briefing in Geneva, Reuters news agency reports. The WHO said 157 suspected cases had been recorded in Guinea, including 20 in the capital, Conakry.

Map of West Africa 

Sixty-seven of the cases have been confirmed as Ebola, it added. In neighbouring Liberia, 21 cases had been reported, with five confirmed as Ebola, WHO said. Mali had reported nine suspected cases, but medical tests done so far showed that two of them did not have Ebola, it said. Last week, Mali said it was on high alert because of fears of an outbreak of Ebola and it would tighten border controls. Saudi Arabia has suspended visas for Muslim pilgrims from Guinea and Liberia, as a sign of the growing unease about the outbreak.
This is the first known outbreak in Guinea - most recent cases have been thousands of miles away in the Democratic Republic of Congo and Uganda.There is no known cure or vaccine for Ebola.
The tropical virus leads to hemorrhagic fever, causing muscle pain, weakness, vomiting, diarrhea and, in severe cases, organ failure and complete bleeding out through the mucous membranes .  It is highly contagious and although  the outbreaks start in Africa they can be quickly transported to other countries by travelers.

Ebola (hemorrhagic fever)
Manifestation of Ebola begins with a sudden onset of an influenza-like stage characterized by general malaise, fever with chills, joint pain, muscle pain, and chest pain. Nausea is accompanied by abdominal pain, diarrhea, and vomiting. Respiratory tract involvement is characterized by pharyngitis with sore throat, cough, dyspnea, and hiccups. The central nervous system is affected as judged by the development of severe headaches, agitation, confusion, fatigue, depression, seizures, and sometimes coma.
In general, development of hemorrhagic symptoms is indicative of a negative prognosis (death).  Death usually occurs due to multiple organ dysfunction syndrome (MODS) due to fluid redistribution, hypotension, disseminated intravascular coagulation, and focal tissue necrosis.
The average time between contracting the infection and the onset of symptoms is 13 days, but can be as long as 25 days.
All people infected show some extent of coagulopathy and impaired circulatory system symptomology. Bleeding from mucous membranes and puncture sites is reported in 40–50% of cases, while rashes are evident in approximately 50% of cases. Sources of bleeds include hematemesis, hemoptysis, melena, and aforementioned bleeding from mucous membranes (gastrointestinal tract, nose, vagina and gingiva). However heavy bleeding or bleeding out does not occur that frequently; bleeding is usually exclusive to the gastrointestinal tract.
Ebola is caused by four viruses in the same family. It is believed to occur after an ebola virus is transmitted to a human via contact with an infected animal host. Human-to-human transmission occurs via direct contact with blood or bodily fluids from an infected person (including embalming of an infected dead person) or by contact with contaminated medical equipment such as needles. In the past, transmission has occurred in under-equipped African hospitals due to the reuse of needles and lack of implementation of universal precautions. Aerosol transmission has not been observed during natural EVD (ebola virus disease) outbreaks. The potential for widespread EVD epidemics is considered fairly low due to the high fatality rate, the rapidity of the demise of patients, and the often remote areas where infections occur.

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