First Ebola Case Diagnosed in the U.S.

GLOBAL HEALTH EMERGENCY
EMERGING & RE-EMERGING INFECTIOUS DISEASES
VIRAL HEMORRHAGIC FEVERS
DEADLY EBOLA DIAGNOSED IN TEXAS
EBOLA EPIDEMIC IN WEST AFRICA
SCENARIOS 797, 444, 333, 080, 011
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Ebola outbreak devastating West Africa could spread globally

The first case of Ebola in the United States has been diagnosed in a person who had traveled to Dallas, Texas from Liberia, the Centers for Disease Control and Prevention (CDC) confirmed.

The patient had no symptoms when leaving West Africa, but developed symptoms about four days after arriving in the U.S. on September 20, said CDC.

The person fell ill on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26. After developing symptoms consistent with Ebola, he was admitted to hospital on Sept. 28. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The laboratory test results confirmed Ebola infection.

“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”

Symptoms of Ebola include

• Fever (greater than 38.6°C or 101.5°F)
• Severe headache
• Muscle pain
• Weakness
• Diarrhea
• Vomiting
• Abdominal pain
• Unexplained hemorrhage (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. [Source: CDC]

Global Health Emergency

WHO declared the Ebola outbreak in West Africa  a ‘Public Health Emergency of International Concern,’ under the International Health Regulations on August 8, 2014.

Related Links

• Ebola: 1.4 Million Cases by January 20, 2015? September 24, 2014
• Ebola Outbreak Declared Global Health Emergency  August 8, 2014
• Ebola Outbreak: Public Health Emergency Declared in Sierra Leone July 31, 2014
• EBOLA Epidemic Spreading in West Africa June 19, 2014

Marburg Hemorrhagic Fever Breaks Out in SW Uganda

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Outbreak of Deadly Marburg Disease in SW Uganda Kills 5, Leaves 6 Hospitalized

An outbreak of deadly Marburg disease has left at least 5 people dead and 6 others hospitalized in SW Uganda, reports said.

The latest death occurred in Bukora Kitumba in Kabale district, said a report.

The following information is provided by CDC:

Marburg Hemorrhagic Fever

Marburg hemorrhagic fever (Marburg HF) is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family. The five subtypes of Ebola virus are the only other known members of the filovirus family.

Marburg virus virion. A colorized negative stained transmission electron micrograph (TEM), captured by F.A. Murphy in 1968, depicts a Marburg virus virion, which had been grown in an environment of tissue culture cells. Marburg hemorrhagic fever is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family. See PHIL 7219 for a black and white version of this image.

After an incubation period of 5-10 days, the onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea then may appear. Symptoms become increasingly severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, and multi-organ dysfunction. Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid fever, diagnosis of the disease can be difficult, especially if only a single case is involved. [CDC/ Frederick Murphy.]

Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). A total of 31 people became ill; they included laboratory workers as well as several medical personnel and family members who had cared for them. There were 7 deaths among the reported cases. The first people infected had been exposed to African green monkeys or their tissues. In Marburg, the monkeys had been imported for research and to prepare polio vaccine. In addition to the 31 cases, an additional primary case was retrospectively serologically diagnosed.

Other Details of MHF

• The case-fatality rate for Marburg hemorrhagic fever is between 23-90%, CDC reported.
• An outbreak of Marburg in the Democratic Republic of Congo in 2000 claimed at least 128 lives (83% fatality rate).
• Another outbreak in Angola killed at least 227 prople in 2005 (90% fatality rate).

Viral Hemorrhagic Fevers (VHFs)

Viral hemorrhagic fevers (VHFs) are a group of diseases caused by ribonucleic acid (RNA) viruses from four distinct families. These diseases include Ebola Hemorrhagic Fever, Marburg Hemorrhagic Fever, Lassa fever, Hantavirus Pulmonary Syndrome, and Yellow Fever. Symptoms vary with the disease, but often include fever, fatigue, and muscle aches. There may be bleeding, although death from blood loss is rare. Severe cases can include shock and coma. Although some types of VHFs are relatively mild illnesses, many of them can cause severe, life-threatening disease with high fatality rates.

Along with smallpox, anthrax, plague, botulism, and tularemia, hemorrhagic fever viruses are among the six agents identified by the Centers for Disease Control and Prevention (CDC) as the most likely to be used as biological weapons. Many VHFs can cause severe, life-threatening disease with high fatality rates. Source: U.S. Gov.

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GLOBAL WARNING

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Viral hemorrhagic fever kills 4 in Johannesburg

Killer virus in South Africa identified

South African health officials  have identified a viral hemorrhagic fever which killed four people in Johannesburg. They believe the bug is a new strain of the deadly arenavirus.

Vero E6 tissue culture cell infected with an arenavirus.  Image shows extracellular virus particles budding from the cell surface.  Magnification approx. 12,000 times. Image courtesy Cynthia Goldsmith, MS, Infectious Disease Pathology Activity, DVRD, NCID, CDC.

Epidemic curve of cases of infection with an arenavirus, South Africa, September – October 2008. Source: Special Pathogens Unit and Epidemiology Division, NICD; Gauteng Provincial Outbreak Response Team and partners; SA-FELTP residents; Department of Anatomical Pathology, University of the Witwatersrand and the National Health Laboratory Service. Image may be subject to copyright.

The Centers for Disease Control and Prevention has identified the new strain, which has not been named yet.  that has yet to be named, said Barry Schoub, executive director of the National Insititute of Communicable Diseases (NICD).

“The virus is new in terms of its genetic make up and there is currently no vaccine against it, [and has] high lethal potential for humans.” said Barry Schoub, executive director of the National Institute of Communicable Diseases (NICD).

South Africa’s department of health first identified the disease in a woman who was airlifted from Zambia to a Johannesburg hospital in September, 2008. AFP reported.

The female patient, a member of the medical staff who accompanied her, a nurse and a hospital cleaner who came into contact with her, later died.

“A last person who is currently under observation at a hospital is responding well to (anti-viral) treatment,” said Janusz Paweska, head of a special pathogens unit at NICD.

What are the Arenaviridae? (Source CDC)

The Arenaviridae are a family of viruses whose members are generally associated with rodent-transmitted disease in humans. Each virus usually is associated with a particular rodent host species in which it is maintained. Arenavirus infections are relatively common in humans in some areas of the world and can cause severe illnesses.

The virus particles are spherical and have an average diameter of 110-130 nanometers. All are enveloped in a lipid (fat) membrane. Viewed in cross-section, they show grainy particles that are ribosomes acquired from their host cells. It is this characteristic that gave them their name, derived from the Latin “arena,” which means “sandy.” Their genome, or genetic material, is composed of RNA only, and while their replication strategy is not completely understood, we know that new viral particles, called virions, are created by budding from the surface of their hosts’ cells. (Source: CDC).  Fact Sheet (PDF)

Related Links

• National Institute of Communicable Diseases (NICD)
• Arenaviridae