Kalra Sarathi, Kelkar Dhanashree, Galwankar Sagar C, Papadimos Thomas J, Stawicki Stanislaw P, Arquilla Bonnie, Hoey Brian A, Sharpe Richard P, Sabol Donna, Jahre Jeffrey A
St Luke's University Health Network, Bethlehem, Pennsylvania, USA.
University of Florida, Jacksonville, Florida, USA.
J Glob Infect Dis. 2014 Oct;6(4):164-77. doi: 10.4103/0974-777X.145247.
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.
埃博拉病毒于20世纪70年代首次在非洲偏远村庄被发现,最初人们认为它是由野生动物传播给人类的。埃博拉病毒(EBOV)可导致人类严重且往往致命的出血热综合征。在过去三十年里,每次埃博拉病毒爆发都在非洲当地和地区民众中引发恐惧和经济动荡。直到现在,它一直被视为主要局限于非洲大陆偏远地区的一种悲惨疾病,但情况已不再如此。自20世纪70年代以来,疫情爆发的频率有所增加。2014年西非的埃博拉疫情是历史上最严重的一次,世界卫生组织宣布其为突发公共卫生事件。鉴于现代交通的广泛使用和全球旅行,埃博拉病毒现在对整个地球村构成威胁,洲际传播只需一趟飞机航班的距离。临床上,症状通常在大约11天的潜伏期后出现。类似流感的综合征可能发展为伴有多器官功能衰竭的全面出血热,并且常常导致死亡。通过检测血液或其他体液中的病毒抗原或核糖核酸(RNA)来确诊。尽管从历史上看,这种感染的死亡率超过80%,但现代医学和公共卫生措施已经能够降低这一数字,并减少埃博拉病毒对个人和社区的影响。治疗包括早期积极的支持性护理和补液。核心干预措施,包括接触者追踪、预防措施、主动监测、有效的隔离和检疫程序以及对患者的及时应对,对于成功控制疫情至关重要。这些措施,再加上公共卫生教育、即时诊断、有前景的新疫苗和药物研发努力以及国际社会的协调努力,为全球消除埃博拉作为公共卫生威胁的努力带来了新希望。在此,我们对埃博拉病毒感染进行综述,以进一步让医学界和政界了解埃博拉病毒病的情况以及建议采取哪些措施来治疗、隔离并最终消除它。