Mariano Marcos State University

Batac City, Ilocos Norte

College of Health Sciences
Department of Nursing

A
REPORT
ON
EBOLA VIRUS
Submitted by:
John Lester Fernandez
Charlimagne Gonzales
BSN II-B

Submitted to:
Prof. Rosemarie Asuncion

September 2015

The Ebola Virus

The Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a

severe, often fatal illness in humans.

It causes an acute, serious illness which is often fatal if untreated.
Researchers named the disease after the Ebola River.
Ebola appeared in Africa only.
The average EVD case fatality rate is around 50%. Case fatality rates have varied from

25% to 90% in past outbreaks.

The first EVD outbreaks occurred in remote villages in Central Africa, near tropical
rainforests, but the most recent outbreak in West Africa has involved major urban as well

as rural areas.
Community engagement is key to successfully controlling outbreaks.
Good outbreak control relies on applying a package of interventions, namely case
management, surveillance and contact tracing, a good laboratory service, safe burials and

social mobilization.
Early supportive care with rehydration, symptomatic treatment improves survival.
There is as yet no licensed treatment proven to neutralize the virus but a range of blood,
immunological and drug therapies are under development. There are currently no
licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.

Causative Agent

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus.
There are five identified Ebola virus species, four of which are known to cause disease in

humans:
Ebola virus (Zaire ebolavirus);
Sudan virus (Sudan ebolavirus);
Ta Forest virus (Ta Forest ebolavirus, formerly Cte dIvoire ebolavirus);
and Bundibugyo virus (Bundibugyo ebolavirus).
The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates,

but not in humans.

The Zaire virus, since it was first recognized in 1976, has caused multiple large outbreaks
in Central Africa, with mortality rates ranging from 55 to 88 percent. It is the causative

agent of the West African epidemic.

The Sudan virus has been associated with a case-fatality rate of approximately 50 percent
in four epidemics: two in Sudan in the 1970s, one in Uganda in 2000, and another in

Sudan in 2004.
The Ivory Coast virus has only been identified as the cause of illness in one person, and
that individual survived. The exposure occurred when an ethnologist performed a
necropsy on a chimpanzee found dead in the Tai Forest, where marked reductions in the

great ape population had been observed.

The Bundibugyo virus emerged in Uganda in 2007, causing an outbreak of Ebola virus
disease with a lower case-fatality rate (approximately 30 percent) than is typical for the

Zaire and Sudan viruses. Sequencing has shown that the agent is most closely related to

the Ivory Coast species.

The fifth Ebola species, the Reston virus, differs markedly from the others, because it is
apparently maintained in an animal reservoir in the Philippines and has not been found in

Africa.
The Ebola Reston virus was discovered when it caused an outbreak of lethal infection in
macaques imported into the United States in 1989. Three more outbreaks occurred among
nonhuman primates in quarantine facilities in the United States and Europe before the
Philippine animal supplier ceased operations. None of the personnel who were exposed to
sick animals without protective equipment became ill, but several animal caretakers

showed evidence of seroconversion.

2008 nothing further was heard of the Reston virus, when the investigation of an outbreak
of disease in pigs in the Philippines unexpectedly revealed that some of the sick animals
were infected both by an arterivirus (porcine reproductive and respiratory disease virus)
and by Ebola Reston virus.

Characteristics of the virus

Ebola virus belongs to the order Mononegavirales and the family Filoviridae
a taxonomic group of non-segmented, enveloped and negative-strand RNA viruses.
Particles of these viruses have a characteristic filamentous appearance that gives the
virus family its name.

Their diameter is uniform at 80 nm, but particle length can be quite variable and up to
14 000 nm.
The genome of the virus consists of seven genes that code for nucleoprotein,
glycoprotein, virion protein (VP) 24, VP30,
VP35, VP40 and RNA-dependent RNA

polymerase.
With the exception of the glycoprotein
gene,

all

aforementioned

genes

are

monocistronic, which means that they

encode for only one structural protein.

Production of a soluble glycoprotein (i.e. protein that contains covalently attached
sugar residues) is an important distinction of Ebola virus from other viruses in the
order. This major pathogenicity factor gets secreted from infected cells in large
quantities, facilitating further viral entry by binding to the receptor present on the host
cells.

Portal of Exit

Ebola leaves its reservoir by contact with body fluids of an infected animal, often by bush
meat hunters.

Portal of Entry

Ebola enters the human body through breaks in the skin, including micro-abrasions and
splashes on mucus membranes.

Personal protective equipment (PPE)

includes full body coverage including
hood, mask or face shield, a tight
fitting respirator, boots or shoe
coverings,

and

double

gloving.

Removing PPE is a point of frequent

contamination and should be done

with help from another robed person.

Source of Infection and Mode of Transmission

Unlike other types of viruses, Ebola cant be transmitted through the air or by touch

alone.
You must have direct contact with the bodily fluids of someone who has it.
The virus may be transmitted through: blood, diarrhea, breast milk, feces, saliva,

semen, sweat, urine, and vomit.These bodily fluids can all carry the Ebola virus.
Transmission can occur via the eyes, nose, mouth, broken skin, or sexual contact.
Healthcare workers are especially at risk for contracting Ebola because they often

deal with blood and bodily fluids.

Other risk factors include: exposure to infected objects, such as needles, interactions
with infected animals, attending burial ceremonies of someone who has died from
Ebola, and traveling to areas where a recent outbreak has occurred.

Incubation Period

The incubation period --the period

between contact with the virus and
the appearance of symptoms -ranges from 2 to 21 days.

Pathognomonic

Pathognomonic sign is a sign or symptom specific

to a certain disease. Since Ebola does NOT have
this, lab tests such as the enzyme-linked
imunosorbent assay are the best way to confirm if a person has Ebola.

Susceptible host

susceptible host refers to an individual not

possessing sufficient immunity against a particular
infectious

agent to

prevent contracting an

infection when exposed to an infectious agent.

A susceptible host must be exposed to an
infectious agent/infected source in a manner that will enable the acquisition of an

infection.
There is a new and strongly implicates that bats as the reservoir host for

ebolavirus.
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus

hosts.
The virus came from the bats are transfer to other animal like chimpanzees, forest

antelopes, gorillas, monkeys, porcupines, rats and deer.

The virus is known as a zoonotic virus because its transmitted to humans from

animals.
Since people may handle these infected animals, the virus can be transmitted via

the animals blood and body fluids.

Humans can also transfer the virus to each other.
Health workers have a high risk of getting infected with Ebolavirus if they are not
wearing correct personal protective equipment

or are not applying infection

prevention and control measures when caring for patients.

Family members or others in close contact with infected people have a high risk
of acquiring this disease same thru with mourners who have direct contact with
bodies during burial rituals because the virus is in the body even the patient was
dead already it is capable of spreading the microorganism if you contact with the
body fluids and discharges of the patient.

Ebolavirus reservoir and susceptible host

Signs and Symptoms

After two to 21 days of incubation

symptoms may appear, on average
symptoms appear within 8 to 10

days.
Take note that humans are not
infectious

until

they

develop

symptoms.

The early symptoms of Ebola is common and non-specific it can be also present

in some diseases and this includes:

Abrupt fever
Headache
Weakness
Vomiting
Diarrhea
Stomach discomfort
Decrease appetite
Joint and muscle discomfort
As the disease progresses the patient may
develop other signs and symptoms
as:

such

rashes
Eye redness
Hiccups
Sore throat
Cough
Chest pain
Bleeding both inside and outside the body (for example, mucosal surfaces, eyes)
Difficulty breathing and swallowing
Image of Ebola victims

Drug of choice

This illness is very lethal to the condition of every person in the world.
Take note there is no FDA-approved vaccine or medicine is available for Ebola.
Experimental vaccines and treatments for Ebola are under development, but they have

not yet been fully tested for safety or effectiveness.

But although there is no drugs and any form of vaccine that can defend us against this

virus early treatment to avoid further complication.

People who recover from Ebola infection develop antibodies that last for at least 10

years, possibly longer.

The body produces Ebola-fighting antibodies in response to the virus. So the idea is to
purify the blood, extract the antibodies and give those to sick patients.

Nursing Care

There is no cure for Ebola but if early treatment and interventions are given to the victims

there is a chance of surviving this fatal disease.

Nurses play vital role in direct care for patients with Ebola, shaping health policy, and

raising awareness about the deadly virus.

Providing intravenous hydration and oral nutrition, managing diarrhea and nausea,

cleaning and feeding patients, and monitoring their overall status.

Recommended care includes:
volume repletion,
maintenance of blood pressure (with vasopressors if needed),
maintenance of oxygenation,
pain control,
nutritional support,
and treatment of secondary bacterial infections and pre-existing comorbidities.
Among patients medically evacuated from West Africa with EVD, large volumes
of intravenous fluids often have been required to correct dehydration due to

diarrhea and vomiting.

Protect all areas of petechiae and echymoses for further injury.
Watch for any changes in the patients respiration rate and pattern.
Closely monitor the patients fluid and electrolyte imbalance.
Monitor intake and output.
Check the results of complete blood count and coagulation studies for signs of

blood loss and coagulopathy.

Test stools, urine and vomitus for occult blood; watch for frank bleeding.
Teach the patients family about ebola virus infection.
Monitor the patients family and other close contacts for fever and other signs of
infections.
Explain the importance of reporting any signs of bleeding.
Explain the purpose of any diagnostic tests and procedures that the patient may
undergo.
Nursing Problem
Social isolation related to to altered state of wellness

Imbalance nutrition less than body requirement related to diarrhea and

vomiting.
Impaired mobility related muscle and joint pain
Impaired breathing related to involuntary contractions of the diaphragm
muscle